【文献Abstract】介護家族へのケア

〈要点〉

・現在米国において、長期間在宅ケアが行われている80%の人が在宅生活をしており、そのなかで90%が家族によるケアが行われている。

・家庭医はケアを行う家族のサポートを行い、ケアを行う家族が適切にサポートを受けられるような支援（社会資源やウェブサイト、レスパイトケア、カウンセリング等）を行う必要がある。

〈雑感〉

米国では核家族でありどちらかというと在宅生活というよりナーシングホームのような高齢者住宅に移り住む印象が個人的にあったが、80%が在宅生活を送っているというのが驚きだった（※詳細は本文にあるのかもしれませんがこのブログを書いている時点ではまだAbstractのみ読んでおり、本文は未読なので間違っていたらゴメンナサイ）。

一般的に介護者へのケアが必要と言われているが、具体的にどのような点が課題となっているか、科学的な研究も今後でてくるのではと思う。これは家庭医療／総合診療における特徴的な研究になるのかな。

〈文献〉

Am Fam Physician. 2019 Jun 1;99(11):699-706.
Caregiver Care.
Swartz K, Collins LG.

Abstract
Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase during the next few decades. Caring for loved ones is associated with several benefits, including personal fulfillment; however, caregiving is also associated with physical, psychological, and financial burdens. Family physicians can aid in the identification, support, and treatment of caregivers by offering caregiver assessments-interviews directed at identifying high levels of burden-as soon as caregivers are identified. Repeat assessments may be considered when there is a change in the status of the caregiver or the care recipient. Caregivers should be directed to appropriate resources for support, including national caregiving organizations, local elder care agencies, websites, and respite care. Psychoeducation, skills training, and therapeutic counseling interventions for caregivers have shown small to moderate success by decreasing caregiver burden and increasing caregiver quality of life. Additional research is needed to further identify strategies to offset caregiver stress, depression, and poor health outcomes. Support and anticipatory guidance for the caregiver is especially helpful during care transitions and at the care recipient's end of life.