米国の図書館による認知症高齢者への教育事業の特徴と課題 : イリノイ州の公共図書館地区によるアウトリーチプログラムの考察と我が国への示唆

本稿は，米国イリノイ州にある公共図書館地区の一つが介護施設で実施している認知症高齢者を主たる対象にした教育プログラムを取り上げ，現地調査及び資料分析を通じてその特徴と課題を明らかにすることを目的とする。米国では，今後数十年間に急増する高齢者を見据え，様々な分野において高齢化に関わる議論や取組が存在する。とりわけ認知症の問題は，当事者だけでなく，それにまつわる社会コストや介護者への負担の大きさ等から深刻な影響が懸念されており，図書館もその対策に積極的に関わっている。米国の公共図書館の中には，認知症者の症状に見合った図書館資料を慎重に吟味し，それらを効果的に活用した教育プログラムの提供により，認知症高齢者の認知機能や社交性，介護者との関係性，介護者の認知症者に対する意識等に肯定的変容をもたらしうる事例があることが判明した。今後の課題として，より良い成果に向けたプログラム内容・方法の再検討，実施者の持つべき専門性に関する熟慮，認知症者にとっての学習及び図書館資料の持つ意味の概念整理と学術的追究，図書館の独自性と本事業に関わる意義の整理等があることが抽出された。米国よりはるかに高齢化の進行する我が国では，既に図書館内で認知症をめぐる問題が顕在化しており，米国のようにきめ細かなプログラムの開発やその実践は容易ではない。とはいえ，図書館資料の注意深い吟味とその効果的活用，認知症事業へのボランティアの積極的活用等，対応が考えられ得るものもある。諸外国の事例にも学びながら，多様な人々を包摂する社会の実現に向け，図書館の持つ潜在機能をより精緻に追究する姿勢が望まれる。

This paper intends to clarify features and implications of libraries’ educational programs for those living with dementia, focusing upon outreach programs held at local health care facilities provided by a public library district in Illinois, US, utilizing its library resources. A short site visit was conducted by the author in August 2018, involving participatory observations of the programs, informal conversations with those who have developed and conducted these programs, as well as with volunteers, and brief paper analysis in order to give an overview of the program. Since the US is expected to face a sharp increase in the number of elderly people over the next few decades, there have been earnest activities, discussions and practical schemes in various fields to cope with this. Above all, the issue of dementia is considered as one of the most difficult to tackle, given its tremendous social cost and negative impact on patients and caregivers. As a familiar educational institution, public libraries have been playing a vital role in approaching those who are living with dementia, by developing meaningful programs with careful selection of library resources and putting them into practice effectively by various means across the US. As a result, several positive effects on both patients and caregivers have been reported, such as increased cognitive and social interaction shown by patients, improved relationships between individuals with dementia and their caregivers, and less of the stigma associated with dementia. It is being proved that libraries have much potential to improve the quality life of those who tend to be isolated from the local community. From an educational viewpoint, some findings suggest ideas for future work, including: more reflection on content and methodology to improve the programs, particularly by hearing about feedback on the programs from those living with dementia; more deliberations on the special knowledge and skills required to conduct these types of program; the need to define the meaning of learning and/or meaning of library materials for those with dementia in participating in programs of this kind; the necessity for research on these themes from several different academic fields and from a long-term viewpoint; and more serious consideration of what it means for a library to be engaged in this kind of service, and its distinctive role in light of the service’s original nature, etc. Compared to America’s, Japan’s public libraries have already been encountering a number of problems caused by those with dementia using the libraries, due to the high proportion of older adults in society across the country. There has therefore been a pressing need for Japanese librarians to acquire special knowledge and skills to understand and communicate with those with dementia appropriately. It would be hard for Japanese librarians to find the time to focus on programming, due to lack of human resources, time constraints, and the need to deal with many other elderly users with unspecified needs. However, it is still possible to learn some lessons from American librarians, such as their devotion, their well-thought-out, flexible and careful selection of useful library resources for those with dementia and caregivers, and the effective way in which these programs are conducted, which includes inviting volunteers to help run the programs, etc. It is suggested that Japanese libraries should continue to investigate how to become dementia-friendly at a deeper level by learning from other advanced countries in this field, with a view to including a greater diversity of people in society.