Vaccination of the new coronavirus requires the consent of the person, and if it is difficult to confirm the intention due to dementia etc., it is required that a close person such as a family member get the intention, but contact with a close person such as living alone. In some cases, it is difficult to get rid of it, and we are still searching for ways to confirm our intentions.
Vaccination requires the consent of the person, but if it is difficult to confirm the intention due to dementia, etc., the Ministry of Health, Labor and Welfare requires that people who are close to us, such as family members and people involved in the facility, carefully understand their intentions. ..
However, some people with dementia or suspected dementia may find it difficult to contact their families due to living alone, and some people who provide support complain of the difficulty.
One of them is Hidenao Tamai, a social worker who provides free welfare consultation in Yokosuka City, Kanagawa Prefecture.
Since the beginning of May, when reservations for vaccination began in Yokosuka City, Mr. Tamai has received a series of consultations from the elderly, confirming his intentions for about 200 people, and making reservations together. That is.
On the other hand, among the consultations, there were 9 elderly people with dementia or suspected dementia, and some of them contacted their relatives and vaccinated, but for reasons such as not being able to find someone close to them. It means that there are still three people who cannot confirm their intentions.
According to the Ministry of Health, Labor and Welfare, it is estimated that the number of dementia patients in Japan will exceed 6 million as of last year, so the field of support continues to seek how to confirm the intention of vaccination.
Difficult to support
Hidenao Tamai, a social worker in Yokosuka City, who accepts a wide range of consultations on living from local residents, has been accepting elderly people since early May when the city began accepting vaccination reservations for people aged 80 and over. There was a series of consultations about the content of inoculation and how to make a reservation.
So far, about 200 people have confirmed their intentions and made reservations together.
On the other hand, some of the elderly people who consulted were suspected of having dementia or dementia, and it was difficult to confirm their intention to vaccinate.
For this reason, we decided not to make reservations on the spot for nine people, but to look for people close to them in order to understand their intentions.
Of these, a 77-year-old woman with dementia who lives alone in a prefectural housing complex was contacted by her eldest daughter, who Mr. Tamai knew, and had completed two vaccinations by last month.
A 77-year-old woman said, "I couldn't get the vaccine without my daughter and Mr. Tamai. Thank you."
On the other hand, there are cases where it is difficult to communicate with the person and it is not possible to trace people close to him, or even if he can find someone close to him, he cannot grasp his intentions, so Mr. Tamai visits regularly. We continue to search through activities.
In the case of an elderly woman who lives alone in a prefectural housing complex and is suspected of having dementia, Mr. Tamai contacted a relative living far away, but was told that it would be difficult to support vaccination.
I have been asking this woman since then, but I haven't seen her, and she says she doesn't know the status of vaccination.
Mr. Tamai said, "Even if I have relatives, it is difficult to ask for them because they are estranged. I have been in this situation since then, but I have been absent and I am worried about what happened."
In addition, elderly couples suspected of having dementia in the same area also asked if they had been vaccinated, but answered, "What is the vaccine?", Which means that communication is difficult.
During the conversation on this day, I finally found out that I had a child, so I will try to follow the contact information in the future.
Mr. Tamai said, "We have no choice but to continue to build relationships of trust and support while making steady visits. Efforts and mechanisms that can reach out to those who need it without asking for help. I think we need it. "
What is confirmation of inoculation intention?
Vaccination of the new coronavirus is a practice rule based on the Immunization Law, which states that the effectiveness and safety of vaccination and side reactions must be explained to the person receiving the vaccination and written consent must be obtained. increase.
In addition, when it is difficult to confirm the intention due to dementia, etc., the Ministry of Health, Labor and Welfare stated in a notification to the local government, "Depending on the situation, the cooperation of people who are close to us, such as family members, family doctors, and facility workers. To confirm the person's intention by carefully grasping the person's intention to inoculate. "
On the other hand, the "Japanese Society of Clinical Ethics" created by doctors and others has compiled a guide on how to confirm specific intentions.
The guide states that the most important thing is the judgment of the person, so it is important to confirm without prejudice whether or not he / she has the ability to make decisions.
On top of that, if the person's intention cannot be confirmed, a family member who knows the person well will make a decision on his behalf.
In that case, the person's intention is estimated based on the way of thinking, values, vaccination history, etc., and the best interests are considered.
In addition, if there is no relative or contact with family members, medical care teams created by various occupations will discuss and decide.
Expert "Need a mechanism to connect medical care and life support"
Dr. Mako Minooka, a director of the Japanese Society of Clinical Ethics, who is familiar with medical and ethical issues such as dementia care, said, "I think that the number of such elderly people will continue to increase. Everyone has the right, and it may be a problem not to be vaccinated just because he or she disagrees or does not have a family member who agrees instead. "
He added, "This problem is not only a medical problem but also a life support problem, and I think we need a mechanism to connect medical care and life support as a series without separating them."