Skills in Caring Dimentiated Persons' Main Obstacles in Creating Self-Decisive Life and Optimum Organization of Such Caring Skills

研究目标大致分为两个方面：(1)支持老年痴呆症患者自主生活决策的专业技能的背景和内容；(2)不同类型专家的这些技能的最佳组织。方法目标是寻找护理资源及其公平提供制度的规范性推理和原则基础。项目的第一年和第二年主要围绕以下问题进行研究：(1)分析护理工作的知识和技能构成，将这些知识和技能作为福利分配的核心资源进行评估；(3)对这种分配提供制度的规范性正义进行合理假设。第三年也是最后一年是在这个问题上(2)，特别关注在护理过程中治疗和护理功能的无缝整合，并对芬兰最先进的案例之一进行了实地研究。三年来的研究成果如下：(1)对痴呆临床类型研究、医保与非医保优化与选择研究、社会养老服务在养老过程中的领域与作用研究进行调查分析（终报告第1章）。(2)规范推理在逻辑上是为了批判性地评估护理技能作为一种核心的社会和制度资源，以增强来访者对其生活的自主管理，同时也是为了证明这种资源的公正和普遍分配供应系统的合理性（第2章）。(3)通过重新审视世界卫生组织章程中关于健康的积极术语，作为个人活力的整体状态，对“健康”的修订解释作出了呼吁。基于对“健康”的这种重新解释，报告的第三章指出，预防性主动护理的新理念有助于即使在痴呆症过程的第四阶段也能持久成功地维持生活。(4)在这一积极的健康术语的基础上，报告的4^< >章对护理专家的知识和技能进行了假设分类，并论证了将隐性知识和人类感官的功能引入护理人力资源开发领域的必要性。(5)分析不同类型的护理工作者在护理过程中的技能内容和联系（Ch.5）。这项研究尚未完成的意义是，它把关键的和目前正在进行的联网问题留在以社区为基础的老年痴呆护理全面一体化的框架内。少

The research targets are roughly categorized in two fold : (1)the contexts and contents of the expertise skills for supporting clients' autonomous decision of life in the area of dementiated persons' care, and (2)an optimum organization of such skills of different type of experts. Methodological target has been on finding a normative reasoning and principle base of the care resources and its fair provision system.First and second years of the project were spent on the issue(1), to analyze knowledge and skill composition of the care work, to evaluate such knowledge and skill as a core resource of welfare to be distributed in fare, and (3)to create some reasonable hypothesis of the normative justice in such distributive provision system. The third and final year was on the issue(2), with special focus on a seamless integration of the cure and care functions in the caring process with performing a field study on one of the most advanced case in this : Finland.Achievements of the three yea … More rs research are briefly as follows.(1)Survey and analysis is done on the researches of clinical typologies of dementia, of the optimization and choices between medicare and non-medicare, and the area and role for social care service within the care process (Ch.1 of the final report).(2)Normative reasoning is logically constructed for the critical assessment on the care skills as a core social and institutional resource for enhancing clients' autonomous management of their life, and also for the justification of impartial and universal distributive provision system of such resources (Ch.2).(3)Ad vocation is made on the revised interpretation of ‘health', by revisiting to the positive terminology on what is the health in the WHO constitution, as a holistic state of liveliness of individual. Bases on this re-interpretation of ‘health', the chapter three of the report points that new idea of preventive-proactive care is useful for the ever lasting successful running of life even at the forth stage of dementia process.(4)Having this positive terminology of health on the base, the 4^<th> chapter of the report goes to hypothetically categorize knowledge and skill of the care expert and to argue the necessity to bring the functions of the tacit knowledge and human sensory into the field of care human resource development.(5)Analysis is made on the contents of the skills and linkages in between different types of care workers in the process of care (Ch.5).The research is not yet completed in the sense that it lefts the crucial and currently moving issue of the networking within the framework of community-based comprehensive integration of the care for dementiated older persons. Less