Abstract
This study aimed to demonstrate how persons with profound intellectual multiple disabilities (PIMD) and nurses, together with welfare workers, communicate with one another and create care at a day care center for persons with PIMD in Japan. The ethnographic method was used. The research participants were persons with PIMD and their mothers, nurses, and welfare workers. The results indicated that care aims at autonomy based on intentions in response to signs. These findings suggest that this practice emancipated persons with PIMD and their mothers from the Japanese "culture of shame" and enable their autonomy.