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】高齢者にみられる代表的な身体症状
【介護支援専門員 NEWS】高齢者にみられる代表的な身体症状
長嶋氏はまず、高齢者の身体疾患の特徴として、動脈硬化や悪性腫瘍(がん)など高齢者特有の疾患を例に、一人の患者がいくつもの疾患を併せ持つケースが多く、若年者では意識障害の原因や死因にならないような疾患でも高齢者では重篤化したり回復が遅れがちであることを告げ、今流行しているインフルエンザやノロウイルスにも注意するよう呼びかけた。
高齢者にみられる代表的な身体症状では、以下を挙げた。
1.めまい
2.頭痛
3.しびれ
4.摂食・嚥下障害
5.歩行・運動障害
6.尿失禁
7.不随意運動
8.褥瘡
9.便秘
10.脱水症
11.浮腫(むくみ)
12.転倒・寝たきり
13.構音障害
この中でも高齢者に多くみられる摂食・嚥下障害は、耳鼻咽喉科などで嚥下内視鏡の検査を受けることが勧められ、便秘は女性高齢者を対象にイメージしやすいが男性にも多いこと、転倒が原因で寝たきりになると認知症の引き金になることなどが伝えられ、リスト最後の構音障害は「言葉が出てこない失語、ろれつが回らないなどの言語障害」であることが説明されると、耳慣れない障害についてメモを取る受講者が多かった。
高齢者の精神疾患では、器質性精神疾患の一例でアルコール中毒や栄養障害初老期や老年期の認知症が挙げられた。
精神障害や脳の器質的疾患がなくとも人格の著しい変化が生じる"老年期人格障害"について、長嶋氏は「原因の多くは、老年期以前よりみられた人格の偏りが環境要因などの影響で目立ってきたと考えられ、自分の性格を本人が悩んで訴えるタイプは少なく生活を共にする周囲の人々から訴え(苦情)が出る」と述べた。またこの老年期人格障害は、自己中心的、頑固、非協調的で自己主張が強く、共同生活が困難でロ論やけんかを起こしやすいため、周囲から苦情が出てしまうタイプと、内閉的、孤立的性格で交際を嫌い、部屋に閉じこもる生活になりがちなタイプに大別されることも解説された。
長嶋氏は、高齢者住宅支援員に求められるアセスメントとして、ふだんと変わりない様子で過ごしているか、高齢者住宅支援員として助言できる問題か、専門職・専門機関につなげるべき問題かなどを見極めることをポイントに、健康状態、ADL、家事、経済状態、家族関係など多岐にわたって高齢者の生活に注意を向けるよう求めた。
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