Problems of Multi Occupational Collaboration to Practice End-of-life Care in Special Nursing Home for the Elderly

論文Articles介護保険制度開始以降、病院死以外の選択肢が求められるようになってきた。結果、特別養護老人ホームもその中に入ってきたが、実績としては十分でなくノウハウも確立することができていない。そこで京都府と大分県の各2 施設（合計4 施設）で終末期介護と多職種連携をテーマに聞き取り調査を行った。介護職の役割は生活支援であり、一次的な情報を収集することにあった。福祉職は相談業務とチーム内、家族との連絡調整を行う役割を担っていた。看護師は利用者の健康管理を中心としながら、終末期には医療の側面から意思と連携しながら支援を行っていた。このように異なる役割を持つ職種が有機的な活動をするために克服すべき課題を検討した。明らかになった課題は、専門性の違いに基づいた役割の違いと情報の伝達、コミュニケーションのあり方であった。具体的な対応方法は専門職種間の壁を乗り越えるために勉強会を開くこと、分かりにくい専門用語を他の専門職に分かりやすく伝えることが行われていた。Since the nursing care insurance system began, options other than hospital death have come to be required. As a result, a special nursing home for the elderly also came in, but as a result it was not enough and know-how could not be established. Therefore, we interviewed them on the theme of terminal care and multi-occupation collaboration at each of the two facilities in Kyoto Prefecture and Oita Prefecture (total of 4 facilities). The role of nursing career is life support, it was to collect primary information. The welfare worker was responsible for coordinating the consultation work, within the team, and with the family. While focusing on the health management of users, nurses were assisting in cooperation with intention from the aspect of medical care at the terminal stage. In this way,jobs with different roles examined issues to overcome in order to perform organic activities.The obvious challenge was the difference in roles based on differences in expertise, the transmission of information, and the wayof communication. Specific measures were to open a study group to overcome the barriers between professional occupations, to convey unclear terminology to other professionals in an easy to understand manner.departmental bulletin pape