老年人罹患癌症後醫療照顧歷程的探討

The Stepwise Medical Care for an Elderly Patient with Cancer

劉樹泉(Shu-Chuen Lau) ； 江維鏞(Wai-Yung Chiang)

《台灣老年醫學雜誌》 1卷2期 (2005/11) Pp. 97-107

https://doi.org/10.29462/TGG.200511.0006

摘要

老化容易成為老年病人退化的標籤，因此對老人問題細心整體性的評估是必要的。乏特氏壺腹腺癌(Ampullar Vater adenocarcinoma)不算是常見的癌症；它佔胃腸肝膽系統癌症極少的比例。對老人而言，這種癌症的罕見與否其實並不重要，醫師對癌症及其他疾病的認識宜轉化成對老人照顧的行動。無論是早期診斷、處理病人的否定作用、討價還價的行為、憤怒情緒、憂鬱表現、追蹤治療等都必須符合病人本身的背景及生活習慣。詳細的問診及參考家屬的觀察、事實的再三肯定但不否定病人、家庭會議、引導家屬的正向反應、維持病人自我身體形象、適當的飲食及運動益處說明、希望的給予、藥物治療與生活品質的取捨平衡、醫師由治療者的角色轉為醫療資訊提供者及關懷者的角色等等，這些都是我們可以根據學理轉化成為行動的重要醫療照顧手段。

關鍵字

老年人 ； 癌症 ； 醫療照顧

並列摘要

Aging is often a stigma of deterioration in the elderly. Doctors should therefore assess the health problems of their elderly patients in a comprehensive and careful manner. Ampullar Vater adenocarcinoma is not a common cancer, accounting for only a small proportion of gastrointestinal cancers. Its rare prevalence poses no concern to the elderly patients. The importance lies in the fact that doctors should turn their knowledge of this rare cancer into practical means of care actually beneficial to the elderly. No matter it is early diagnosis, management of the patient’s denial, bargaining, angry mood, and depressive reaction, or follow-up care, the doctor should take into consideration of the habit and developmental background of the patient. Doctors should stretch beyond the traditional role of health care professionals to assume the roles of a medical information provider and a caring supporter for detailed history-taking, sensitive appreciation of the family's attitude, careful confirmation of the results of factual observation, proper restraint in contradicting patient and family members, generous offer of anticipatory guidance and hope, active support in the maintenance of patient's self-esteem, appropriate instructions on diet and daily activity, as well as professional advice on balancing medication and quality of life, are all important means to successful care for the elderly.

並列關鍵字

aged ； cancer ； medical care