運用中、晚期失智者照護需求建構護理之家－－以舊有醫院建築體改建為例

Building the Nursing Home to Meet Middle and Late Stage Dementia Residents' Care Needs: The Example of Remodeling the Building Structure of an Existing Hospital

「失智症」是屬於老年人的退化性疾病，隨老年人口的增加有逐年增加的趨勢。而中、晚期失智者因異常行及日常身體功能受損，需要外力協助，故依其需求建構安全、自我、人性的護理之家，做有效的收療與安置，實乃社會當前最重要的課題。文內以440坪的舊有病房改建為失智者照顧機構為例，描述護理人員在構思建築空間的過程，運用中、晚期失智者之照護需求與行為模式，結合空概念與美學藝術，將整體建築特性、個人化居家情境、住民安全、知覺成刺激、多元化交誼休閒空間及公共服務設施與裝備整多方面，列為失智者環境建構設置之要點，並做深入的剖析與探討，同時將此寶貴的經驗，與有意投入失智者照顧行列的護理人員分享，做為機構規劃設計之參考依據，同步提昇服務的「質」與「量」，為失智老人創造更美好的未來。

Dementia is a degenerative disease of elderly people and the incidence rises year by year as the elderly population increases. Middle and late stage dementia residents need help from other people due to their abnormal behaviors and impairment of physical functions. So it is really a most important issue for current society to build safe, respect and humanistic nursing home to accommodate, treat, and settle these patients effectively. The example described in this article is the remodeling of an old 1500 square meter ward into a unit for accommodating demented residents. The authors describe the critical thinking process of nurses who designed the space of the building based on the care needs and behavioral patterns of middle and late stage dementia residents. The designers also integrated space concepts and esthetic art, and considered the key points of the environment for demented residents, such as the characteristics of the whole building, an individualized home-like environment, the security of the residents, sensory and perceptive stimulations, social and leisure room for establishing friendships, utilities and shared facilities. In addition, they further analyzed and explored the important issues of the environment for this population and shared their valuable experience with other nurses who are willing to devote themselves to the care of demented residents. This paper will be a reference for planning and designing the organization for dementia patients, improving the service quality and quantity simultaneously, and creating a better future for demented elders.