Departmental Bulletin Paper 精神科病院家族会アンケート調査から見えてきた 認知症患者家族の課題と支援体制
Issues facing families of patients with dementia and support systems for those families as revealed by a survey of members of families with a member in a psychiatric hospital

木下, 一雄  ,  Kazuo, KINOSHITA

10pp.79 - 86 , 2016-03-31 , 名寄市立大学
The Organization for Economic Cooperation and Development (OECD) has compiled reports indicating that Japan hasmarkedly more Psychiatry beds per population, with 4 times as many as the average number of those beds in other members of theOECD. In advanced countries, patients with psychiatric disorders are primarily treated while living in the community rather than inhospital. According to observers, Japan continues to lag behind in efforts to deinstitutionalize patients with psychiatric disorders.The proportion of inpatients who were age 60 or older was 29% in 1996 but 48% in 2008, so the age of inpatients has risen markedly.In a bid to remain viable, psychiatric hospitals are accepting patients with dementia and placing those patients in affiliated facilities,and psychiatric hospitals have created a system featuring outpatient visits, visiting care, and other services that passes patients aroundto those facilities. Psychiatric hospitals themselves are also increasingly growing in scale. Thus the current study surveyed 20members of families with a member who had been in a psychiatric hospital for a year or longer regarding psychiatric care fordementia and support systems for families. Respondents answered open-ended questions about factors that hampered the familymember's discharge. Responses indicated that various factors preclude discharge even if a family member no longer needs to behospitalized. The issue is not simply the psychiatric hospital system. Instead, the nature of support for care of patients with dementianeeds to be reconsidered, and that care needs to be considered from multiple perspectives. Long-touted goals of psychiatric care wereto enhance outreach to patients' homes and outpatient services of nursing homes in order to provide community living assistance topeople with dementia. Survey results suggested that a system of deinstitutionalization needs to be created to benefit patients ratherthan benefitting psychiatric hospitals as organizations.

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