ケアリングと教育 : 痴呆高齢者介護倫理の変容と実務者研修・教育(<特集>教育における臨床の知)

抄録

Since the 1980's, the concept of 'caring' has been used in the United States and England.The paradigm of nursing care for the sick, taking care the aged and people with mental disorders have been sifting from'care'to 'carein'.Though 'Care'is, for example, traditional nursing care based on the 'medicalmodel'(help with eating, taking a bath, evacuation, etc), 'Caring' is based on the socalled 'life-support model', aiming towards mental and emotional rest and the development of A.D.L.(centering on the relationship between tendersand the tended people, in which behavior the good relationship on the mutual behavior and act between both sides have to be accomplished with affection, help, and sympathy.)Since the 1990's in Japan, similar tendencies have been applied in such fields, which means the shift from mass-care to unit-careing (formed by several menbers less than 10 persons) has occured.Unit-caring movement started on the civilian sector, and then recently, government sector promoting the 'caring' concept and its movement.It is very important for the tenders to create the 'whereabout' of the tended persons, to acquire the competence and skills to consider thier identity, will and motivations of old age, and to understand them with open mind at the encounter 'here and now' as a subject of 'doing'.As a result, presently, paradigm-shift from 'care' to 'caring' is being applied through study and training courses in Japan.In this paper, I consider the paradigm-shift from 'care' to 'caring', which have been applied to taking care of dementia old age.Also, I attempt to order the process of constructing 'caring ethics' on such a background, as well as to enlighten the matter with the training and curriculum for practical workers.Next, I mention the circumstances of nursing care of the old aged with dementia and the importance of 'caring' competence and skills.Finally, I analyze the logical meaning of this new 'caring' paradigm, using the data by 'process-record method' which was presented in the training for professional caring workers in the 2001 current year in 'K' city in Japan.(*'Process-record method' were suggested in a field nursing care mental disease, noe this method has been expended in all nursing care.The Wiedenbach's method is the following format constructed by 1)talk and behavior of clients, 2)the reaction of the trainee, 3)the responsible reaction of trainees 4)simultaneously considering time)