周全性老年評估個案報告：運用於老年生長維持不良的評估與處置

Comprehensive Geriatric Assessment Case Report: Application of Comprehensive Geriatric Assessment in Evaluation and Managements of Geriatric Failure to Thrive

鄭翔如(Hsiang-Ju Cheng) ； 楊登棋(Deng-Chi Yang)

《台灣老年醫學暨老年學會雜誌》 15卷4期 (2020/11) Pp. 283-293

https://doi.org/10.29461/TGGa.202011_15(4).0004

摘要

老年生長維持不良在老年人族群中是一種常見但卻在早期時易被忽略的癥候，通常是由多因子所引發，若無妥善的處理，最終會導致老年人的死亡。因此如何確認老年生長維持不良的問題，用一套有效的評量老年生長維持不良的方法或工具來增加醫師對其診斷的確定性，以及關於治療照護目標的早期討論是相當重要。本文描述一位老年男性個案因肺炎住院治療，透過周全性老年評估發現體重減輕、食慾下降、營養不良、憂鬱情緒。藉由跨領域的團隊照護，在過程中不斷觀察治療反應、檢討原因、和病人與家屬溝通，最終找出肺癌的問題，並針對病患的營養、認知／情緒、預立醫療自主計畫給予協助，讓整體醫療以「維持功能和生活品質」為照顧主軸，達到兼顧身體、心理健康之目標。

關鍵字

老年生長維持不良 ； 周全性老年評估

並列摘要

A common syndrome among the elderly but often overlooked in its early stage, geriatric failure to thrive is usually a multi-factor condition that could result in death if not properly treated. Therefore, it is very important to identify the problem of geriatric failure to thrive by using a set of effective methods or tools, helping physicians to assess this problem, and draft the goal of treatment. In this article, we report an older male hospitalized for pneumonia and was found to have weight loss, loss of appetite, malnutrition, depression through Comprehensive geriatric assessment. With the care of the interdisciplinary team, and constant observations of the treatment response, review of the active problems, and communication with patients and his families, we successfully identified the diagnosis of lung cancer. We also provided assistance to the patient's nutrition, cognition/emotion, and advanced care planning, so that the medical care's focus was on ＂maintaining function and quality of life＂, and achieved the goal of balancing physical and mental health.

並列關鍵字

Geriatric failure to thrive ； Comprehensive geriatric assessment