運用賦能概念協助照顧者照護失智晚期老人之護理經驗

Applying Empowerment to Improve Primary Caregivers' Ability when Caring for an Aged Patient with Late-Stage Dementia

林耕暉(Geng-Hui Lin) ； 高綺吟(Chi-Yin Kao)

《高雄護理雜誌》 37卷1期 (2020/04) Pp. 64-74

https://doi.org/10.6692/KJN.202004_37(1).0006

摘要

失智症易衍生長期健康問題，尤其晚期因失能嚴重增加對照顧者之依賴，因此照顧者能力於此時格外重要。本文個案因失智導致失能，且照顧者無法因應個案因失能所衍生的健康照護，故引發筆者想運用賦能概念照護個案及其家屬。於2016年5月3日至2016年5月7日照護期間經評估後，確立個案具皮膚完整性受損、潛在危險性肺吸入及排尿型態障礙等護理問題。筆者透過賦能與照顧者建立夥伴關係後，照顧者能反思自身困難、喚起內在覺察及學習動機、發展照護技巧等，並利用時間表、工具等方式克服困難，且返家後持續執行以達到自我實踐。因此，筆者建議將賦能融入照護理念中，並分享此經驗供臨床同仁日後運用賦能提升失智晚期老人之照顧者照護能力之參考。

關鍵字

失智 ； 失能 ； 照顧者 ； 賦能

並列摘要

Dementia is a progressive condition and currently cannot be cured. During the late stage of dementia, people become increasingly frail and need more support from their family or primary caregivers, which highlights the importance of caregivers' ability. This case report presents an experience of applying the concept of empowerment to care for a patient with late-stage dementia and her caregivers. Data were collected via interviews, observations, and physical assessments on May 3-8, 2016. Three health problems were identified, including impaired skin integrity, risk for aspiration, and impaired urinary elimination. Through applying the concept of empowerment and building partnership, caregivers could recognize deficiencies in care, arouse self-awareness, enhance their motivation, and then develop appropriate care skills. Also, they could participate actively at home in order to meet long-term care needs. This report could provide a reference for nurses using the concept of empowerment to improve caregivers' ability when caring for patients with late-stage dementia.

並列關鍵字

Dementia ； disability ； caregiver ； empowerment

參考文獻

王守訥、張佳琪、李碧霞(2016)．失智患者進食困難探討．護理雜誌，63(4)，128-134。doi: 10.6224/JN.63. 4.128

伍碧濤（2006）。愛的樂章－以一個失智老人家庭個案家屬長期照顧角色之探討。未出版的碩士論文，臺北：國立臺灣大學社會工作學研究所。

吳勁儫、陳雅美(2014)．失智老人家庭雇用外籍看護工之經驗．長期照護雜誌，18(1)，95-112。doi: 10.6317/LTC.18.95

陳秀惠、劉雪娥、李佳琳、高振益(2012)．外籍看護工生活品質及其相關因素之探討．醫護科技期刊，14(1)，57-68。doi: 10.6563/TJHS.2012.14(1).5

陳品元、李玉春、陳雅美(2017)．家庭照顧者之正、負向照顧經驗與健康相關生活品質關係探討．長期照護雜誌，21(3)，285-302。doi: 10.6317/LTC.21.285