【前編】介護する側が大変にならないために～介護保険の仕組みについて～
介護が大変にならないためには、何が必要なのでしょう。
今回は介護が始まる前に知っておくべきことを紹介します。
前編では「介護保険の仕組みについて」
後編では「介護保険の利用方法と協力体制について」
説明していきます。
目次
介護は何が大変なの？
「うちの親は元気だから」と、安心していませんか？
しかし、実は介護というものは、ある日突然やってくる方が多いことをご存じでしょうか？
準備万端で介護が始まることなんて、なかなかありません。
高齢者に限らず、怪我や病気は何の前触れもなく私たちにも襲ってくるものです。
若いうちはまだなんとかなるかもしれませんが、高齢者はそうはいきません。
ある日突然、一人で生活する事が難しくなり、介助が必要になります。介護が大変になるのは、突然始まるからなんです。わからないことが多いから、全て後手の対応となってしまいます。
そして、誰が介護をするのか。
費用はどうするのか。
これには配偶者や子、親戚などの意向も聞き、様々な話し合いが必要です。
介護が大変になるのは、何も決まっていないからなんです。そうならないためにも、いつ介護が始まっても大丈夫なように、理解を深めましょう。
介護保険の仕組みについて
■介護保険制度
・介護保険
2000年4月から施行されました。介護を必要とする人が適切なサービスを受けられるように、社会全体で支えあうという目的の制度です。
「自立支援」「利用者本位」「社会保険方式」の3つを基本に成り立っております。
・対象者
65歳以上の方を「第1号被保険者」といいます。
40歳～64歳までの方を「第2号被保険者」 といいます。
39歳以下の方は、介護保険を利用できません。
・保険料
40歳以上の全国民が収めている保険料、と国や市町村の公費があてられ、実際に介護サービスを受けた費用の7割～9割（その方の収入による） を負担してくれる仕組みです。
介護保険で受けられるサービス
■居宅サービス
介護保険で受けられるサービスには大きく分けて3つのサービスがあります。
・訪問介護
訪問介護員が利用者宅を訪問し、日常生活の介助や支援を行う。
・通所介護
利用者がデイサービス等を訪れて、介護サービスや支援を受ける。
・短期入所生活介護
短期間の間、施設に入所し、介助や支援を受けるサービス。
ショートステイとも呼ばれます。
・その他
「訪問看護」や「特定施設への入居」「福祉用具貸与」
などなど。
■施設サービス
・介護老人保健施設
病院から退院後、在宅復帰を目的としたリハビリや医療ケアを受ける事ができる施設。（長期の利用はできません。）
・特別養護老人ホーム
常時、介護が必要な状態の方を対象とした施設。入居希望者が多いため、順番待ちがあり、なかなか入れない。
・介護療養型医療施設
比較的重度なよう介護者に対し、医療処置やリハビリに特化した施設。将来的には廃止になる予定がある。
・地域密着型サービス
要介護状態になった高齢者が、いつまでも住み慣れた地域で、住民とも交流を持ちながら、介護サービスを受ける事ができます。
地域住民を対象に、グループホームや２４時間対応型サービス、定期巡回型サービスなど、柔軟なサービスを受けることができます。
要介護認定とは？
介護サービスを受ける際に、どの程度の介護を必要としているかを判断する基準になるもので、7段階に分類されます。
申し込み後、全国共通の認定調査書をもとに、認定調査が行われます。コンピューターによる一次判定が行われ、認定審査会を経て、結果は市町村に通知されます。
介護認定の区分は「自立」「要支援」「要介護」の3つに分けられます。
「自立」
自立と認定された場合は、給付金を受けることができません。日常生活は介助が必要ではないとみなされています。
※下記の区分より、介護保険適用のサービスが利用できます。
また、各区分によって限度基準額が設定されています。
「要支援１」
一部支援が必要な状態です。
週１回の訪問サービスや、デイサービスの利用ができます。
「要支援２」
動作時に見守りが必要な状態です。
週２回の訪問サービスやデイサービス、一部の福祉用具のレンタルが利用ができます。
「要介護１」
動作時に見守りや、一部の介助が必要な状態です。
「要介護２」
日常生活動作に、一部介助が必要であり、物忘れや理解力の低下などがみられる状態です。
「要介護３」
日常生活動作の能力の低下や、物を使うなどの能力が低下し、全面的な介助が必要な状態です。
「要介護４」
さらに動作能力が低下し、排泄、入浴、食事にも介助が必要な状態です。介助なしでは日常生活を送る事が難しくなります。
「要介護５」
動作能力が著しく低下し、「寝たきり」の状態で生活全般にわたり、全面的な介助が必要になる状態です。
※上記はあくまでも標準となる目安なので、一概には言えません。認知症状は人によって様々な症状が現れますので、参考程度に知っておいて下さい。
以上が前編「介護保険の仕組みについて」となります。
後編では「介護保険の利用方法と協力体制について」紹介したいと思います。
「今後の生活環境が変わる事への不安」や「介護を使って生活をどうデザインをしていったら良いか」など介護は協力体制で成り立っております。 ちょっとでも解決できる、ストレス軽減できる記事を目指し、一つの相談場所のメディアを目指しております。
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