照顧一位社區老人口腔機能退化之護理經驗

Nursing Experience of a Community Elder Who has Oral Functional Degradation

本文運用周全性老人評估探討一位社區老人口腔機能退化之護理經驗。筆者自2015 年9 月25 日至2015 年11 月30 日依周全性老人評估之架構進行評估，藉由觀察、會談、傾聽、身體評估、居家訪視及電話訪談等方式收集資料，確立個案主要護理問題為：（1） 知識缺失／ 不了解口腔清潔原則及方法。（2） 潛在危險性營養少於身體需要／ 因口腔機能退化，無法正常吞嚥食物導致。（3）社交隔離／ 因吞嚥困難嗆咳及口臭導致不敢與人相處有關。於照護過程中，與個案建立互信關係，透過個別性護理活動介入，引導並鼓勵個案參與活動，藉由教導學習正確的口腔清潔方法、定期洗牙及健口瑜珈操，來改善口臭及吞嚥困難問題，使其重新建立新的交友圈，使個案生活品質更加完善。將此護理經驗提出分享，期望提供護理人員照護之參考，以進一步提升老人的生活品質。

In this article, we use comprehensive geriatric assessment to explore the nursing experience ofa community elder who has oral degradation. From Sep. 25 to Nov. 30, 2015. The author followedthe guidelines of comprehensive geriatric assessment to evaluate the patient by gathering informationthrough observation, conversation, listening, physical assessment, home visits and telephone interviews.The author identified the patient's main nursing problems as follows: (1) Knowledge deficit related tonot understanding the principles and methods of oral cleaning (2) Hidden risk of undernourishment lessthan the body actually required due to difficulty of swallowing caused by oral function degradation (3)Social isolation because of swallowing cough and self-conscious bad breath. In the process of care, weestablished a relationship of mutual trust with the elder through individual care intervention, guiding andencouraging participation of activities, teaching the correct oral cleaning methods, performing regularprofessional scaling and oral health yoga exercises. All of these contributed to improving halitosis anddysphagia problems, re-establishing a new circle of friends, which lead to the improvement of quality oflife. In sharing the nursing experience, we expect to provide care reference of the nursing staff to furtherenhance the quality of life of the elders.