護理之家一位無望感住民的護理經驗

Nursing Experience with a Hopelessness Case in a Nursing Home

本篇報告主要在顧於分享照顧一位遷移至護理之家住民嚴重憂鬱與無望感之護理經驗。個案因羅患腦血管疾病造成身體功能障礙及外觀改變，導致拒食、不理人，又因遷移至陌生環境產生的限制及目睹室友的急救過程，形成社交完全中斷，嚴重憂鬱、無望與完全自我放棄。經由觀察個案行為與情緒改變、及與家屬、工作人員、機構主管溝通後，擬定照護措施。護理措施包括傾聽、身體觸摸、環境改善與安排個案回家等。在家屬、機構與筆者的配合之下，個案在一次開始打開心胸，在一般的互動中已開始能表達個人感受。

The purpose of this paper is to share a nursing experience with a nursing home resident who was severely depressed and felt hopeless because of being relocated to a nursing home. Due to physical function impairment and appearance change caused by cerebral disease, she refused food intake and interaction with others. In addition, she totally shut down her social interaction, behaved in severely depressed and hopeless manner, and gave up on herself over a short period of time because of her relocation to nursing home and seeing her roommate die during CPR. A nursing care plan based on observation of the resident's behavior and mood change was formulated, communicated to family and staff, and negotiated with the manager of the nursing home. Diverse nursing interventions were provided, including listening, physical touch, environmental modification, and arranging for her to go home. Through family, staff and nurse cooperation, the resident began to re-open her mind and expressed some feelings when interacting with others.