運用多元運動實證介入方案於一位失智症長者之護理經驗

國際失智症協會(ADI)2019年全球報告，估計超過5千萬名失智者，使家庭和社會沉重的負擔，每年估計費約1,720億美元，因此，預防功能退化是迫切的課題。本文運用多元運動介入照護一位失智症個案因身體及認知功能急速下降，照護期間2020年2月19日至2020年6月15日，由醫院至居家進行12次家訪，運用周全性老年評估收集資料，分析個案護理問題，確立個案有：(1)慢性混亂；(2)身體活動功能障礙；(3)家庭因應能力失調，以實證文獻為基礎擬訂個別性多元運動方案促進個案認知、身體活動功能以及減輕家屬照護之負擔。結果：認知功能MMSE由9分提升至24分；身體活動功能，在助行器使用由5秒站立增加至每次10秒；家屬壓力負荷，於壓力自我檢測量表總分20分下降至14分。期望筆者照護經驗，提供整體性全人照護，做為未來失智症護理照護上的方針。

In 2019, the International Dementia Association (ADI) Global Report estimated that more than 50 million people diagnosed with dementia posed a significant burden on both families and society, with annual costs reaching approximately US$172 billion. Preventing functional decline thus emerges as an urgent imperative. This article centers on the care of a dementia case characterized by a rapid decline in physical and cognitive functions, resulting in cognitive impairment, reduced physical activity, and heightened family pressure. During the nursing period from February 19, 2020, to June 15, 2020, 12 home visits were conducted, employing a comprehensive elderly assessment framework to collect data, analyze care problems, and identify key issues: (1) chronic confusion, (2) physical activity dysfunction, and (3) ineffective family coping. Drawing from empirical literature, individualized exercise programs were devised to promote cognition, physical activity, and alleviate family caregiving burdens. Results showed notable improvements: the MMSE score increased from 9 points to 24 points, physical activity function progressed from standing for 5 seconds three times to standing for 10 seconds five times with the aid of a walker, and the family stress self-detection score decreased from 20 points to 14 points. It is hoped that this nursing experience, emphasizing Holistic Health Care, will serve as a valuable reference for future dementia care, offering comprehensive support to patients and their families.