第6回金沢元町在宅医療を考える会コラボ研修会を開催いたしました。

☆支援者の能力が試される意思決定支援☆

元町在宅医療を考える会(金沢東地区)の皆さんと6回目となるコラボ研修が浅野川総合病院にて開催されました。今年のテーマは「自らが望む人生の最終段階を迎えるために地域ができる支援について」。

意思決定支援について、弁護士の北島先生から代行意思決定との違いについて解りやすく講義がありました。代行意思決定は本人の判断能力がゼロであるという前提に立つが、意思決定支援は本人の判断能力が僅かでもあることを前提とする。そしてその僅かな能力でも理解できるように支援者が情報を提示する必要があり、それが出来る能力が要求される。

グループワークでは早速支援者の能力が試されました。下顎歯肉癌で在宅生活を続けている事例。本人、家族とも病状が落ち着いている間は在宅生活を続けたいが、状態が悪くなったら入院を希望されている、とのこと。

「状態が悪くなったら」と漠然と考えているが、支援者はここを整理し、予後予測して提示する必要がある。疼痛が増悪したら、なのかADLが落ちたら、なのか呼吸困難が生じたら、なのか?など。そして整理することによってまだ在宅でも対処する方法がみつかる。

オピオイド薬の調整、訪問リハビリの導入、在宅酸素の導入、環境調整、など各グループから次々と支援方法が提案され、本事例を担当する訪問看護師が「まだまだやれることが沢山有ることが解った」と感想を述べて下さいました。

加賀脳卒中地域連携協議会では脳卒中に限らず、地域で難渋する事例を急性期、回復期、生活期を連携し、医療職以外も巻き込んで考えるコラボ研修を続けていきます。今後ともよろしくお願いいたします。

第6回金沢元町在宅医療を考える会コラボ研修会を開催いたしました。” に対して134件のコメントがあります。

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