照護失智症之護理經驗－個案報告

Nursing Care Experience in Dementia: A Case Report

謝逸靜(I-Ching Hsieh) ； 楊式辰(Shih-Chen Yang) ； 陳頌云(Sung-Yun Chen)

《北市醫學雜誌》 11卷3期 (2014/09) Pp. 92-102

https://doi.org/10.6200/TCMJ.2014.11.3.10

摘要

本篇描述一位失智症個案，因認知能力退化且因為跌倒，導致右髖骨骨折，手術後需照顧者全天陪伴，引發照顧者角色緊張，有鑑於此引發筆者對照護失智症個案的研究動機。護理期間自2012年11月20日至12月19日止，以Beck及Heacock（1988）提出的失智患者護理評估模式，評估發現主要健康問題：一、慢性混亂與失智症病程有關；二、身體活動功能障礙與失智症造成生理功能退化，及骨折手術後肢體乏力有關；三、照顧者角色緊張與印傭聽不懂中文且缺乏照護技巧有關。經增加與人互動、採漸進式復健運動、製作印尼文護理指導手冊及技術光碟、教導及學習照護技巧、以改善照顧者角色緊張。期望藉此護理經驗對失智症照護品質有所助益，並可提供長期照護機構相關人員臨床照護之參考。

關鍵字

失智症 ； 慢性混亂 ； 身體活動功能障礙

並列摘要

This case study described an 81-year-old female patient with dementia who had impaired mobility because of a fracture caused by fall and muscle weakness. Because of cognitive degeneration, the patient was unable to recognize her Indonesian caregiver, resulting in problems such as caregiver role strain. The patient received nursing care between November 20, 2013 and December 19, 2013. Assessment of the patient using a dementia care assessment model revealed three major problems: (1) chronic confusion; (2) impaired physical mobility and (3) caregiver role strain. On increment of interactions with other people, the severity of her chronic confusion was reduced. To ease caregiver strain, we provided the caregiver a nursing care guidebook written in Indonesian language and an instructional CD covering dementia care techniques and strategies. This experience may help improve the quality of care for dementia patients, and serve as a reference to elderly care institutions for assisting residents with dementia.

並列關鍵字

dementia ； chronic confusion ； impaired physical mobility