@article{oai:nsg.repo.nii.ac.jp:00004892,
 author = {小山, 歌子 and 稲垣, 千文 and 宇田, 優子 and Koyama, Utako and Inagaki, Chifumi and Uda, Yuko},
 issue = {2},
 journal = {新潟医療福祉学会誌, 1346-8774},
 month = {Nov},
 note = {application/pdf, 論文(Article), 【目的】本研究の目的は、豪雪地帯・無医地区において住民参加による高齢者を在宅で看取るケアシステムの構築に向けた示唆を得るために、地域住民の生活面における互助の実態、高齢者の介護・看取りのニーズを明らかにすることである。【方法】豪雪地帯の無医地区に居住し、日常生活が自立している65歳以上の者9人に地域内の互助、終末期の介護や療養場所の希望等の半構造化面接を実施し、質的帰納的分析方法を参考に分析した。【結果】地域内の互助では、「相互の見守り」「除雪の手助け」「家族の代行」「野菜のお裾分け」等を日常的に行っていた。看取りのニーズは、独居高齢者動けるうちは1 日でも長い在宅療養を希望し、要介護状態になった時は入院・入所を希望していた。同居高齢者は全員在宅介護・在宅看取りを希望してた。家族等と話し合っている者は9人中1人であった。最期を迎える場の決定は本人以外であった。豪雪時以外は必要時いつでも医療を受けられる体制あるが、豪雪時は自動車の交通が途絶するため必要な医療を受けられない状況となる。【考察】高齢者を在宅で看取る際に、近隣住民が現在の支え合い中で、高齢者本人や家族の精神面および生活面を支援することは可能であると考える。また、高齢者の介護・看取りのニーズを叶えるためには、早い段階から高齢者と家族が話し合うこと、豪雪時の医療確保のためには、TV電話による遠隔診療の推進の必要性が示唆された。, 【Objective】 To clarify the current status of mutual aid in daily life among community residents and older adults’ needs related to care/end-of-life care, and establish a system to provide such care at home with residents participating in heavy snowfall areas. 【Methods】 Semi-structured interviews were conducted with 9 older adults aged 65 or older, who were living in doctorless districts of heavy snowfall areas, and able to perform activities of daily living independently, to clarify the current status of mutual aid in their communities and their wishes about care to manage end-stage conditions and the place to receive long-term care. The obtained data were analyzed, adopting a qualitative, inductive approach. 【Results】 In their communities, they performed various mutual-aid activities daily, such as 〈mutually observing〉, 〈helping with snow removal〉, 〈taking over family members’ duties〉, and 〈sharing vegetables〉. Concerning end-of-life care, older adults living alone hoped that they would receive home care as long as they maintained mobility, and be admitted to a hospital/facility when they became care-dependent, whereas all those living with their families hoped that they would receive care/end-of-life care at home. Only 1 had talked with other family members about this issue. None could make their own decisions regarding the place to spend the last days of their lives. Medical care was available whenever needed, except when there were heavy snowfalls. 【Discussion】 The current mutual-aid system involving neighbors may allow mental and daily life support for older adults and their families when providing end-of-life care for the former. The necessity of promoting early consultation regarding this issue between older adults and their families to fulfill their care/end-of-life care-related needs and remote medical systems using TV telephones to ensure the sufficient availability of medical care during periods of heavy snowfalls was also suggested.},
 pages = {40--48},
 title = {特別豪雪地帯・無医地区の高齢者の介護・看取りのニーズ},
 volume = {19},
 year = {2019}
}