岡山県の都市部･農村部における高齢者の在宅ケアの実態

高齢者の在宅ケアの必要性が増大している一方,女性の就労者の増加や核家族化は在宅でのケアを困難にしている。そこで,実際にどのような現状や問題があるのかを検討する必要があると考えた｡今回,全国の高齢化率(14.1%)より高い高齢化率(16.9%)の岡山県で,在宅ケアの実態を1995年8月から9月にかけて調査した｡都市部(岡山市)･農村部(高梁市･邑久町･久米南町)で比較すると,在宅ケアは都市部に比べ農村部が少なく,農村部では施設での介護の方が多いことを認めた｡分析対象は140名で都市部が39名,農村部が101名である｡在宅でケアを受ける75歳以上の高齢者は77.1%と多かった｡農村部の方が高年齢で障害度も重く,特に過疎地域では介護期間も長く5年以上が過半数を占めていた｡主たる介護者は都市部では配偶者が63%と多かった｡過疎の農村部では息子の妻および孫の妻が多く,また70歳以上の高齢の介護者が3分の1を占めていた｡入浴･更衣回数などのケア回数は県北の農村部では特に少なかった｡また家族の介護時間は都市部は1日につき約7時間であったが,農村部では約3時間のみであった｡保健婦･看護婦などの専門職者によるサービスは都市部に多く,ホームヘルパーによるサービスは農村部に多かった。民間のサービス利用率は都市部･農村部いづれも低かった｡以上のごとく農村部における高齢者の介護がより問題が多く,深刻な状況であることが明らかになった｡

The purpose of this study is to demonstrate the actual condition of care for the elderly, especially to make clear the difference between urban and rural areas of Okayama prefecture in which the rate of aging (16.9%) is higher than that of the whole country (14.1%). A survey distributed by municipal employees such as public health nurses and homehelpers, was done in the prefectural capital (Okayama) which was used for the urban aera study and one small city (Takahashi) and two towns (Oku and Kumenan) which were used for the rural areas study groups from August through September, 1995. The rate of persons cared for at home was low in the rural areas compared to that in the urban area, namely many persons were cared for at faclities for elderly or at hospitals. Date obtained from 140 families, 39 in the rural area and 101 in the urban areas respectively, were analysed. Persons cared for at home were generally old. 77.1% of them was older than 75 years of age and they suffered from many disorder. The period of care was quite long in the depopulated area, as 63% of them were cared for more than 5 years and one third of persons caring for them were more than 70 years of age. In the rural area, more than half of the elderly were cared for by their spouses. The time spent in helping them bathe and change their clothes was lower in the rural area than in the urban area. The time perdiem spent caring by each family was 3 hours in the rural area, while 7 hours in the urban area. The rate of persons who utilized visiting nurses was high in urban area, while homehelpers were high in the rural areas. The utilization of non-governmental services was low in both areas. The author concludes that care for the elderly in the rural areas is actually difficult and poor in quality compared to that in the rural aera.