施行安寧緩和照顧協助機構長者在機構善終之實務經驗－以台中市某私立養護機構執行現況為例

Clinical Experiences of Applying Hospice and Palliative Care to Assist Elder Residents Having A Peaceful Death - Example of A Long Term Care Facility in Taichung

劉依薰(Yi-Hsun Liu) ； 黃淑鶴(Shu-He Huang)

《安寧療護雜誌》 22卷3期 (2017/11) Pp. 310-324

https://doi.org/10.6537/TJHPC.201711_22(3).004

摘要

安寧療護概念雖已逐漸為大眾所接受，但因國內較少有在機構施行安寧療護的實務經驗分享，使得機構負責人及工作人員對協助長者能在機構中接受安寧照護自然往生，存在很多的擔憂和不確定感。致使生命末期長者在瀕臨死亡或是已經死亡的狀況下，被送至醫院進行急救醫療，造成末期長者往生前接受無效醫療，徒增長者和家屬的痛苦，並增加醫療資源的耗費。筆者所服務機構的照護團隊，透過積極推動「在機構安寧、在地往生」概念，輔導長者和家屬簽署「預立安寧緩和醫療暨維生醫療抉擇意願書」，並積極與其他醫療院所合作，協助生命末期長者可以在適當的醫療與機構安寧照護下安詳往生。我們希望將此實務經驗分享，做為機構經營者與照護人員施行機構安寧照顧之參考，讓機構長者得以尊嚴地善終。

關鍵字

安寧 ； 緩和照護 ； 長期照顧機構 ； 善終

並列摘要

In Taiwan, many people understand and accept the concept of hospice care gradually. However, because there’s lack of sharing the experience of hospice care in long term care facilities (LTCFs), the manager and the staff of LTFCs worried about how to help elder residents to die naturally in LTCFs. Therefore, while the residents are dying, they would be sent to the hospital to receive cardiopulmonary resuscitation. This would cause great suffering to the residents and the sorrow of their families. It also increased the consumption of medical resources. The team workers of LTCFs served by the author initiate and disseminate the concept of ＂Hospice care and good death in place＂. The aim of this article was to describe the process of applying advance care planning for elderly residents and their families in LTFCs, including how to initiate informed consent of DNR (Do not resuscitate) to elder residents and their families, and how to cooperate two medical teams between LTCFs and hospitals to assist elder residents to have appropriate medical treatments and good death at the end of life in LTFCs. The authors hope to share the experience with the managers and the staff of LTCFs, as a reference of providing appropriate hospice and palliative care, to assist elder residents having a natural, dignified and peaceful death.

並列關鍵字

hospice ； palliative care ； long term care facilities ； good death

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