提升居家失能老人自我照顧能力之護理經驗

Nursing Experience in Improving Self-Care Ability of Disabled Elders in Home Care: A Case Report

張莉琴(Li-Chyn Chang) ； 高雅玉(Ya-Yu Kao) ； 徐美華(Mei-Hwa Hsu)

《長期照護雜誌》 13卷1期 (2009/04) Pp. 109-119

https://doi.org/10.6317/LTC.200904_13(1).0009

摘要

老化及慢性疾病常是影響個人日常生活活動的主因。老人失能比率逐年增加，日常生活活動依賴的病患，不僅在生活型態上須做極大的調整，還面臨各種共併症的威脅。本文為應用Orem自我照顧缺失理論，有效提升一位居家失能老人自我照顧能力的護理經驗，居家護理照護期間自2006年10月1日至2007年5月1日，總計家訪10次，電訪6次。以整體性護理評估為指引，發現個案主要有三個護理問題：1.自我照顧能力缺失：進食、沐浴及衛生、如廁；2.皮膚完整性受損；3.無力感。針對這些問題協同家屬提供個案適當的護理措施，使個案願意在家人的協助下降低活動限制的程度，不再依賴家人照顧，而皮膚傷口已呈現癒合，也順利將鼻胃管及導尿管拔除，同時個案已能面對疾病帶來的無力感，並發揮其最大的自我照顧能力，進而改善生活品質。因此，適當的護理介入有助於失能老人自我照顧能力的改善，以及其信心的增加及健康的改善。

關鍵字

失能老人 ； 自我照顧能力 ； 居家護理

並列摘要

Aging and chronic illnesses are the main factors affecting daily activities of an individual. Elderly patients who are dependent in activities of daily activities not only need to modify their lifestyles, but also face the threats from the comorbidities. This paper present provision of home care to a disabled elder through clinical nursing appraisal using Orem's theory. Ten home visits and six telephone visits were made in 7 months. Comprehensive assessment identified three nursing problems: self-care deficit, impaired skin integrity, and helplessness. At the end, the activities of daily living of the case and quality of life improved and the wound healed. The nasogastric tube and urinary catheter were also removed. The case was able to face the helplessness and maximize her self-care ability. Therefore, appropriate nursing interventions improve disable elders' ability of self-care, confidence and health.

並列關鍵字

disabled elder ； self-care ability ； home care