Top > ご連絡など > ケアマネジャーの介護保険NEWS > 【介護支援専門員 NEWS】認知症の要介護認定について
【介護支援専門員 NEWS】認知症の要介護認定について
認知症の人に対する要介護認定について、介護保険部会の意見書では、「適切に評価できているかなど、引き続き適切な仕組みとなるよう継続的に評価・検討していくべきであり、必要に応じて介護給付費分科会などにおいて十分議論されることが望ましい」と提言している。
同日の分科会では、三上裕司委員(日本医師会常任理事)が「認知症の要介護度認定への反映が十分でないということがあるので、検討を何らかの形で始めてほしい」と提案した。これに対して池田省三委員(龍谷大教授)は、要介護度と「認知症高齢者の日常生活自立度」はおおむね一致していると指摘し、「(認知症の人の要介護度が)軽く出るというのは『神話』」と強調した。さらに、要介護認定をめぐる介護保険部会の議論にも言及し、「恐ろしく荒唐無稽な議論が展開されていた」と批判した上で、まずは役に立つ認知症ケアのサービスを開発することが必要とした。
介護保険部会の委員でもある勝田登志子委員(認知症の人と家族の会副代表理事)は、この発言に対して「『思い付きや荒唐無稽なことを議論した』ということはない。侮辱だ」と抗議。三上委員は「認知症の人(のケア)は身体介護のように時間で判断できないため、研究してほしいということだ」などと述べた。
■次の報酬改定は「ゼロサムかマイナス」?
同日の分科会では、厚労省が介護保険法改正案のポイントを説明した。細川律夫厚労相が同日発表したもので、介護保険部会の意見書と民主党の「介護保険制度の見直しに関する提言」を踏まえ、居宅介護支援(ケアプラン作成)サービスへの自己負担導入など利用者負担の増加につながる内容を全面的に見送る方針だ。これについて池田委員は「介護給付費分科会に、次の介護報酬改定はゼロサムかマイナスサムを覚悟しろという文章に受け取れる」と指摘した。
■介護従事者処遇状況等調査の結果などを報告
また厚労省は、今年実施した「介護従事者処遇状況等調査」の結果や来年の「介護事業経営実態調査」の実施案などを報告した。これらは20日の介護給付費分科会調査実施委員会でも示されている。
介護職員処遇改善交付金の創設後、介護職員の給与が月額で約1万5000円上がったとの今年の処遇状況等調査の結果については、「現場が努力して(対象職種以外の賃金も上げて)いる点を評価してほしい」(川合秀治・全国老人保健施設協会会長)などの意見が上がった。一方、池田委員は「介護職員の給与をどこまで上げればいいのか。世の中全体の給与は下がっている」として、介護職員の給与についての検証が必要と指摘した。
また、来年実施する経営実態調査をめぐっては、馬袋秀男委員(民間介護事業推進委員会代表委員)が、介護職員処遇改善交付金の収入を計上する項目が事業者間で異なっていることを挙げ、「ばらつきがないよう精査が必要」と述べた。
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