協助一位失智症病患及其主要照顧者之居家護理經驗

A Nursing Outreach Service for a Patient with Dementia and His Caregiver

10.6847/TJPMHN.200906_4(1).0006

張敬俐(Ching-Li Chang)；蘇以青(Yi-Ching Su)；黃美蓉(Mei-Jung Huang)

失智症 ； 主要照顧者 ； 居家護理 ； dementia ； primary caregiver ； home care

精神衛生護理雜誌

4卷1期（2009 / 06 / 01）

47 - 56

繁體中文

本文呈現居家護理過程中照顧失智症病患及其主要照顧者之護理經驗。護理期間自2006年12月初至同年12月底，照護期間藉由居家訪視、家庭會談、病歷記載及標準化量表收集資料。病患護理問題為自我照顧能力缺失、睡眠型態紊亂；照顧者的健康問題為：知識不足、個人因應能力失調；透過護理過程將主要照顧者列入護理計畫中，提供病患所需之整體性護理，同時指導主要照顧者失智症疾病知識、照顧技巧、發展調適方法及運用社會資源等。病患在日常生活照顧及睡眠方面獲得改善，主要照顧者在照顧技巧及個人調適能力方面也有明顯進步。在居家護理經驗中，除了提供整體性的照顧之外，應同時以家庭為中心，教導主要照顧者照顧技巧及增進調適能力，才能使病患在居家治療得到優質的照顧。

This case report presents a nursing experience of providing a home care service for a patient with dementia and his primary caregiver. The home care service was provided throughout December, 2006. Data were collected through observations, family interviews, home visits, medical records, and standardized questionnaires. The nursing problems of the patient consisted of self-care deficit and sleep pattern disturbance, while the problems of the caregiver were insufficient knowledge and ineffective individual coping. During the nursing period, the caregiver was included in this holistic nursing service and given instructions in dementia-related knowledge and caring skills, effective coping strategies, and utilization of social resources. It was found that the patient experienced improvements in activities of daily living function as well as sleep quality, and that the caregiver was able to develop good care giving skills and adaptation capability. This experience of outreach nursing suggests that both patient and caregiver should be included in family-based care.