This study investigated the relationship between feelings and opinions, non-wandering patterns, and types of wandering in wanderers with Alzheimer's Disease, with the ultimate aim of exploring methods of nursing care appropriate to their feelings while wandering. There were basically two types of wandering, purposeful and non-purposeful. The former could be categorized into four types, work, going home, interaction, and physiological. Regardless of the degree of impaired cognitive function, two or more wandering types were exhibited by all participants, and the combination of types differed from individual to individual. Feelings were broadly classified into positive and negative in investigating the relationship between feelings during wandering and types of wandering. In three purposeful types of wandering (except for going home) - work, interaction, physiological - feelings were positive in the case of accomplishing their purposes but negative in the reverse case, and were also negative in the non-purposeful type. Four patterns in the non-wandering situations - concentrating, peace of mind, relating to others, and physiological needs - were identified. The best pattern for discontinuing wandering was peace of mind, which was effective for all five wandering types. In particular, for the going home wandering type, this was the only way to discontinue wandering. On the other hand, work and physiological types were available in all four patterns as an effective way to discontinue wandering.

本研究では,認知症高齢者の徘徊時の気持ちや徘徊中断について聴取,および観察を行なった。認知症高齢者の徘徊の目的および理由と徘徊時の気持ちや徘徊を中断するときの関連から,徘徊者の気持ちを踏まえたより効果的な援助方法を探ることが目的である。徘徊には大きく分けて,有目的と無目的の二つのパターンがあり,前者は,さらに「勤勉性」「帰宅願望性」「親密性」「生理的要因性」の四つのタイプに分類された。個人を主体とした徘徊行動では,全ての対象者のタイプは単一ではなく,認知レベルにかかわらず,二ないし五タイプであり,個人における組み合わせも異なっていた。また,徘徊時には,肯定的及び否定的な感情があり,非徘徊時のパターンには,「集中する」「精神的安寧が得られる」「他者と関わる」「生理的欲求がある」があった。そして,「精神的安寧が得られる」ことは全ての徘徊行動パターンに有効な徘徊中断への対応方法であった。

原著

Original Article

国立情報学研究所で電子化