「閉じこもりを解消したい。」両親が家でテレビばかり見て、外にでない
「年を取ったら、家で静かにしていてもいいよね。それのどこが悪いの？」両親から言われ、外出が減り閉じこもり状態が多くなってきました。
加齢による心身の変化で外出するのが怖くなったり、おっくうになったりして、自宅にこもる高齢者は少なくありません。
長期間、閉じこもりの状態が続くと、色々な症状が発症するリスクがあり、要介護にもつながります。ただ、家族などが外出を強引に連れ出すのは逆効果です。
本人が納得し、自ら進んで外出してもらうには、どうすればいいでしょうか。
今回は「閉じこもりの危険性について」「閉じこもり解消法」などをまとめています。ぜひ参考にしてください。
目次
閉じこもりとは？
「閉じこもり」とは、寝たきりなどでないにもかかわらず、1日のほとんどを家の中で過ごし、日々の行動範囲が家の中か庭先ぐらいで、週に1回も外出しない状態を言います。
※閉じこもりチェック
・週に1回以上は外出をしていない→ はい・いいえ
・昨年に比べて外出の回数が減っている→ はい・いいえ
・今日が何月何日かわからない時がある→ はい・いいえ
・（ここ２週間）毎日の生活に充実感がない→ はい・いいえ
・この1年間に転んだことがある→ はい・いいえ
・転倒に対する不安がある→ はい・いいえ
・15分位続けて歩くことができない→ はい・いいえ
２つ以上「はい」になった場合は要注意です。
「外出したくない」原因はなに？
外出が良いとわかっていても、ご本人にも事情があります。
どうして外に出たくないのか、理由を把握していなくては外出をうながすことはできません。
生活のほとんどを家の中で過ごす「閉じこもり」の要因をあげてみましょう。
① 身体的な問題
・転倒や骨折で歩行が困難
・低栄養で体力がない
・難聴で会話が楽しめない
② 心理的問題
・転倒に対する恐怖心
・身近な人と死別し、やる気が起こらない
・色々なことに興味がなくなった
③ 社会環境問題
・家族が外出に連れ出さない
・家の周辺の交通量が多い
・家の段差が多く外に出られない
・家の外に坂道や階段があるなど
・友人がいない
これらの問題が相互に関連して、閉じこもりにつながると言われています。
「閉じこもり」が続くと認知症や寝たきりのリスクが高くなる
外出頻度の減った状態が長く続くと、活動量が減り、心身機能が低下した廃用（はいよう）症候群と呼ばれる状態になります。
悪化すると、認知機能が低下し、認知症や寝たきりになる可能性が極めて高くなります。
※廃用症候群（はいようしょうこうぐん）：過度に安静にすることや、活動性が低下したことによる身体に生じた様々な状態をさします。筋肉の低下、関節の動きが悪くなります。
活動性を低下させることで、悪循環をきたして、全身の身体機能に悪影響をもたらし、最悪の状態では寝たきりとなってしまうことがあります。
日光にあたらないと危険!?
日中、外へ出ないと、陽の光を浴びる機会が減ります。
日光を浴びないと起こる症状
①気分が落ち込みやすい
②疲れやすい
③体を動かしたり、何かをするのがおっくうになる
④集中力の低下
⑤ 好きなことも楽しめなくなる 等
日光にあたることで体内でビタミンDが活性化されます。
ビタミンD：人体にとって重要な骨の健康維持に欠かせない栄養素です。
閉じこもりを防ぐ方法
①規則正しい生活リズムを作る
毎日、三食きちんと食べて規則正しい生活を心がける。
（バランスの取れた食事、十分な睡眠、メリハリのついた生活）
身体のリズムが整いやすくなり、気分が安定しストレス耐性が向上します。
基本的な生活リズムを大事にしましょう。
②家族のサポートも重要
・家での役割を持ってもらう。
・必要以上の制限をしない。
・できることが増やせるように関わる。（手を出しすぎない）
・外出するきっかけをつくる、一緒に出かける。
・一緒の時間を楽しむ。
・外に出る機会を作る
介護サービスや家族のサポートで補う部分が増えてくると、「やることがない」「外に出る意味がない」と外出の目的がなくなってしまいます。
そのような場合は、あえて外出の理由をつくることをおすすめします。
たとえば、公共料金の払い込みは銀行引き落としも可能ですが、あえてコンビニ払いを選んでご本人と一緒に行くのもひとつの方法です。
また、買い物は便利な宅配もありますが、ご本人と一緒にスーパーやコンビニまで行き、自分で買い物をしてもらうと刺激になります。
③趣味を楽しみ、ボランティア活動に参加する
趣味を持つことで仲間と出会えるきっかけになり、人間関係が広がります。またこれまでに得た知識や経験などを活かして、自分が出来そうなボランティア活動などに参加し、自分の役割がみつかる可能性があります。
さいごに
現在、閉じこもっている高齢者にとっては、急な変化が難しい場合もあります。
比較的変化が容易なものとして、「家庭での役割」です。
そこで、家庭で何か一つ役割を持ってもらいます。ゴミ出しや、ちょっとした日用品の買い物は、一度外に出るので、とても効果的です。
難しい場合には、もっと簡単に、「部屋の掃除」「食事の後片づけ」「庭の手入れ」など、家の中できる役割をすると閉じこもりから解消のキッカケにつながる可能性があります。
外出が困難な人は、さまざまな市区町村のサービスを利用しましょう。
身近な活動の場や、集いの場がどこにあるか知りたい人は、お住まいの地域を担当する地域総合支援センターに尋ねてみてください。
「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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