減緩日間照護失智症患者認知功能退化之改善專案

Project to Ameliorate Cognitive Function Deterioration in Day Care Dementia Patients

背景：失智症認知功能退化是本單位最常見的現象，除了對人、時、地、物等定向感產生混淆外，記憶、語言及辨識等能力變差，影響人際互動及日常生活處理能力，而造成人力、物力更多的負荷。目的：本專案旨在減緩失智症者認知功能退化，提昇對周遭環境事物之辨識力。解決方案：自2007年1月1日至2007年6月30日，實施照護人員教育訓練、訂定照護規範及環境改造（設計現實導向板、時鐘改造及增加圖相標識），以及重新規劃活動設計與執行，並公開表揚執行力最佳者，而執行最不完整者則由護理長予個別輔導。結果：24位失智症患者認知功能平均得分，由6.58±3.19降至5.11±3.20，改善1.47分；而廁所、個人床、衣櫃、用餐位置及時間等定向感之辨識錯誤平均發生率由38%降到13%，改善了25%。結論：經由本專案實施照護人員之失智症照護教育訓練，增進照護知識與技巧，並改造環境設施等經驗，進而達到提昇患者認知及辨識力，可做為失智症照護機構人員之參考。

Background & problems: Deterioration of cognitive functions, including disorientation related to people, time and place, loss of memory, and deterioration in interpersonal skills, is very common in dementia patients. Expense of care rises as conditions worsen.Purpose: The authors designed this project to ameliorate the deterioration of cognitive functions and enhance cognition in daily life.Solution: The project was carried out between Jan 1, 2007 and June 30, 2007. The three strategies used included: (1) educating staff and establishing care guidelines; (2) introducing environmental keys such as a reality-oriented board, clock information, photo labels, and image signs; (3) redesigning and implementing daily activities.Results: Following the intervention, average cognitive functions improved from 6.58±3.19 to 5.11±3.20 (total: 10). The mistaken recognition rate for items including the toilet, personal bed, clothes closet, meal seating position and time decreased from 38% to 13%.Conclusion: This project significantly improved cognitive function and recognition in dementia patients. The experience described within may serve as a reference for dementia institutions and healthcare workers.