Departmental Bulletin Paper 高齢精神障害者の地域生活支援の現状と課題:ソーシャルワーカーへのインタビュー調査の結果から
Reality and problems of community life support for elderly mentally handicapped people:social worker interview survey results.

松浦, 智和

11pp.87 - 95 , 2017-03-31
ISSN:18817440
NCID:AA12272535
Description
本研究では、高齢精神障碍者の地域生活支援について、その現状や課題を調査すべくソーシャルワーカーへのインタビュー調査を実施したところ、多くのソーシャルワーカーが高齢精神障害者の地域生活支援を実際に経験し、支援に課題を感じていることが明らかとなった。その内容としては、「身体合併症とそれにともなう支援の難しさ」や障害者総合支援法と介護保険法の接続などを中心とした「制度の問題」、「当事者自身のモチベーションや意識の問題」などが確認された。先行研究でも指摘されるように「長期に渡る入院」の影響も含めて「本人の強い地域生活への不安」「表明されない(地域生活支援への)ニーズ」「根強い入院継続希望」が実際に当事者から語られる現状があることは明白であったが、一方で当時者が介護保険制度のサービス利用に拒否的であることが示唆されるなど、高齢精神障害者の地域生活支援における新たな現状や課題が明らかとなった。
For this study, an interview survey of social workers was conducted to elucidate the reality and difficulties of community life support for elderly mentally handicapped people. Results showed that many social workers actually experienced community life support for them and felt some difficulties related to the support. The contents include “physical complications and the difficulties in support associated with them,” “system problems” mainly related to Services and Supports for Persons with Disabilities Act and Long-Term Care Insurance Act, and “difficulties of motivation or consciousness of the handicapped people themselves.” As previous reports have described, it has been readily apparent that a present state prevails in which handicapped people talk about “their intensive anxiety about community life,” “their needs (for community life support) life unsaid,” and “their deep-rooted hope to be hospitalized,” attributable to effects of “their long-term hospitalization.” Results of this study shed new light on the state and issues of community life support for elderly handicapped people, including the suggestion that they themselves are unwilling to receive the Nursing Care Insurance services.
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