照顧一位慢性腎病高齡獨居者出院安置之護理經驗

Nursing Care Experience for an Older Patient with Chronic Kidney Disease who Lives Alone after Hospital Discharge

高齡獨居者日益增加，在全球高齡化的社會中高齡長者自我的生活品質及安全是我們需要擔憂的。本文描述一位高齡獨居長者因慢性腎病出院安置之護理經驗。照護期間2023年05月04日至05月26日，筆者運用Gorden十一項健康功能型態評估，透過照護、觀察、會談及身體評估等方式收集資料，確立個案有體液容積過量；身體活動功能障礙；無望感；家庭運作過程改變等四項護理問題。對於疾病期間透過飲食衛教及藥物控制個案血壓，另發現個案另有家庭支持系統薄弱，依據個案個別性需求，藉由跨團隊的介入提供資源，密切向個案及家屬討論出院後續安置的困難點及需求，也鼓勵並建議個案及家屬增加見面機會，增長談話時間，促進父女關係的連結，減少了相互的矛盾及隔閡，幫助個案得到正向支持，能調適心理，度過無望感危機，讓個案可於出院後有安全舒適的照護環境，透過此次照護經驗提供臨床護理人員參考。

The number of older people living alone is increasing daily. In the global aging society, the number of older people is increasing. However, their quality of life and safety are a concern. This article describes the case of an older man living alone with chronic kidney disease and our nursing experience and renal care after discharge. He received care from May 4 to May 26, 2023. During his care and observation, the author used Gordon's 11-item health function assessment. Information was collected through interviews and physical assessment, which established that the patient had excessive body fluid volume and low physical activity. Nursing issues included motor dysfunction, sense of hopelessness, and changes in family functioning processes. During the care period, the patient's blood pressure was controlled through diet, education, and medication, and the patient received family support. If such a support system was weak, resources were provided through cross-team interventions based on the individual needs of the patient. Moreover, close support will be provided to the patient and family members to discuss the difficulties and needs of follow-up placement after discharge. Furthermore, patients and their families received encouragement and suggestions. Family members were given increased opportunities to meet and conversation time to promote the connection between parents and children and help the patient get positive support, adjust their psychology, and overcome the feeling of hopelessness so that patients can have a safe and comfortable care environment after discharge. This care experience provides clinical reference for caregivers.