周全性老年評估個案報告：住院後失能之探討

住院後失能（hospitalization-associated disability, HAD）是老年人住院後很常見的問題，定義為在住院期間產生的功能衰退，可能起因於疾病的影響或是所處的治療環境，容易導致老年人與照顧者很大的負擔，本文針對一位住院相關失能的個案，從危險因子、導致失能的原因、相關評估與建議改善方式進行探討，除了治療導致住院的疾病本身外，老年科團隊進行周全性老年評估，住院過程中持續追蹤其功能性、營養、認知與活動力的變化，偵測住院後失能的情形並進行介入，建議老年人急性住院後應該都要進行周全性老年評估，老醫病房的環境與醫療團隊比一般病房更能預防住院後失能，主要原因為老醫病房針對老年人提供跨專科的照顧，預防失能並協助復能，有助於減少老年人出院後的功能衰退、縮短老年人住院天數、減少相關花費，亦能增加老年人出院後回家的機會。

關鍵字

周全性老年評估；住院後失能；功能衰退；衰弱

並列摘要

Hospitalization-associated disability (HAD), defined as functional decline occurring during hospital stay, is a common problem among the elderly. It might be due to the impacts of the diseases or the surrounding environment. HAD poses a heavy burden on both patients and caregivers. We reported a case of HAD and discussed the possible predisposing factors, precipitating factors, evaluation, and treatment course during hospitalization. Multi-disciplinary geriatric team care improved HAD through facilitating comprehensive geriatric assessment and further interventions including encouraging mobility, rehabilitation and nutrition. The patient returned home with improvement in activities of daily living. Comprehensive geriatric assessment upon admission for elderly patients is strongly recommended, and compared to the general ward, the geriatric ward is considered an environment more compatible with effective HAD prevention.

並列關鍵字

comprehensive geriatric assessment ； hospitalization-associated disability ； functional decline ； frailty

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周全性老年評估個案報告：住院後失能之探討

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