わが国における高次脳機能障害者支援の現状と課題

This paper describes current status and issues of the social security system for persons with higher brain dysfunction in Japan. Brain injuries often create impairment or disability which can vary greatly in severity. The acquired brain injury be called a "higher brain dysfunction" in Japan. The Ministry of Health, Labour and Welfare started model project for supporting persons with higher brain dysfunction in 2001. The model project created the diagnostic standard, the rehabilitation method, and the consultation support system. Now, The higher brain dysfunction is set as the object of a medical treatment fee system or a social welfare system. The organization which supports persons with higher brain dysfunction specially is specified by all prefectures, and the support coordinator is stationed there. The number of consultations is 47 /100,000 population/year. While persons with higher brain dysfunction support progressed, mental burden of the family and support coordinator became a problem. In particular, it is suggested that 57.6% of families suffered from depression, and 13.8% of support coordinators tended to burnout. Moreover, there is no cooperation with the dentistry and the medical department which support comprehensively persons with higher brain dysfunction of oral health dysfunction. From now on, construction of a new social system to such subjects will be desired.