ケアサポート９／ケアマネージャー（介護支援専門員）試験／ＴＯＰへ

今年４月の介護報酬改定で、認知症患者の在宅復帰を促す認知症短期集中リハビリテーション（認知リハ）の対象が拡大されました。重い認知症患者と暮らすのは、家族にとっても辛いものですが、リハビリで著しい改善が見られるようです。

「先生は、保護者からずいぶんモテたって聞いていますよ」

　作業療法士が川辺徳三さん（７７）＝仮名＝に声をかけると、川辺さんの強ばった表情に、ぱっと花が咲いたように笑顔がはじけた。

　川辺さんは小学校の校長で定年退職を迎えた。現在は６０代の妻と２人暮らしで、「しょうわ」の通所リハビリテーションとショートステイ（短期入所）を利用している。

　作業療法士らが、川辺さんに「先生」と声をかけるのは、回想法の一環。昔の記憶を思い出させて、脳を活性化させる療法だ。校長時代について聞かれた川辺さんは「先生はギャグを知らないといけない」「宿直をしていたときは大変だったよ」など、目尻にしわを寄せて語った。

　川辺さんは要介護４。かつては怒ったように「おーい、おーい」と叫び続けたり、話しかけると「なんだよ」と怒り出す暴言や介護拒否の症状があった。重度のアルツハイマー型認知症と診断され、２０年１１月、入所した。

【用語解説】認知症短期集中リハビリテーション

　認知症と診断され、リハビリで生活機能の改善が見込まれる人が対象。従来は軽度認知症の老健入所者が対象だったが、４月から介護療養病床や通所リハビリで、中重度の認知症患者にも拡大された。入院日（入所日）から３カ月以内に、医師または医師の指示を受けた理学療法士、作業療法士、言語聴覚士が個別に２０分以上のリハビリを週２、３日行うと、１日約２４００円の介護報酬がつく。<産経新聞>

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