改善一位中度失智症合併精神行為症狀之居家照護經驗

Improving the Home Care Experience for A Moderate Dementia with Behavioral and Psychological Symptoms

本文描述一名中度失智症女性合併精神行為症狀個案的精神科居家照護經驗。照護期間為2021年10月13日至12月22日，筆者藉由家訪、電訪、會談及運用身體、情緒、智能、社會及靈性五大層面評估收集資料。確立有思考過程改變、感覺知覺改變、焦慮等問題。因個案合併有精神行為症狀，讓照顧者壓力倍增也影響全家的生活品質。筆者運用精神科居家照護模式，運用關懷友善態度與個案建立治療性人際關係，定期家訪及電訪，引導個案說出症狀干擾時內心感受，並共同討論精神症狀干擾時處理技巧。運用客制化家庭支持系統，聯結失智症共照中心及家庭照顧中心等資源，協助個案及家屬找到彼此適切的相處方式。提供個別性精神行為症狀的照護知識及技巧，持續增進個案與疾病共存並減少精神行為症狀干擾的能力。筆者建議照護期間需將照顧者身心健康納入治療計畫，定期評估照護能力及協助其紓壓，以幫助全家適應艱辛的照顧過程。

This article aims to describe the home care experience for a 72-year-old female patient with moderate dementia with behavioral and psychological symptoms. The care period was from October 13 th to December 22 nd, 2021. We collects data through home visits, telephone interviews, and assessments based on the five dimensions of physical, emotional, cognitive, social, and spiritual. The questions included“changes in thought processes”,“changes in sensory perception”and anxiety. The caregiver’s stress was multiplied, affecting the overall quality of life for the family. We employed a psychiatric home care model, utilizing a caring and friendly attitude to establish a therapeutic interpersonal relationship with the client. Regular home visits and phone interviews were conducted to encourage the client to express her inner feelings when experiencing symptoms and discuss coping techniques for managing psychiatric symptoms. Customized family support systems, dementia care centers, and family care centers were utilized to connect resources and provide empathy and support to the client. We taught the client and her family appropriate ways to interact with each other, individualized knowledge and skills in dementia care and managing behavioral symptoms, aiming to enhance the client’s self-care abilities and reduce the interference caused by behavioral symptoms. We suggests that the caregiver’s physical and mental well-being should be included in the treatment plan during the care period with a greater emphasis on mental health. Regular assessments of caregiving abilities and assistance in stress relief should be provided to overcome the challenges of the caregiving process. It is hoped that this article will serve as a reference for healthcare professionals caring for similar cases.