失智患者進食困難探討

Exploration of Eating Difficulties of Patients With Dementia

失智症人數隨著人口老化亦逐年增加，而隨著失智症疾病進展，有一半以上的患者會面臨進食困難的問題，這也是造成家屬困擾的問題之一。病因大多是錯綜複雜，一旦病患有進食困難問題，緊接而來的是體重下降、營養不良、吸入性肺炎住院增加，甚至死亡。本文藉由失智症進食困難文獻回顧，將進食過程分為四個階段，如：辨識食物、拿取食物放入口中、咀嚼、吞嚥的過程，分別探討患者在各階段出現進食困難可能的因素及可能出現行為徵象，進而介紹改善進食困難問題的方法，提供給有進食困難問題的失智症患者或照顧者多項選擇方法。希望除了提升醫療人員及照顧者對失智症進食困難原因及呈現徵象更加了解外，更期待醫療團隊應該更謹慎評估病患整體狀況，提供最適切介入措施，讓病患獲得最舒適及最非侵入性的進食方式，改善病患進食品質，也使病患與家屬可獲得心靈安適。

The number of people living with dementia is growing as the average age of the population rises. Eating difficulties are a common problem for dementia patients and their caregivers. The etiology of these difficulties is often complicated. Weight loss, poor nutrition, aspiration pneumonia, and associated medical admissions or even mortality may occur as soon as an eating difficulty develops. This paper presents a literature review of the eating difficulties of dementia patients. The process of eating involves four stages: recognizing food, taking food into the mouth, chewing, and swallowing. We discuss the causes and clinical manifestations of eating difficulties at each of these stages and introduce an intervention for overcoming eating difficulties, aiming at providing choices of methods to improve eating behavior. The author hopes that this review will help medical personnel / caregivers enhance their understanding of the etiology and the clinical manifestation of eating difficulties in dementia patients, evaluate the overall condition of their patient(s), and provide an appropriate intervention in order to help these patients experience the most comfortable and non-invasive ways of eating or feeding, improve their quality of eating, and realize with their family improved spiritual well-being.