Exam 37 · 第37回 · 認知症の理解 (Understanding Dementia)
Question 45 問45
次の記述のうち，「認知症（dementia）の人の日常生活・社会生活における意思決定支援ガイドライン」（2018年（平成30年）（厚生労働省））で示されている，意思決定支援として，最も適切なものを1つ選びなさい。
- 認知症（dementia）の人の家族の意思を支援することである。
- 意思決定支援者は特定の職種に限定される。
- 一度，意思決定したら，最後まで同じ内容で支援する。
- 看取りの場面になってから支援を開始する。
- 身振りや表情の変化も意思表示として読み取る努力を最大限に行う。
Translation
According to the 'Guidelines for Supporting Decision-Making in Daily Life and Social Life for People with Dementia (認知症)' (2018, Heisei 30, Ministry of Health, Labour and Welfare), which of the following describes decision-making support (意思決定支援)? Choose the most appropriate one.
- It means supporting the wishes of the family of a person with dementia (認知症).
- The people who give decision-making support (意思決定支援者) are limited to certain job roles.
- Once a decision is made, the support should stay the same until the end.
- The support starts only when the person is close to the end of life.
- The support makes every effort to read gestures (身振り) and changes in facial expression as ways the person is showing their will (意思表示).
Show answer and explanation
Answer: 5
Why 5 is correct
The guideline asks supporters to make every effort to read the person's wishes even from gestures (身振り) and changes in facial expression, for people who cannot say things well in words. Decision-making support (意思決定支援) means never giving up on finding out what the person wants.
Why 1 is wrong
What is supported is always the wishes of the person with dementia (認知症), not the family. The family's words are used as a reference, but the support is not for the family's wishes.
Why 2 is wrong
Decision-making support (意思決定支援) is not limited to certain job roles. Care workers (介護福祉職), medical staff, family, and everyone around the person can give this support.
Why 3 is wrong
Feelings can change. Even after a decision is made once, supporters should check again and again, and if it changes, the support should match the new decision.
Why 4 is wrong
Support is not only for when the person is close to the end of life. It is given in everyday scenes of daily life and social life, such as meals, clothes, going out, and social activities.
Key point
Even if a person cannot say it in words, read their wishes from gestures and facial expressions.
Key terms
- 意思決定支援
- Helping a person decide things for themselves, by giving them information and the right setting.
- 意思表示
- Showing your own thoughts or wishes to another person.
- 身振り
- Showing feelings through movements of the hands or body.
Practice all 375 questions in the app
Exams 36–38, all 13 subjects, with furigana and an English explanation of every choice. The subject 「認知症の理解」 is free.