福祉用具って何？何のため？気になる福祉用具の使い方
福祉用具と聞くと「車椅子」や「介護ベッド」などを思い浮かべませんか？
介護保険サービスで利用できる福祉用具貸与には実はたくさんの種類があり、「杖」一本から、レンタルする事ができます。
では福祉用具とはいったい何なのでしょうか。
今回はもっともよくレンタルをされている、人気ベスト３の福祉用具を紹介
「正しい使い方」
「適切な選び方」
「実際に利用した感想」
などを紹介したいと思います。
目次
杖
杖は、筋力がおちて歩くことが難しくなった方や、ひざ痛など、足の不自由な方にとって、自力で歩くための道具です。
いわば杖は「３本目の足」のようなもの。本人の体型に合ったものを選ぶことが大切です。長さや重さ、握りやすさなど、無理のかからない物をお勧めします。
使いやすさも大切ですが、まずは使用する本人が「便利だから使ってみたい！」と思ってもらえるように、正しい使い方を知って頂きましょう。
・正しい使い方
①持ち方
杖は利き腕で持つ物と思うかもしれませんが、そうではありません。
杖は利き手ではなく、「痛みがない側の手」で持つのが基本です。
・左側の足や腰に痛みがある場合は「右手」
・右側の足や腰に痛みがある場合は「左手」
②握り方
杖によってもグリップの形に違いはありますが、基本的には同じです。
シャフト（柄の部分）の中心にしっかりと重心がかかるように、握ります。
その際、人差し指と中指でシャフト部分を挟むようにすると、普段の歩行状態に近い状態で歩く事ができます。逆に、人差し指を伸ばして持つと、体重をかけやすくなり、ゆっくりと歩くことができます。
③歩き方
足の痛みや歩き方によって、杖の使い方も変わってきます。今回は一番ポピュラーな「３動作歩行」を紹介します。
（A）痛みのない側の手で持っている杖を前に出します。
（B）痛い側の足を一歩出します。
（C）痛くない側の足を一歩出します。
この歩き方を連続する事で、前に進むができます。通常の歩行ではどちらか一本の足で支えますが、「３点動作歩行」では、常に足と杖の２点で支える事ができるため、安心して歩くことができます。
・実際に使ってみた感想等
以外に思うかもしれませんが、「使うのがはずかしい」という意見が一番多くあります。「杖を使う＝年をとった」と自分で認めることになってしまい、人前で使うことに抵抗があるそうです。
ここでは実際に使った方の感想を紹介します。
「歩くことに不安があったが、これなら安心して外出ができる」
「止まっている時でも体重を分散する事が出来て、膝の負担が減った」
「豊富なデザインがあり、他者との会話の糸口になった」
など、良い意見がたくさんありました。一方で、「足先に当たってしまい、歩きづらい」「体重をかけるのが怖い」 「足は楽になったが、腕が痛くなってきた」など、使い方によっては窮屈に感じる方もおられます。
車椅子
車椅子は、体の痛みや機能の障害によって、歩くことが困難な方の「移動」を助けるための福祉用具です。目的や意義はたくさんありますが、屋内屋外を問わず、歩行機能を代替するものです。そのため、用途によってたくさんの種類や機能があり、今現在も新しい種類の車椅子がどんどん開発されています。
基本的には、介護認定で「要介護２」以上の方がレンタルする事ができます。
・正しい選び方と使い方
車椅子はたくさんの種類があります。今回はスタンダードな物を紹介し、特徴を説明させて頂きます。
①自走用車椅子
本人が操作するタイプです。椅子の両脇にあるハンドリム（車輪に付属する輪）を押したり引いたりして、行きたい方向へ進みます。タイヤを止めるストッパーはありますが、ブレーキは介助する持ち手にしかありません。そのため、本人が手でスピードを調整する必要があります。
②介助用車椅子
介助者が操作するタイプのものです。そのため、本人は動かすことができません。ハンドリムはついておらず、タイヤも小さいのが特徴です。ブレーキも介助する方が使えるよう、背中の押し手の部分についています。
③電動車椅子
電動モーターで車輪を動かすタイプです。バッテリーが搭載されているため、とても重く、一人では持ち運びはできません。十字レバーで操作するものが多く、使用するには練習が必要です。屋内では広さも必要ですので、生活スタイルによって選ぶ必要があります。
※このほかにも「ティルト式車椅子」「リクライニング車椅子」等があります。
・実際に使ってみた感想
車椅子は多くの場合が「使わなくてはならない状況」の方が多く、抵抗などは少ないようで、多くの方が便利に感じておられるようです。
使い心地はそれぞれ感じ方が違うため、少し紹介します。
「座面が硬く、お尻が痛くなる」
「段差を超えるのが難しく、一人で出かけるには不安がある」
「地面が低いので、ゆっくりでもスピードが出ているようで怖い。」
「地面のボコボコなどでも振動が直にきて、気持ち悪くなる。」
車椅子は本人と介助する側の目線が違うため、感じ方に「大きな違い」が出てきます。特に高齢者は介助を受けていると、気を使って口にしない事も多く、こればかりは、実際に乗ってみないと乗り心地はわかりません。
本人に気持ち良く利用してもらうには、介助者も車椅子の特徴を知っておくことが大切ではないでしょうか。
介護ベッド（特殊寝台）
介護ベッドとは、自分で身体を起こすことが難しい方や、立ち上がる時の補助やサポートができるベッドです。サイドレール（手すり）を取り付けることができます。電動タイプは背部や脚部の角度調整や高さ調整をすることができ、家族や介助者の負担を軽減する事ができます。
基本的には、介護認定で「要介護２」以上の方がレンタルする事ができます。
・機能の説明
介護ベッドには大きく３つの機能があります。この機能を知っておくことで、選び方が変わってきますので、説明します。
①背上げ機能
背もたれを好きな位置まで上げることができ、体を起こしやすくすることができます。読書やテレビが見やすくなったり、食事もすることができます。
②脚上げ機能
背上げをした時に、体が下にずれることを防ぐことができます。また、血流が悪い方なら、脚上げをすることで、脚のむくみを改善する事ができます。
③高さ調節機能
使用する方が楽に立ち上がる事ができ、座っている時には座面がちょうどいい高さに調節する事ができます。また、車いすなどに移り変わる時にも移乗先の高さに合わせることができます。
万が一、転落した時の不安の軽減や、家族や介助者の腰の負担も軽減する事ができます。
・正しい使い方や選び方
こちらも用途によって、選び方が変わってきます。主に介助が必要な方が多いため、本人だけでなく。家族や介助者のことも考慮して選ぶ必要があります。
上記で説明した機能を、目的に合わせて選ぶことが大切です。
基本的にはリモコンのボタンで操作するため、本人が使用される場合は、必ず説明が必要です。ボタンを押し間違えただけでも、事故につながる事もしばしば見受けられます。できるだけ、家族や介護者が行うか、見守りのもと操作する事をお勧めします。
① 特殊寝台(モーター数1つ)
ベッド下にモーターが取り付けられており、リモコンで操作します。「背上げ機能」、もしくは「高さ調節機能」のどちらかを選ぶことができます。
② 特殊寝台(モーター数2つ)
「背上げ機能」と「高さ調節機能」の両方が使用する事ができます。
③ 特殊寝台(モーター数3つ)
「背上げ機能」と「高さ調節機能」に加え、「脚上げ機能」ができます。
④ 特殊寝台(モーター数4つ）
３モーターに加え、左右に傾け、寝返りを補助する機能が使用できます。自力で寝返りができない方や、褥瘡（床ずれ）がある方などは、定期的に体位を変える必要があります。そのため、タイマーをセットし、自動的に左右へ寝返りを支援できるベッドもあります。
⑤モーターなしベッド
最低限の簡易式ベッドです。付属品としては「サイドレール（手すり）」や「マットレス」などが設置可能です。転落防止や、起き上がりの時に支持物としてサイドレールが活用できます。また、マットレスにより、寝心地だけでなく、動きやすさや体圧を分散する事ができます。
※上記５点、のベッドはモーターが付いてある事が前提で「特殊寝台」と呼びます。
家具屋などで販売されているモーターが付いていないベッドは「特殊寝台」
とは呼ばない商品となり、介護保険を使ってのレンタルは出来ません。
※モーターだけでなく、体格に合わせたベッドの大きさも大切です。
また、体圧を分散させることができる「エアマット」がセットされたベッドもあります。
・実際に使ってみた感想
電動の介護ベッドにおいては、本人や、家族、介護者の反響も紹介します。
【本人】
「背上げ機能は、自分で操作できれば加減ができるが、人にやってもらうと、落ちそうな感覚で、少し怖い」
「横幅が狭いと、落ちそうな気がする」 「寝相が悪いので、あちこちで身体をぶつけてしまう。」
【介護者】
「高さが調節できるので、介助の時は腰の負担が減った」
「体調に合わせて、ベッドでの食事ができるので、とても便利」
「購入に比べ、レンタルの方が経済的にも助かる。」
介護ベッドにおいても、本人と家族や介護者の視点は異なるため、意見に違いが出てきます。こちらも車椅子と同様、体感しない事には良し悪しはわからない。ものです。ベッドは長い時間使用するため、安心感や使い心地が、もっとも気になる部分ではないでしょうか。
まとめ
福祉用具は実際に体感してみないと、良さも悪さもわかりにくい物です。
どんなに便利に感じても、その用途に合わさなければ、かえって不便に感じる事や、怖く感じてしまうものもあります。
また、正しい使用方法を知っておかなければ、重大な事故にさえつながってしまいます。
福祉用具のレンタルは介護保険サービスなので、ケアマネージャーや福祉用具の担当者との相談が必要です。使用するのはご本人ですが、家族や介助者も使い方や、本人の身体の事をわかっていないと、せっかく便利な物なのに、効果も半減してしまいます。
そうならないためにも、福祉用具をレンタルする時はできるだけ、本人と同席し、一緒に使ってみることをお勧めします。それだけでも、使用する方の気持ちがわかりますし、今日、紹介した感想なども直に感じる事ができるようになります。
福祉用具とは、ただ、便利な道具というわけではありません。使うことでより安全に、より意欲的に生活をしていくための物です。
そのため、身体の状態や本当に必要な物を使用してもらえるよう、本人の事を知る必要があります。
ご両親の事が心配で、福祉用具レンタルを考えておられるなら、まずはご両親との関わりを増やし、何気ない会話の中から、今、必要としている事をくみ取ってい 食事が重要ではないでしょうか。
使い心地や安心感は人によって違うため、本人も家族も納得のいく福祉用具に出会えることが大切ですね。だからこそ、福祉用具は「レンタル」なのかもしれませんね。
「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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