著者

木内 千晶 吉田 千鶴子 Chiaki KINOUCHI Chizuko YOSHIDA

出版者

岩手県立大学看護学部

雑誌

岩手県立大学看護学部紀要 = Journal of the Faculty of Nursing, Iwate Prefectural University (ISSN:13449745)

巻号頁・発行日

vol.6, pp.77-82, 2004-03-01

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高齢者の終末期を考えていく上では,その主体となる高齢者自身が,終末期に対し,どのような考えをもっているのか,実態を把握することが大変重要であり不可欠である.今回,M市老人クラブの,自宅で生活する高齢者を対象に,自由記述により終末期の迎え方に対する希望を調査した.284名,平均年齢74.6歳 (SD=5.41) より有効回答を得た.記述内容を意味の共通性に従いカテゴリー化し「(1)死に方の希望」「(2)死ぬ時の身体的,精神的状態の希望」「(3)死ぬ時の環境・状況の希望」「(4)死ぬまでの身体的状態の希望」「(5)死ぬまでの生活・生き方の希望」「(6)死後の希望」の6つのサブカテゴリーに分類できた.さらに,「1.死ぬ時に関する希望」「2.死ぬまでに関する希望」「3.死後に関する希望」の3つのカテゴリーに分類できた.希望の内容は,死ぬ時のことに限らず,現在から死後のことに及んでおり,高齢者の終末期のとらえ方は個人により異なることが明らかになった.また,終末期の希望に現在のことが含まれていたことから,死ぬ時だけでなく,死を迎える以前の生活や生き方もケアすることが重要であると示唆された.一方,希望は抱いていても,それを,他者に伝えている高齢者は少ないことが明らかとなり,高齢者の希望を尊重するためには,終末期に対する考えや希望を表出できるように援助する必要があると考えられた.When considering the elderly's period of life immediately before death, it is important, if not essential, to grasp how the elderly themselves actually feel. We surveyed members of a senior citizens club in M City on elderly people who live in their own home and about they wanted to see out the last days of their lives. We received 284 valid responses, with an average respondent age of 74.6 (standard deviation of 5.41 years). We were able to categorize the responses of the free form survey into the following subcategories: (1) Preferred way of dying; (2) Preferred symptoms and emotions at death; (3) Preferred environment and circumstances at death; (4) Preferred physical condition up until death; (5) Preferred lifestyle up until death; and (6) Posthumous preferences. These six subcategories were further classified into the following three categories: 1. Preferences up until death; 2. Preferences at death; and 3. Preferences after death. Their preferences were not limited to just at death, but rather extended from the present to after death, and it became apparent that the way they saw this final chapter of their lives depended on the individual. Their preferences for this end-of-life period included current events.This indicates that it is important to care about how the elderly live during the lead up to death, not just at death. It is apparent that even if they have preferences, those that share their views with others are few and far between. Accordingly, to respect the wishes of the elderly, we need to support them in venting their thoughts and hopes in this lead up to death.