- 期刊
失智症合併精神行為症狀之評估與介入
Comprehensive Geriatric Assessment Case Report: Evaluation and Management of Behavioral and Psychological Symptoms of Dementia
摘要
失智症精神行為症狀是指發生於失智患者的一群非認知障礙相關症狀，如重複問話、睡眠障礙、冷漠、激躁、妄想、幻覺等，在失智老人中十分常見，是照顧者的主要負荷來源，易造成病患及照顧者生活品質的下降，且造成照顧者心理與精神的負擔。有鑑於藥物治療副作用較多且效果因人而異，非藥物處置目前仍是被建議的第一線治療方式。相較於失智症的認知功能障礙改善較不易，精神行為症狀如果得到有效且安全的處置，往往會有明顯的改善效果。如此就能減輕家屬照顧的負擔及提升生活品質。本文描述一位老年男性居家照護個案，透過周全性老年評估發現有失智症合併精神行為症狀、體重減輕、營養不良、用藥及照護者負荷等問題。藉由跨領域的團隊照護，在過程中不斷觀察治療反應、和個案與照顧者溝通，針對個案及家屬的身體、心靈、社會議題給予協助，達到全人、全家、全程、全隊的「四全」照護目標。
並列摘要
Behavioral and Psychological Symptoms of Dementia (BPSD) refers to a group of non-cognitive symptoms that occur in patients with dementia, such as repeated questioning, sleep disturbance, apathy, agitation, delusion, and hallucination. Highly common in the elderly with dementia, these symptoms can be a grave source of physical and psychological burden for family members, lowering the quality of life of both the caregivers and the patients themselves. As pharmacologic treatment tends to cause more side effects and its efficacy varies from patient to patient, non-pharmacologic treatment remains the recommended first-line treatment for BPSD. Learning how to treat BPSD in a safe and effective manner helps cope with cognitive impairment of dementia, thereby enabling caregivers to alleviate care burden and improve quality of life. In this article, we report an elderly male home care patient with BPSD and found to experience weight loss, malnutrition, and inappropriate medication. An interdisciplinary team was formed to conduct a comprehensive geriatric assessment. With constant care, observation of the patient's responses to treatment, and communication with caregivers, the team strove to respond to the biopshychosoical needs of both the patient and his caregivers so as to achieve the goal of holistic care.
延伸閱讀
- 黃竑嘉（2018）。失智症患者的認知、動作、行為問題與日常生活功能之相關性探討〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-1501201823121100
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- 魏宇祥、林玟玓、顏啟華（2020）。Comprehensive Geriatric Assessment of a 66-Year-Old Female Patient with Major Depressive Disorder and Sjögren's Syndrome: A Case Report。台灣老年醫學暨老年學會雜誌，15(1)，39-53。https://doi.org/10.29461/TGGa.202002_15(1).0004
- Suzuki, M., Hattori, H., Oshiro, H., Saruhara, T., Furuta, Y., Abe, K., Fukuda, K., & Kanamori, M. (2019). Behavioral and Psychological Symptoms of Dementia Influencing Care Dependency of Older People with Dementia in Geriatric Residential Facilities in Japan. International Journal of Gerontology, (), s18-22. https://doi.org/10.6890/IJGE.201910/SP.0002