訪問介護のコロナリスクとコロナ対策
2019年末から未曽有の社会問題となった新型コロナウイルス感染症（COVID-19）在宅介護でのコロナ感染の危険をお伝えいたします。
目次
ヘルパー自身が感染媒体になる恐れ
ヘルパーさんにも常勤のヘルパーさんと非常勤の登録ヘルパーさんがいます。
登録ヘルパーさんの大半が複数事業所で掛け持ち登録されている方がおります。
また、同じ事業所であっても、１回のサービス提供がだいたい６０～９０分ぐらいですので、１日に何件かの利用者宅を定期的に回って行きます。
多い方で５～６件も訪問される方がいます。
ほとんどのヘルパーさんは事業所からマスク、消毒液、プラスチックグローブ等、感染予防のための衛生用品は支給されており、利用者宅を入室前後には感染症予防は徹底する教育・指導はされています。
さすがにプラスチックグローブは使用後にすぐ捨てますが、マスクなんかは同じもので一日動きます。衣類に関しても同じです。
そう考えると、ホームヘルパーさんが感染媒体になる可能性も少なくないです。
そのため、入室前後の手洗い、消毒は必須になってきます。
よく消毒と手洗いをごちゃ混ぜにして考えてしまって、消毒したから、手洗いしたからと、どちらか片方だけされることがありますが、手洗いして消毒も必要になります。
先日、こんな質問がありました。
「ご利用者と通院に行ったんですが、病院側はプラスチックグローブされてますが、同じグローブで、前の人を対応（ファイルを触ったり等）して、そのまま、グローブを変えずに次の方の対応してますが、それって意味ないんじゃ・・・」と。
その通りです。
患者さんやお客さんの立場で厳密に言えば、毎回付け替えて接するのが本来重要かもしれません。
ですが、自分の身を守るのであればグローブを付けたままです。
医療従事者でもその対応です。
しかし、毎回、対応してたら備品も持たないでしょうし、多くの方が来られる大きい病院なら物理的に難しいと思います。
ですので、病院だから大丈夫ではなく、自分の身は自分で守るのが一番と思いました。
誰がどこでいつ新型コロナウィルスを感染するかは、ヘルパーであろうとなかろうと平等にリスクがあるという事であり、そのリスクを背負い、渡り歩いていることが必要です。
マスクや手洗い・消毒に慣れない高齢者
現場でたまに聞くのは、いくら高齢者にマスクの重要性を訴えても、なかなか理解してくれない。
特に認知症のある方は簡単に外してしまいます。
物のない時代を生きてこられた感覚として、使い捨てはもったいないというのがあり、サージカルマスクを何回も使い回しをする方が大変多いです。
また、布マスクも数回使用して汚れたら洗うという使い方をしている人が結構見受けられました。
合わせて、定着しない高齢者の手洗い習慣があります。
ご自宅に洗面所がないお家も多くあり、手洗いができにくい環境があります。
また外出からの帰宅時に手洗い習慣が身についておられない方が思いの他多く、ヘルパーから何度訴えても忘れてしまう方がいらっしゃいます。
高齢ヘルパーが抱えるコロナ禍でのサービス提供の不安
連日、テレビ報道でも飲食業界が深刻なダメージを受け、閉店になり従業員も解雇と大変な状況であるとお聞きしますが、ではそこで働いていた方々が介護業界に流れるかというと、一部転職されてこられる方もいらっしゃいますが、なかなか難しい状況に変わりはありません。
また、現在働いているヘルパーさんもご自身が７０歳以上の高齢ヘルパーさんが増えており、中にはご夫婦で住まれてるヘルパーさんは、家族にコロナ感染の可能性が拡大するのを今は避けたいと、一時お仕事を休まれる方もいます。
ヘルパーのサービス業務で入浴介助や排泄介助、食事介助といった身体介護サービスは、どうしても高齢の方や障がいをお持ちの方と接触するお仕事ですので、感染リスクが高くなります。
また施設でのクラスター対策は大事ですが、合わせてご自宅へ伺う訪問介護もリスクは高くなります。
ご自宅からご自宅へと連続してサービス提供に動くことが多く、移動の多いヘルパーさんで日に６件程ご自宅に伺いますので、「感染リスクを背負ったまま、自身が感染媒体になって移動しているのでは？」
「その状態で自宅に帰る自分は、高齢の家族に移すのでは？」との不安を感じていることがあります。
今の状況下が続くと、もともとの介護業界の人材不足に合わせて、今従事している方がいつまで働き続けてくれるか・・・と不安ですね。
東住吉介護センターの対応
訪問介護での対応は、昨年コロナが流行し始めた時、すぐさまヘルパーさん全員へ追加のマスク・消毒・非接触型検温計を無料配布しました。
■高齢ヘルパーさんにも安心して業務継続取り組み
① コロナ対応の相談がある時、職員やマスメディアによって違う見解や意見で振り回さないためにとコロナ相談窓口を一本化
② 陽性者や濃厚接触者が出た場合の決めごとを作成
③ 休みたい時は若手社内職員で対応できる体制
④ コロナ関係で休む際の給料補償
を行いました。
■感染症予防の意識、知識向上の取り組み
① オンラインができる職場環境の整備
② 感染症専門家によるオンライン研修は毎月開催
しています。
■社内環境整備
① 業務の一部オンライン化
② 飛沫防止の透明カーテンや透明防止ボードを設置
③ ご利用者やご家族が相談に来られた際の感染予防をした相談室へ再構築
④ マスクや消毒液、体温計、PCR検査キット等の必要備品の備蓄
を行いました。
まだまだ取り組める内容はあると思います。
今後、感染症だけなく自然災害含め不測の事態が起きても、ご利用者の皆さんのサービス継続していけるため、社員さんが安心して働き続けるため、業務継続計画（BCP）に会社一丸で取り組んでいきます。
まとめ
新型コロナウイルス感染症は現在変異種も増えております。
今後も様々なウイルス対応は無くなることはありません。
高齢の方や障がいをお持ちの方の生活を守るために、介護事業所は人材不足を乗り越えて、息長く存続していく対策（感染症対策含む）を、今この時にしっかりと計画していく必要があります。
改めて様々なウイルスと向き合う事重要です。
ウイルス対策や、コロナ渦での家族の介護についてご相談をお受けしております。お気軽にご連絡お待ちしております。
「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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