| 英文摘要 |
The population of elders with dementia is rapidly increasing in Taiwan. Dementia is an irreversible process, as cognitive function and activities of daily living reveal progressive degeneration resulting in an increasing demand for long-term care. Therefore, to understand the reasons of their behaviors among the elderly with dementia may retard the progression of illness and reduce the burden of caregivers. The aim of this article was to describe a nursing experience of taking care for a 91-year-old man with severe dementia who lived in a care center for dementia. During the nursing care period from April 16, 2013 to May 13, 2013, the authors applied the method of "person-centered assessment", which includes five domains: demographic information, lifestyle information, physical and psychological information, the focus information, and 24-hour needs assessment, to assess psychophysical issues. Based on the observation of the person-centered assessment, and listening to and interviewing with the family caregivers, we found that the health problems for the patient included: (a) degeneration of cognitive function which was caused by dementia; (b) unwillingness and inability to perform self-care related to aging, disability and fear of pain; (c) poor vitality due to unanticipated institutionalization. Through building trust relationships, and communicating with the family caregivers and staff, the person-centered care was provided to the patient’s and family-caregivers’ needs at reasons for the patient’s behaviors, removal of obstacles to living, and empowerment of the residual ability. Employing cognitive stimulation (reminiscence therapy and reality-oriented therapy), we tried to improve the cognitive ability, utilized care-related resources to assist the cooperation among family caregivers and staff, and increased the life vitality. We also provided adequate interventions to maintain the client’s ability of daily activities. In summary, this report shares an nursing experience with the person-centered assessment and the concept of person-centered care to taking care of an elderly with dementia and family care-providers in order to improve the quality of care for patients with dementia. |
