【後編】介護する側が大変にならないために ~介護保険の利用方法と協力体制について~

前編の記事では、介護保険の仕組みについて紹介をさせて頂きました。
介護が大変になる要因の一つとして、「突然始まることにある」ことを踏まえ、事前に知っておく情報です。
全編をまだ読んでない方はそちらからお読みください。

今回は「介護保険の利用方法と協力体制について」紹介していきます。

目次

介護保険を利用する

■介護保険サービスの利用までの流れ

①申請
まずはお住いの市町村の介護保険担当窓口で、申請書を記入し提出します。持ち帰ってもいいですし、その場で職員と一緒に記入することもできます。

②認定調査
申請書を提出すると後日、要支援・要介護認定のため、認定調査の日程調整の連絡があります。認定調査とは調査員が自宅に来て、本人の生活状態や身体機能の確認を行います。

③結果通知
認定調査後、「非該当(自立)」「要支援1、2」「要介護1~5」のいずれかの結果が、自宅に郵送されます。
結果はおよそ1か月程度は時間を要します。
※認定結果に納得できない場合は、不服申し立てをすることができます。
  
④ケアマネージャーを探す
介護認定がでたら、お近くの地域包括支援センターや、居宅介護支援事業所(ケアプランセンター等)に連絡し、ケアマネージャーさんを紹介してもらいます。もし連絡先が分からなければ、市町村の介護保険担当窓口でも紹介してもらえます。

⑤ケアプランを作成
担当するケアマネージャーさんが決まれば、本人や家族の希望を盛り込んだ、「ケアプラン」を作成してもらいます。介護が始まる前はわからないことも多いので、できるだけ話しやすく、相性のいいケアマネージャーさんを探しましょう。

■介護保険を利用するための条件

①介護保険の被保険者である事
介護保険の被保険者とは、市町村の40歳以上の住民です。39歳以下の人は利用できません。年齢によって分類されます。

・「第1号被保険者」・・・65歳以上の住民
・「第2号被保険者」・・・40歳~65歳未満の医療保険加入者
   
②認定調査で「要支援」か「要介護」と認定されている事
上記にありました、介護保険の要介護認定を受けておく必要があります。
「自立」と決定された場合は、介護保険が利用できません。

■本人や家族が手続きをできない場合

介護を必要としている本人か、またはその家族が申請する事ができます。
しかし、生活環境や健康状態によっては難しい場合があります。
そのような場合には代行することが可能です。


    ・地域包括支援センター
    ・居宅介護支援事業所
    ・病院のソーシャルワーカー
    ・成年後見人 

協力体制について

■全員で力を合わせる

まず初めに知っておいてもらいたいことは、家族の誰かが介護を担当するのではなく、介護とは「家族全員が力を合わせて行うもの」との認識が大切です。

「同居しているんだから・・・」「近くに住んでいるんだから・・・」という考え方をしていると、その人だけに負担がのしかかり、たちまち困難を招く状態に陥ってしまいます。

■チームを作る

そのような状態にならないためにも、家族全員が一つの「チーム」となって、サービスの方針や費用の管理をスムーズに行えるよう、話し合うことが重要です。

介護の課題は様々ですが、チームが一丸となれるよう、窓口となる「リーダー」を決めて、以下の点に気を付けながら話し合いを進めましょう。

話し合う時の注意点

①家族全員が参加して話し合う
全員が一同に集まって話し合いをするというのは、なかなか難しいかもしれません。
しかし、誰か一人が欠けてしまい、せっかく決めた事柄が、また振り出しに戻るという事もあります。

介護をスムーズに進めるためには、できるだけ全員が参加できるようにしましょう。

②一人に負担がかからないようにする
生活環境や周囲の圧力により、むりやり介護を担当させられるといった場合もあるかもしれません。
例えば兄弟でも、「長男の嫁」や「独身」といった場合だと、断れない場合もあります。
皆が本音で話し合える場としていきましょう。

③課題を整理しながら行う
介護される方の身体状態や、今後予想される課題なども、紙に書き留めておきましょう。
家族の中ではわからないことも出てきますので、相談ができるよう、整理をしながら進めましょう。

④できない事も話し合いましょう
介護はきれいごとばかりではありません。それぞれの家族の事情やタイミングなどもあり、できない事も当然あります。
そこで大切なことは「できない」で終わるのではなく、「こういう風にならできる」「ここまではできる」など、前向きに考えていきましょう。

物理的な問題(金銭面や住んでいる場所など)があっても、できる事は必ずあります。

⑤リーダーは粘り強く
話し合ううちに、意見の分かれる場合もあります。特に親戚などの世代や生活してきた時代の違いから、無理なことを言われることもあります。
しかしそれを鵜呑みにしてしまい、後で体制が崩れてしまっては元も子もありません。

そういう時もリーダーは粘り強く、話を聞くことが重要です。
「親の介護は子が行うもの」「施設に入れるなんて、もってのほか」こういう意見に対しては、勇気を出して話合うことが大切です。

社会資源を積極的に利用する

社会資源とは、個人や集団が福祉ニーズを充足するための、施設、機関、設備、法律、人材、技能などの総称です。

具体的には、行政機関、各種施設、団体、企業、ソーシャルワーカー、ケアワーカー、保健師、介護士、家族、友人、ボランティアなど。

■介護で知っておくべき社会資源とは?

協力体制として欠かせない、社会資源を紹介します。介護保険はもちろん、地域には無料で利用できる福祉サービスが多く存在します。
この社会資源の情報を多く持つ事で、安心して介護に携わる事ができるのではないでしょうか。

■社会資源の例

・地域包括支援センター
市町村に設置された、高齢者の生活に関する総合的な相談窓口 です。
福祉に関する専門家が在籍し、困りごとに対して必要なサービス や制度を紹介してくれます。

・かかりつけの医院(医療ソーシャルワーカー)
定期的な通院をすることで、Drとの信頼関係や疾患を把握してもらえる、心強い味方です。
入院中であれば、退院後の介護を見据えて、要介護認定の申請の代行なども行ってくれます。

・民生委員
国が認定した相談員で、主にボランティアで活動され、定期的な訪問による見守りサービスや、災害時による安否確認などを、行ってくれています。

・その他
地域の高齢者に対して行われている体操教室や、食事会などもあります。市(区)役所の【介護保険課】でも様々なサービスを紹介してくれます。

まとめ

介護保険の申請から、利用の仕方、協力体制などを紹介しましたが、介護が始まっても大変にならないために知っておいてもらいたい知識になります。

実際、手続きなどはケアマネージャーや、役所の職員が大半を手伝ってくれます。
この情報をすべて把握しておかなければならないというわけではありませんので、安心して下さい。

TBSテレビ系「金曜ドラマ」長瀬さん主役の「俺の家の話」でもあるように、介護は家族が一致団結することで、素晴らしいケアをすることができます。

介護で一番大変なことは、どうやって皆が同じ方向を向くことができるのか、粘り強く話し合う事かもしれません。

介護の相談窓口
  • 「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。

介護保険

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