- 期刊
周全性老年評估－個案報告
Comprehensive Geriatric Assessment-A Case Report
摘要
老年評估有別於一般的評估方式，其強調老年病人的健康狀態，除本身疾病的影響，更與社會、心理、以及環境因素有關，此外也相當著重功能的評估，功能狀態不只是評估的面向之一，同時也是可以增進或維持的最終結果。周全性老年評估是由跨領域的醫療團隊，包括老年科醫師、護理師、復健科醫師／治療師、營養師、社工師、藥師，以及老年精神科醫師等，藉由系統性的評估，找出可治療的(remediable)健康問題以增進健康。 吾人嘗試以周全性老年評估的方式，介入一位罹患多重系統疾病且有持續性噁心、嘔吐及腹瀉症狀之八十歲女性病患。經過詳細的整體回顧及評估，發現其嗜睡狀況、語言表達及認知功能在停用quetiapine之後大幅改善；腹瀉症狀在改變飲食配方及餵食方式後亦獲得改善。另外，關於病患的社會心理問題與照顧者的負擔方面，也同時做一整體性的評估及建議，確立後續治療及追蹤的方向。
並列摘要
Geriatric assessment differs from general medical evaluation in that emphasis is placed not only on clarifying medical condition but also on detecting social, psychological, and environmental factors and their effects on the health status of older persons. Geriatric assessment also attaches great importance to functional status as both a dimension to be evaluated and a final outcome to be maintained or improved upon. Comprehensive geriatric assessment is performed by an interdisciplinary team composed of geriatricians, nurse practitioners, rehabilitation physicians/therapists, dietitians, social workers, pharmacists, and geriatric psychiatrists working together to perform a systemic review to identify remediable health problems for improving the health status of elderly patients. In the case study, we performed a comprehensive geriatric assessment on an eighty-year-old female patient with multiple systemic diseases and troubled by persistent nausea, vomiting and diarrhea. After carefully reviewing and assessing this patient, we were able to significantly alleviate her problems in somnolence, verbal output, and cognitive function by discontinuing quetiapine. And her diarrhea problem reported obvious improvement after we adjusted the diet formula and feeding method. We further conducted a systemic assessment, provided psychosocial support for the patient and her caregiver, and offered suggestions for further treatment and follow-up.