特別養護老人ホームにおける福祉と医療:その協働の変遷と課題 : 終末期ケアへの制度的支援体制構築の視点から
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概要
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Since the introduction of the long-term care insurance system，special nursing-care homes for theelderly（NHs）have preferentially accepted those heavily requiring nursing care，induced by theircompensation-oriented policies. Along with the progression of aging，nursing care required by facilityusers is becoming more marked and the conditions of their complications are growing severer. Nowthat their returning home is no longer easy，NHs are required to regularly provide individual care forusers entering the terminal stage. To improve the quality of terminal care at NHs，on the otherhand，the vulnerability of their human resource and financial bases，such as the limited coverage ofbenefits by long-term care insurance，remains a major obstacle.NHs must discuss how to upgrade their terminal-care systems on the basis of their strengths notfound at medical institutions，i.e.，both supporting and improving elderly lives，and how to findfinancial sources to manage those systems.This report describes the representative cases of terminal-care support from both social welfare andhealth care identified through a current situation survey among NHs in Hyogo Prefecture. A strongintention to work to provide terminal care was found mainly in nurses and other care staff even atNHs with limited financial/human resources. The lack of institutional support，however，imposes agreat burden on those staff in their practicing of terminal care.Focusing on the recent transition in systems surrounding NHs，particularly on the management ofsocial welfare facilities under the long-term care insurance system，I considered future collaborationat NHs between social welfare and health care that is balanced in both aspects of care practice andfacility management.
- 武庫川女子大学の論文