找回生活動力：一位失智老人的護理經驗

Regain the Meaning of Life: Nursing Experience of a Dementia Elderly

本文是以周全性老人評估(comprehensive geriatric assessment, CGA)，描述照護一位具身、心、靈、社會等多層面健康問題失智老人之護理經驗。筆者於2010年1月7日至2月5日護理期間藉由觀察、訪談、傾聽、實際參與照護等方式，確認個案的問題包括(1)生理層面：噁心嘔吐、便秘腹脹、日常生活自我照顧功能障礙；(2)心理社會層面：認知功能退化；及(3)靈性層面：喪失生活意義與動力。三層面的問題環環相扣，相互影響，筆者以周全性老人評估為照護中心，針對其多層面健康的原因，提供適宜的護理措施，經由護理整體層面之需求，使個案重拾生活意義與動力，持續恢復身體的功能。希望藉此報告，強化臨床對老年病患周全性評估與全人照護之重視。

This case report presented a comprehensive geriatric assessment (CGA) to illustrate the nursing care for a dementia elderly with physical, mental, spiritual and social health problems. The author provided nursing care and gathered information by observation, interview, and listening during his hospitalization period from January 7, 2010 to February 5, 2010. Based on CGA, the author identified patient掇 health problems as followings: (1) physiological dimension: nausea, vomiting, constipation, bloating, self-care deficit; (2) psychosocial dimension: cognitive function impairment; and (3) the spiritual dimension: loss of meaning and motivation in life. The health problems of three dimensions were intertwined and influenced with each other. The author provided appropriate nursing resources to meet the demand of all dimensions, then the patient regained the meaning and motivation in life and all dimensions recovered gradually. We expect that this report can assist to strengthen a more comprehensive clinical evaluation of elderly patients with an emphasis on holistic nursing care.