照護一位血液透析合併失智症末期老年患者之護理經驗

The Nursing Experience of Caring an Elderly Hemodialysis Patient with End-Stage Dementia

蕭亞欣(Ya-Hsin Hsiao)；徐少慧(Shao-Hui Shu)

照顧者無力感 ； 血液透析 ； 失智症 ； caregiver powerlessness ； dementia ； hemodialysis

志為護理-慈濟護理雜誌

14卷2期（2015 / 04 / 01）

69 - 78

繁體中文

本文為協助一位血液透析合併失智症末期患者改善照護品質，增進家屬及外籍看護對疾病及照護認知之護理經驗。護理期間自2013年07月18日至11月18日，運用Gordon十一項功能性健康形態評估、電訪及會談進行評估，發現問題有疼痛、皮膚完整性受損及照顧者無力感。筆者整合醫療資源，與家屬及照護者共擬照護方針，因應衰老與病情惡化問題，提供舒適護理，減輕疼痛；採漸進式衛教，累積外籍看護對疾病與營養認知，促進傷口癒合；提供轉介與協商分擔照顧工作，降低負荷。外籍看護照護高齡者日益普遍，期藉由本文護理經驗，提供日後照護此類個案及家屬參考。

This report describes the nursing experience of caring a female hemodialysis elder with endstage dementia. We aimed to improve her family and foreign caregiver's illness knowledge and care skills. During the nursing period between July 18th and November 18th 2013, data was collected through phone and face-to-face interview. Also, Gorden's 11-item Function Health Pattern was applied to evaluate the patient's health status. Problems identified included pain, impaired skin integrity and powerlessness of caregivers. The author reexamined the resources, devised the care plan together with the families and caregiver, provided comfort care to alleviate the pain, improved the caregiver's knowledge and skills of disease and nutrition, promoted wound healing, and offered referral and respite care to share the burden of caring. Nowadays more elderly patients are cared by foreign caregivers. We shared the experience as a reference for those who care for similar patients.

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