「グループホームってどういう施設??」 有料老人ホームとの違い
最近は街中でも介護施設をよく見かけるようになりました。
中でも有料老人ホームは、新しく建物から作り始めることが多いようです。
グループホームと呼ばれる施設も多く、一階部分を病院やクリニック、また、デイサービスとして併設し、連携の取りやすいシステムを作る事で、入居される方も安心して過ごすことができるようになりました。
中には古民家を改装して、あえて昔なじみの住居を提供する施設もあり、その多くがグループホームです。
ではグループホームとはどういうものなのか、また有料老人ホームとどう違うのか、説明したいと思います。
目次
グループホームの特徴
グループホームとは、正式名称を「認知症対応型共同生活介護」という介護保険サービスを提供できる老人ホームです。
認知症を患っても、住み慣れた地域で安心して生活する事ができるよう、配慮されております。
① 少人数制
入所者は５～９名の少人数です。
認知症の方は新しく出会った人や、新しく覚えることなどが難しいといわれています。
大きな施設では入所者の入れ替わりも多く、なかなか理解しあえる関係を作る事が難しいものです。
しかし職員を含め、少人数なら関係性を築くのにも適している環境です。
② 施設の設備
できるだけ自宅で住んでいるような共同生活を送る事を目的としているため、施設内は家と同じように、【自分の部屋・リビング・食堂・台所・浴室・居間】が整っています。
もちろんトイレは自分の個室にも、共同用もあります。
③ 役割ができる
共同生活を送るため、家事を分担して行う必要があります。
得意な事を「役割」として持つ事ができ、毎日の生活の中で欠かせない、食事作りや洗濯、掃除など、職員と一緒に行い、認知症の進行を緩和する事ができます。
自分の役割をもつ事で「お世話になるだけ」ではないという気持ちを持つ事ができ、自尊心を回復する事ができます。
④ 認知症ケア
認知症ケアの知識と経験が豊富な職員が多くいます。
日常生活のお手伝いや、精神的なケアまで、職員がしっかりサポートする事ができます。
また24時間、見守りがあるため、入眠中でも安心して生活する事ができます。
⑤ 生活スタイル
ごく普通の生活リズムを崩さないよう、朝から昼には共同で行う家事を、職員と共に行います。
食事の支度や掃除、洗濯など。午後からは入浴をされたり、認知症の方に合わせた音楽療法や回想法などのレクリエーションを行います。
夕食後は各居室で過ごされ、そのまま眠られる生活です。
介護が必要な方にはその都度、職員が対応します。
有料老人ホームとの違い
有料老人ホームでは主に食事、洗濯、清掃等の生活支援や排泄、入浴等の身体介護を行い、機能訓練やレクリエーション等のサービスを受けることができ、国から介護保険制度上の特定施設入居者生活介護の指定を受けている高齢者住宅となっています。又、施設の職員が介護を行う一般型と、外部の事業所が行う外部サービス利用型があります。
有料老人ホームの中にも種類があります。
・介護付有料老人ホーム
・住宅型有料老人ホーム
・健康型有料老人ホーム(ケアハウス)
等があります。
グループホームと有料老人ホームは同じ老人ホームでも、入居条件やサービスの内容などが違いますので、比較してみましょう。
① 入居条件
【グループホーム】
・65歳以上で要支援２、又は要介護１以上の認定を受けておられる方。
※特定疾病を患っておられる場合は65歳未満でも入居可能な場合があります。
・医師に認知症の診断を受けた方、また、過去に診断されたことがある方。
・集団生活を営むことに支障のない方。
・施設と同一の市区町村に住民票を持っている方。
【介護付き有料老人ホーム】
・65歳以上で要支援２、又は要介護１以上の認定を受けておられる方。
※特定疾病を患っておられる場合は65歳未満でも入居可能な場合があります。
・認知症を含め、医療面は施設で対応できる状態の方
・入居金や月額費用の支払いができる方
・保証人や身元引受人がいる方
※地域による制限は特に設けていません。
②入居人数
【グループホーム】
1ユニットにつき9名。 1施設に原則2ユニットまで
【介護付き有料老人ホーム】
多いところでは10名～100名規模
③サービスの内容
【グループホーム】
グループホームは認知症高齢者を対象に特化した施設であり認知症状の進行を遅らせる等を目的とし入居者同士で共同生活を行っていくのが基本。介助が必要な場合はその都度サービスにあたる。
【介護付き有料老人ホーム】
「特定施設」の指定を受けているため、介護保険の範囲内でサービスが行われます。身体介護や生活援助など、利用者の状態に合わせたサービスを提供する事ができます。日常生活やレクリエーションを通してリハビリなども行われております。
④医療体制
【グループホーム】
看護師等の配置義務はありません。利用者は個々にかかりつけ医などの訪問診療を利用します。緊急時などは医療の連携しているため、サポート体制は整っています。
【介護付き有料老人ホーム】
ホーム内の健康管理サービスとして、血圧測定から怪我の処置まで行われており、法令では看護時、准看護士の配置が義務付けられています。
施設によってはクリニックが併設されていることもあります。24時間体制を義務付けられてはいませんが、協力体制は整っています。
運営と費用の違いは？
【グループホーム】
運営：自治体の指定を受けた地域の民間事業。監督は自治体が主体です。
費用：地域や施設によって家賃相場が変わります。
・初期費用（入居一時金や保証金） 数十万～数千万円
・月額介護サービス費（介護度や負担割合による。） 2万円～4万円
・生活費（家賃・食費・光熱費・共益費・おむつ代など） 約15万円
【介護付き有料老人ホーム】
運営：民間企業や社会福祉法人、医療法人、NPO法人など。
費用：土地や建物、介護や医療体制などにより、費用に大きく開きがあります。
高額になると共用設備などで、温泉やプール、ジム等が付いています。
・初期費用（入居一時金） 0円～数億円
・施設介護サービス費（入浴や排せつ介助など行う費用） 1万円～4万円
・生活費（家賃・食費・光熱費・日用品費など） 15万円～（家賃による）
グループホームのメリットとデメリット
メリット
・小規模なのでスタッフも少なく認知症高齢者が混乱する事が少ない。
・認知症について知識のあるスタッフが対応する。
・家事を共に行うので生活は認知症のリハビリにつながる。
・有料老人ホームより費用が安い。
デメリット
・要支援2以上、認知症の診断、住民票がその地域にある方しか入居できない。
・看護師配置が義務ではない為、医療ニーズの対応に限界がある。
・入居待ちが多い為すぐに入れない場合が多い。
まとめ
認知症の方が入居する施設として考えた場合、進行を遅らせる事を目的とするならば、グループホームが適していると言えるでしょう。
ですが持病などが悪化している場合によっては看護師が常駐している有料老人ホームに入居する、又は移り住む必要性が出てくることを視野に入れておく必要があります。
今すぐ老人ホームの入居を考えていなくても、先々の事を考えた時に、どういう特徴かを知っておくことで、本人にとって一番適した住処を選ぶことができます。
「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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