社區善終照護準備計劃

Death Care Planning in the Community

10.6320/FJM.2011.15(1).05

吳風鈴(Feng-Ling Wu)；陳慶餘(Ching-Yu Chen)；謝博生(Bor-Shen Hsieh)

末期照護 ； 安寧緩和醫療 ； 出院準備 ； 在家往生 ； 善終 ； end-of-life care ； hospice palliative medicine ； discharge planning ； dying at home ； good death

台灣醫學

15卷1期（2011 / 01 / 25）

22 - 31

繁體中文

生老病死乃人生必經之過程。當人們論及死亡議題時往往都是避重就輕的帶過，而傳統習俗在家壽終正寢的作法已隨著醫療科技的進步產生變化，許多人已是生命末期無法治癒，接受急救是死亡前“急救套餐”的折磨。從過度科技化醫療照護的發展回歸人性化的考量，為此，我們將推動「社區善終照護準備計劃」，讓末期病人回到熟悉的社區接受照顧。給予家屬返家照護的支持，及強化在家照護之能力，使病人能安心且有尊嚴地走過人生最一段路。而要達成在家往生的目標需要社區資源與醫療照護體系的結合，形成末期病人返回社區照顧的支持網絡。本文提供一位成功在家中往生的案例，希望藉由案例的呈現能傳達「社區善終照護準備計劃」的實施指引。

The way from birth, aging, and sickness to death is an inevitable process of life. When people subconsciously avoid to talk about the issue of death, peaceful dying would not be possible when high technology is used to save life. Many patients with terminal diseases are suffering from ”package of cardiopulmonary resuscitation” as a routine procedure before death. In consideration of humane care instead of over-medicalization, we proposed 「death care planning in the community」 to allow patients back to his familiar community receiving hospice palliative care at home. Meanwhile we must support family caregivers and improve their care ability to achieve the preferred death at home of patients. In order to carry out this novel plan, a community support network integrating social and medical resources is necessary for back up patient care at home. Finally we presented a case report to demonstrate how to achieve a good death care planning at home and concluded with guidelines in practice.