人生会議とは?コロナ禍の今だからこそ考える!終活だけでいいのかな?

人生会議とはなんでしょうか。実は死に関係する非常に大切なキーワードです。近年「終活」といった言葉もメディアでは取り上げられますね。

いずれも自らの死に向き合い、自分らしい人生の送り方を考えることを指しますが、今日は人生会議についてまとめてみました。

目次

人生会議とは?終活と違うものなの?

人生会議とは2018年厚生労働省が公募で募集したものから、この愛称を決めました。もともとは「ACP=アドバンス・ケア・プランニング」と呼ばれています。

これは本人とその家族が医療従事者や介護者と一緒に考えます。検討する内容は、現在の病気における状態だけではなく、意志を示せない状態やそれに近い状態になった場合に備え、前もって終末期を含めた今後の医療・介護についてです。また意思決定が出来なくなった場合を想定し、本人以外の人に代わって意思決定をする人を決めておくことも意味しています。

それに対して終活は自身の死に向き合い、経済面や人間関係についての準備、自分の人生を振替えることも含めておりもう少し範囲が広い意味です。いずれも死について向き合うと言う点では一緒と言えます。

人生会議、みんなやっているの?

実際みなさんはどうなのでしょうか。

平成29年度に厚生労働省が発表した結果のグラフ(*1)ですが、「医療ケアについて家族等や医療介護関係者等とあらかじめ話し合い、また繰り返し話し合うことについて」の是非を調査したところ、65%が賛成であるとの回答をしています。比較的多くの人が人生会議をおこなうことについて前向きであると考えられます。

同様に「どのような医療・療養を受けたいか等を記載した書面をあらかじめ作成しておくこと」についても66%の人が賛成と考えているようです。

その一方で実際に人生会議を行ったり、それに関する行動をしているかですが上記のような考えに準じてはいないようです。

「人生の最終段階における医療・療養に関する家族等や医療介護関係者との話し合いの状況」について、“詳しく話し合っている”または“一応話し合っている”と回答した人は40%にとどまっています。

実際に「意思表示の書面作成状況」についても“作成している”と回答した方は8%でした。
つまり、人生会議について個々で考えたりすることはあっても、家族で話し合うことや実際に準備、対応をしている人は少ないのが現状です。

(*1)引用:平成29年度人生の最終段階における医療に関する意識調査(厚生労働省)を参考に筆者がグラフ作成。小数点以下は四捨五入しています。

人生会議とはどんなことを話し合えばいいのでしょうか…

いざ取り組もうとしても、ではどんな内容を話し合うのでしょうか。答えは自分の人生が豊かになるにはどうしたらいいかを中心に話すことで、難しい内容でありません。
例えば、“こんなことをしてほしい”、“自分はこんなことを大切にしている”と言ったことです。そうすることで自分でも思ってみなかった場面や、気づくことができなかったことが洗い出されることもあります。

同時に、“こんなことはしてほしくない”、“これだけは嫌だ”と言ったことも考え、提示します。

下記のような流れを例とし、話し合いを進めるのもよいでしょう。

● 自分が大切について思うことを考える
    ⇒人、物、思い出、仕事、場所、価値観…
●自分の気持ちを理解してくれる人や価値観を分かってくれる人はだれか、どんな人か、あなたが信頼する人を考える
    ⇒家族、親戚、友人、後見人他…
●あなたを理解してくれる人達と自分の意志を伝える話し合いをする
● 医療者や介護者と上記の話をシェアする
    ⇒自分の意志を話しておく、または話し合いの場に参加してもらう●計画を実行に移す
    ⇒意志表示の書面作成をする等

人生会議は一度でなく何度も繰り返し伝えることが大切です。

時間が経過する上で、考えが変わることは誰にでもあります。そのためにもお互いが理解できるように話し合います。

それでも人生会議に抵抗があるならこんな手も!

それでも「人生の最期を意識した会話だなんて、縁起が悪い」「わからない…」と思われる方もいらっしゃるのでは?その証拠として少ない割合ですが、上記の厚生労働省の調査結果から見てわかります。人生会議について“反対である”、“わからない”と回答された方がいました。そんな方にゲームを取り入れながら人生会議=『もしものための話し合い』をするきっかけになるカードがあります。『もしバナゲーム』の名称販売されています。

人生の最期にどう在りたいか。「もしバナゲーム」

家族のだんらんの時間に、ゲームとして取り組んでみてはいかがでしょうか。話のきっかけにつながるかもしれませんね。

生きていれば誰でも死はやってくるもの、後ろ向きにばかり捉える必要はないのかもしれません。

まとめ

人生会議とは自身の死を選択について考える機会であると言えます。

実際に話し合いを行うきっかけがない方が多いようですが、コロナ禍の今家族で過ごす時間が多い人も多いはず。

少しずつ家族の会話の場に交えてみることはいかがでしょうか。そこで話し合った結果、どう動けばよいか…とお悩みの方は医療従事者、介護従事者に相談するのが最もよい手段です。

専門家のふんだんな経験から、ヒントに繋がります。

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。

終活

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