照顧一位反覆跌倒之社區長者的家庭護理經驗

Family Nursing Care of an Elderly Patient with Recurrent Falls in the Community

10.6692/KJN.202112_38(3).0009

洪文謙(Wen-Chien Hung)；李慧貞(Hui-Chen Lee)；陳明宜(Ming-Yi Chen)

反覆跌倒 ； 長者 ； 家庭護理 ； 否認行為不當 ； recurrent falls ； elderly ； family nursing ； ineffective denial

高雄護理雜誌

38卷3期（2021 / 12 / 01）

100 - 110

繁體中文

本文描述一85歲長者家庭護理之經驗，個案因視力障礙、肌力衰退、居家不安全等，一年內發生三次跌倒。護理期間為2017年6月7日至7月7日，以家庭護理評估確立有潛在危險性跌倒、營養多於身體所需及否認行為不當之健康問題。因面臨跌倒個案有否認行為不當，透過傾聽、澄清修正其輕忽觀念，並介入家庭支持功能，使其能重視跌倒的危害，並藉由營造安全環境減少外在危險因子，如不易辨別門檻處有貼設反光條、移除地板雜物等；另外，透過創意設計肌力訓練計畫、體位控制及營養指導等，改善內在危險因子，介入後使案家能正視跌倒問題，並連結家庭支持，有效預防長者跌倒，降低跌倒發生事件。

This article describes the home nursing experience of an 85-year-old elderly patient. The subject had fallen three times within one year due to visual impairment, degenerative muscle power and an unsafe environment. The period of nursing was from June 7, 2017 to July 7, 2017. The home nursing evaluation confirmed health problems, including potential risk for falls, overnutrition more than the body's needs, and inappropriate patient denial. The subject exhibited denial behavior towards falling, and this regretful concept was corrected through listening and clarification. Intervention was carried out through the family support function, allowing the subject to see the importance in harm from falling, and a safer environment was constructed by reducing external risk factors such as attaching reflective strips to door sills that were difficult to recognize, removing miscellaneous objects on the floors of different rooms, etc. In addition, the subject's internal risk factors were improved by designing a creative muscle strength training plan, fitness control, and nutrition instructions. After the intervention, the subject's family understood the crucial importance of falling avoidance, and through connecting via this family support, we were able to effectively prevent the elderly patient from falling and reduce further falling incidences.