Exam 38 · 第38回 · 認知症の理解 (Understanding Dementia)
Question 90 問90
Ａさん（88歳，女性）は，4年前に，認知症（dementia）と診断された。在宅で長男が介護している。Ａさんは，3か月前から，何度もトイレ以外で排泄しようとする様子がみられた。長男が繰り返しトイレの場所を教えているが，状態は変わらない。長男はＡさんに対して，「何回，同じことを言ったら，わかるんだ」と大声でどなってしまい，その後で落ち込むようになった。また，長男は，「認知症（dementia）がいつまで続くのか」「自分に何か問題があったのではないか」と言って，自分を強く責めている。次のうち，Ａさんの認知症（dementia）を長男が受け入れる過程と考えた場合，このときの長男の心理的特徴に該当する段階として，最も適切なものを1つ選びなさい。
- ショック期
- 否認期
- 混乱期
- 解決への努力期
- 受容期
Translation
Ms. A (88 years old, female) was diagnosed with dementia (認知症) 4 years ago. Her eldest son cares for her at home. Since 3 months ago, Ms. A has often tried toileting (排泄) somewhere other than the toilet. Her son has repeatedly shown her where the toilet is, but nothing has changed. Her son has shouted at her, saying, 'How many times do I have to tell you before you understand?' and has felt down afterward. He also blames himself strongly, saying things like, 'How long will this dementia (認知症) go on?' and 'Was there something wrong with me?' If this is seen as the process by which the son comes to accept Ms. A's dementia (認知症), which of the following stages matches his psychological state at this time? Choose the most appropriate one.
- Shock stage (ショック期)
- Denial stage (否認期)
- Confusion stage (混乱期)
- Effort-toward-solution stage (解決への努力期)
- Acceptance stage (受容期)
Show answer and explanation
Answer: 3
Why 3 is correct
The confusion stage (混乱期) is when a person feels anger and sadness about a situation they cannot control, and feels down or blames themselves. The son felt down after shouting and blames himself strongly, so answer 3 is correct.
Why 1 is wrong
The shock stage (ショック期) is right after receiving the diagnosis, when a person feels strong shock and cannot keep up emotionally. It has been 4 years since the diagnosis, so the son is not in this stage.
Why 2 is wrong
The denial stage (否認期) is when a person will not accept that it is dementia. The son is worried on the assumption that the dementia will continue, so he is not in denial.
Why 4 is wrong
The effort-toward-solution stage (解決への努力期) is when a person moves past anger and self-blame and starts thinking positively about what they can do. The son is still blaming himself.
Why 5 is wrong
The acceptance stage (受容期) is when a person accepts the dementia as it is and has gotten used to their new life. The son has not yet accepted it.
Key point
The confusion stage (混乱期) brings anger and sadness, feeling down and blaming oneself.
Key terms
- 混乱期
- The stage when strong anger, sadness, and self-blame appear.
- 否認期
- The stage of not accepting an illness or disability.
- 受容期
- The stage of accepting an illness or disability as it is.
- 排泄
- Toileting: passing urine or stool out of the body.
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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.