一位失智症患者初入住護理之家護理經驗

Nursing Experience in a Newly Resident with Dementia of The Nursing Home

本文探討一位失智症患者初入住護理之家之護理經驗，護理期間從2016年2月1日至3月20日間，運用觀察、會談、直接照顧及周全性老年評估（comprehensive geriatric assessment，簡稱CGA）等方式收集資料，評估發現個案有一、慢性混亂／與失智症造成意識混亂有關；二、身體活動功能障礙／與骨折、失智症造成肢體活動受限；三、照顧者角色緊張／案妻擔心、自責自己無法照顧個案有關。過程藉由醫護等專業團隊的介入，予控制及改善精神症狀，經過護病關係信任感的建立，增加個案與人的互動，透過跨專業團隊會議擬定具體可達成的復健計畫，及多次諮商及失智症家屬支持團體的介入下突破家屬的心房使其願意相信並接受團隊照護，使得個案與家屬生活品質得以改善。建議：機構內可增加視訊設備，以連繫遠方親友或關心的人，讓個案能得到親情的撫慰。此護理經驗之分享，期望能使醫療工作人員更關心失智症個案與家屬的需求，給予個別性及持續性的照護，並且適時給予提供資源與協助，陪伴個案與家屬一起走過生命的幽谷。

This report introduces the nursing experience in taking care of a newly nursing homeresident with dementia. The author took care of the case from February 1st, 2016 to March20th, 2016 and collected data by observing, interviewing, taking care and comprehensivegeriatric assessment. After the assessment, the case was diagnosed with nursing problemswhich were stated as following: 1.chronic confusion/ due to the cognitive impairmentcaused by disease; 2. physical activity dysfunction/ due to the restriction of limbs motilitycaused by dementia and fracture; 3. caregiver role strain/ due to the concern that thecase’s wife worried about her lack of taking care of him. We controlled and improved hispsychological symptoms through the interventions of healthcare professional cooperation.We increased his social interaction with others by the establishment of nursing-patientmutual trust. We improved the quality of life in the case and his family through theachievable rehabilitation plan made by multidisciplinary conference, repeated consultationand the intervention of support group for caregivers of patients with dementia. Suggestion:the video equipment could be set up to help residents contacting distant relatives, so thatresidents can be comforted. We hoped that healthcare providers could consider the needs ofdementia patients and their families more to deliver individual and continuous health careand stand by their side with full support in such difficult time.