周全性老人評估與護理

Comprehensive Geriatric Assessment and Nursing Practice

至民國95年6月我國65歲以上人口比率已達9.86%，其中73%的老年人主訴至少有一種慢性病。老年人平均每次住院費用是15-44歲住院患者費用的二倍，而且佔總醫療費用的43.8%，顯示老年人的健康問題值得護理人員的深切關注。本文介紹衰弱老年人（frail elderly）的生理疾病、心理狀況和生活功能，並整合多種專業、多個面向的診斷及處置過程的「周全性老人評估」，就其適用對象、施行原則、評估內容、成效與護理的關係做簡要的闡述。周全性老人評估的價值如同老年人健康促進及預防策略，唯有本著倫理關懷，堅持全人照護的理念，以團隊方式提供老人整合性的服務，才能讓老年人獲得最妥善的照護。

The elderly now constitute 9.86% of the population of Taiwan. Seventy-three percent of them have at least one chronic disease. The medical costs of the elderly are double those of young adults. This article introduces the concept of the comprehensive geriatric assessment, which has been defined as, ”a multidimensional, often interdisciplinary, diagnostic process intended to determine a frail elderly person's medical, psychosocial, and functional capability and problems, with the objective of developing an overall plan for treatment and long-term follow-up.” The article introduces geriatric physiological diseases, mental states and physical functions, and the multi-disciplinary, comprehensive geriatric assessment itself, with its multi-dimensional diagnoses and procedures, the population at which it is targeted, the principles under which it is carried out, its content and outcomes, and a brief explanation of its relevance to nurses. The value of the comprehensive geriatric assessment is similar to that of a health advancement and disease prevention strategy for elderly people. Only by adhering to the theory and insisting on care of the whole person, providing comprehensive geriatric care in groups, can the best quality of care be achieved for elderly patients.