中西照護活動，對於社區預防及延緩失能失智之經驗探討

The Experience Explore to Prevention and Delay of Disability and Dementia with Chinese and Western Physical Exercise Care Activities

台灣2018年已邁入高齡社會，在長照2.0「在地老化」、「在地安養」目標下，我們參與了預防及延緩失能照護計畫並執行於社區的失智據點和C級巷弄長照站，照護輕中度失智及失能民眾。文獻指出傳統中醫健身養生方法中例如八段錦、太極拳等大多屬低運動強度，可以調節身心，有益於生活品質，加強認知能力。我們以中醫養生為核心結合其他復健、語言、營養等專業專家，開展一個預防及延緩失能照護計畫，回溯2019年3期活動，159名社區民眾分成失智組與一般失能組完成參與了本方案活動。活動後結果探討，衰弱評估上失智組有顯著的改善，介護上也呈現風險降低；Kihon Checklist評量上失智組在活動後，社交困擾及認知功能兩項風險有顯著性降低，一般失能組在活動後抑鬱風險方面有顯著性降低。我們以為實施本方案在降低認知、社交及抑鬱等風險有幫助，對於獨立生活及活動運動的評量需要更多的設計探討與研究。

Taiwan has entered a senior society in 2018. Under the goals ''Local aging'' and ''Aging in place''of Long-Term Care 2.0 (LTC 2.0), we participated in the prevention and delay of disability health care plan and implemented it in dementia care center and the community point C, for people with mild to moderate dementia and disability. The study points out that TCM health exercise such as Baduanjin and Tai Chi are mostly low-intensity exercise, which can adjust the body and mind, benefit the quality of life and strengthen cognitive ability. We take Chinese medicine health care as the core and combine other professional experts in rehabilitation, speech, nutrition, etc. to carry out a plan to prevent and delay disability care. After three periods a year in 2019, 159 people in the community, dementia and disability group are included the group participates in this program activity. Post-activity analysis of the results, Study of Osteoporotic Fractures (SOF) assessment has a significant improvement in dementia group, and there is also a reduction in risk in nursing care; In addition, Kihon Checklist (KCL) criteria dementia group has a significant reduction both in the risk of social distress and cognitive function after the activity. The general disability group had a significant reduction in depression risk after the activity. We think that the implementation of this program is helpful in reducing the risk of cognition, socialization and depression. It requires more design discussion and research on the evaluation of daily living and physical strength.