特別養護老人ホームにおける重度入居者への対応に伴う直接介護と共用空間との関係

 【Objectives】<br> The condition of elderly residents in nursing homes in Japan is deteriorating, partly due to Japans super-aging society which is leading to more elderly people with severe health conditions being admitted into nursing homes.<br> Because of the elderly residents' physical disabilities and severity of their dementia, they are both unable to communicate with each other and unable to experience much freedom of movement, so most residents can only stay either in their bedroom or the nursing homes common areas.<br> Past reports on residents who have severe dementia mainly focused on the residents and their surroundings, however this study focuses on the care staff's approach toward elderly residents, in which their presence and caring methods are essential to actively stimulate them.<br> Unit Care and Care Work in Sociology by Oka (2016) states that the recent ways in caring for the elderly with dementia have changed due to multi-tasking, therefore this paper will analyze the following concerns;<br> ·The relationship between direct contact care work and the common spaces in the nursing homes.<br> ·The relationship between the concurrent care and common spaces<br> ·The relationship between the time order of care work and common spaces<br> In addition, another purpose of this study is to clarify the interaction and establish the relationship between the residents, care staff and the facility's floor plans. Therefore, this paper divides the care staff's tasks into direct and non-direct care work and then carefully analyzes direct contact care and how this is connected with the floor plans of two specific nursing homes.<br><br> 【Methodological approach】<br> Two nursing homes which have similar management styles and levels of dementia were selected for this research, however their common spaces are completely different.<br> One is located in Hiroshima and another is in Tokyo with floor areas respectively of 4604 m² and 4114 m².<br> Qualitative surveys ware carried out by one observer in both nursing homes regarding the following points:<br> ·Movement and activities of 3 care staff in one unit<br> ·Movement and activities of 10 residents in one unit<br> ·Interviews with 3 care staff in one unit<br><br> 【Main findings and conclusions】<br> ·Various spaces and appealing sceneries are important for residents who are able to experience moderate freedom of movement in the nursing home.<br> ·The care staff's sympathetic approach toward residents is important especially for those who are unable to experience freedom of movement.<br> ·More direct contact care takes places in the nursing home which has 4 common spaces because of the assistance procedures during meal times.<br> ·More concurrent care situations leads to an increasing amount of direct contact care which is beneficial to the residents, therefore the appropriate layout of the living room, kitchen and work desk is essential in order to increase these situations.<br> ·To further increase direct contact care, a second living room like Chanoma is positioned between the residents bedrooms, in which care staff have to pass through, therefore staff can care for residents before entering the residents bedrooms, and it is positioned near a toilet and washstand, therefore staff can care for residents after using them.