照顧護理之家一位無望感老年住民之經驗

The Nursing Experience in Caring a Hopeless Elder in a Nursing Home

本文主要在於分享照顧一位護理之家無望感老年住民的經驗。個案因身體功能退化，家人無力照顧，所以入住護理之家。她不僅有被動、情緒低落、情感反應少的表現，甚至出現自殺之念頭。筆者藉由觀察、會談等方式收集資料，並根據文獻，將護理評估分為身體、認知狀態、功能性、心理與社會評估等五大類，確認個案有「無望感」的護理問題，再進一步運用建立希望的技巧，包括經由協助個案維持自我照顧能力，增加正向社交互動，鼓勵表達對健康及未來的感受與關注，並與她共同確認生活的意義等相關護理措施。最後個案可以維持自我照顧的能力，與外界互動頻率增加，願意表達出內心的感受，並能表現出正向的情緒。自護理過程中發現護理人員扮演著激發希望的重要角色，只要多用心，就能協助護理之家的老人，在晚年仍有充滿意義與希望的生活。

The purpose of this report was to share the nursing experience of caring for a hopeless elderly resident in a nursing home. Due to a physical function impairment, the family were unable to provide any care, this case was admitted to the nursing home. She was passive and down in the dumps. She also lacked initiative and had suicidal thoughts. The authors collected data by observation and interview. According to the literature , the nursing assessment included physical , mental, functional, psychological, and societal domains. The results showed that the main health problem was hopelessness. The authors adopted appropriate care plans to assist her establish sense of hope, including maintaining self-care ability, increasing positive social interactions, encouraging her to express concerns about her health and future, and identifying the meaning in life. Through these nursing interventions, this case should maintain self-care, increase interactions with others, and express her feelings as well as positive emotions. From the nursing process, it was found that the nurse played a very important role in inspiring hope for the client. Nurses are in an excellent position to help nursing home residents to lead a meaningful and hopeful life during old age.