ブックタイトル教育医学 J.Educ.Health Sci.　第63巻　第3号　通巻 第289号

概要

教育医学 J.Educ.Health Sci.　第63巻　第3号　通巻 第289号

Kanako OGISO, Sayuri TOIDA and Miyuki WATANABEcodesubcategorycategoryAlthough a patient often talks about long-term care insurance, he/she does not think that the insurance is necessaryUse of long-term careHome recuperationfor him/her.A nurse who is familiar to a patient and has information on long-term care insurance should explain the insuranceto the patient and his/her family.A nurse who is familiar to a patient should explain future problems and use of social resources available to thepatient and his/her family.It is difficult for a patient and his/her family to understand the explanation of long-term care insurance from amunicipality.Nursing intervention makes an emergency outpatient use long-term care insurance when he/she consults with aphysician.insuranceEven if a patient does not want to contact his/her children or relatives, a nurse should contact them according toLiving alonethe situation.A patient who lives alone has a strong desire to manage his/her affairs.Because an elderly couple does not want to disturb their children, they sometimes work too hard.Elder-to-elder nursingChildren want to believe that their parents stay healthy and strong.Because information on a patient’s actual situation is difficult to obtain from the patient, the patient’s living situationLiving situation at homecannot be sufficiently understood.A patient has lived alone without being supported by others.The fact that the amount of medicine is insufficient and the patient lost medicine should be assessed according tocognitive ability.The situation of oral administration at home can be assessed by checking the amount of leftover medicine.Medication adherenceThe number of elderly outpatients with dementia has markedly increased.A patient behaves suspiciously or acts violently while waiting for consultation.Even if a patient has dementia, the patient’s disease must be cured.In the process of therapy, the patient cannot understand the necessity of changing the internal medicine.A nurse should occasionally confirm whether the patient understands his/her explanation.When a patient is disordered due to environmental change, a nurse should individually find a way for the patientto calm down.When a patient’s family cannot understand a nurse’s explanation, the nurse should explain again in a different way.When a patient interprets a doctor’s explanation in his/her own way, a nurse should explain again.A nurse should learn how to cope with elderly patients with dementia through experience.A nurse should prepare a calm environment for patients.A nurse should receive dementia care training.A nurse should always try to cope with patients with dignity.A nurse should be slowly and steadily involved in a patient in order to draw the patient’s desire.A nurse cannot receive a sign from elderly patients with dementia.It is difficult to perform dementia care for outpatients because the time for each outpatient is limited.A patient’s family is not aware of the patient’s cognitive decline.A patient’s desire differs from his/her family’s desire.A patient’s family members cannot care for the patient because they are too busy.A patient’s family cannot care for the patient with the same level of quality as professionals.A patient’s family is capable of collecting information.A patient’s family members independently cope with the patient.A patient’s family members make every effort to take care of the patient.ex-Easy-to-understandplanationPrimary disease and dementiaAcquisition of dementiacareDifficulty in dementiacareFamily members whodo not want to admit thepatient who has dementiaFamily’s caring abilityFamily members whoadmit the patient who hasdementiaCare after recognizingdementiaImprovement in dementiacare skills as aprofessionalThe circumstances of apatient’s familylimited. Here, 10 subcategories were extracted.(1) Consultation with a physician together withthe facility staffWhen an elderly dementia patient in a facilityundergoes a medical examination at a medicalinstitution,“because a patient or his/her familysometimes does not sufficiently explain his/her condition, the facility staff should attendconsultation with a physician in order to obtaininformation on the patient.”For the medicalinstitution,“a patient or his/her family shouldunderstand the situation of ADL and BPSD incooperation with the facility staff.”However,there is a problem because“the facility sometimesinsufficiently cooperates with facilities for theelderly other than facilities covered by long-termcare insurance.”(2) Consultation with a physician together withthe familyIt is important for a patient?s family to visitthe medical institution because“when a patient?sfamily also attends consultation with a physician,information on the patient may be obtainedfrom the family.”Many things about a patient?sdementia cannot be easily understood by others.Therefore,“even if a patient?s family attendsconsultation with a physician, the family does notunderstand the patient?s condition”in many cases.In such cases, an approach must be adopted to helpthe family understand dementia.(3) Consultation with a physician aloneIt is not unusual that an elderly dementia patient? 245 ?