- 期刊
75歲男性帕金森氏症患者合併失智症之精神行為症狀
Comprehensive geriatric assessment of an older male with Parkinson's disease complicated with behavioral and psychological symptoms of dementia
摘要
失智症的照護問題在老年人口急遽上升的時代相當重要，而失智症患者的照護已經相當不容易，當患者又合併精神行為症狀時，會使得照顧者的壓力及負擔更大。本文之個案為一位75歲男性，過去病史有糖尿病、帕金森氏症、出血性中風及失智症，此次因為嚴重精神症狀合併傷害及自殺行為被家屬送至急診就醫，診斷為認知障礙症併失智症之精神行為症狀、帕金森氏症、糖尿病合併高血糖、低血鉀、低血鈉、Benzodiazepine（BZD）藥物過量。入院後進一步處理其身體心理問題及社會經濟問題，並進行周全性老年評估。藉由跨領域團隊照護提供個案及家屬多面向的協助，個案於住院中得到全人醫療照顧之外，也能在出院後利用相關資源得到妥善照顧。因為老年病症候群的複雜特性，此類患者對於醫療的使用率及長照資源的需求量相當高，因此使整體照顧負擔及費用提升，著實是家屬照顧者的主要壓力來源。期望藉由此個案報告以及處置經驗，增加對於此類疾病的了解，而做出更好的處理，就能提升患者及照顧者的生活品質，減輕照顧與經濟負擔。
並列摘要
Caring for people with dementia can be daunting task as the old adult population is growing rapidly, and the presence of behavioral and psychological symptoms often increases the caregiver's pressure and burden even greater. This case is a 75-year-old male with past medical history of type 2 diabetes mellitus, Parkinson's disease, hemorrhagic stroke, and dementia, sent to the emergency room by his family because of severe psychological symptoms combined with self-injury and suicidal behavior. He was diagnosed with 1. Major neurocognitive disorder with behavioral and psychological symptoms of dementia; 2. Parkinson's disease; 3. Type II Diabetes mellitus, with hyperglycemia; 4. Hypokalemia; 5. Hyponatremia; 6. Old hemorrhagic stroke; and 7. Benzodiazepine (BZD) intoxication. After admission, we addressed his physical, psychological, and socioeconomic problems. Comprehensive geriatric assessment and interdisciplinary team care were performed to provide the patient and his family with multi-faceted assistance. He received complete medical care and relevant resources after discharge. Geriatric syndrome can be highly complicated, and both patients and families need considerable medical care and long-term care resources, thus increasing the overall care burden and cost. Enhancing the understanding of these diseases and making better treatment plans are therefore of crucial importance for improving the quality of life and reducing the care and economic burden of patients and caregivers.