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 WATANABEthe patient?s condition. When their diseasecannot be cured by attending a hospital on anoutpatient basis, the patient may be hospitalized.In such cases,“information should be providedto inpatients? wards,”or“information should beprovided by wards to outpatient departments.”When the disease is treated at an outpatient clinic,intentional management, such as management ofmedications, may be required according to thepatient?s cognitive capacity. Therefore,“a nurseshould cooperate with the department of pharmacyfor a patient to take medicine.”(2) Cooperation with people in a communityTo promote community-based integrated caresystems,“a nurse should cooperate with medicalpractitioners.”A nurse?s work should not takeplace only on the ward or at the outpatient clinicin a medical institution, but he/she must recognizethat activities in the community are also valuable.“A nurse should continuously perform communityinvolvement tasks such as exchange meetings.”Inthis way, the support provided to elderly dementiapatients can be more consistent with their dailylives.(3) Cooperation for leaving the hospitalIn the process from hospitalization to discharge,support for elderly dementia patients must bestarted as soon as they are hospitalized.“A nurseshould support a patient toward leaving thehospital from the day of hospitalization.”“Whena nurse supports a patient toward leaving thehospital from the early stage of hospitalization,the patient can easily leave the hospital.”When“anurse cooperates with care managers,”seamlesscare can be easily provided.3) Home recuperation(1) Use of long-term care insuranceFor elderly dementia patients to live in localcommunities, various social resources must beappropriately used. It is true that although a patientoften talks about long-term care insurance, he/shedoes not think that the insurance is necessary forhim/her. It is important for a nurse who is familiarto a patient to explain future problems and use ofsocial resources available to the patient and his/her family.(2) Living aloneA patient who has lived alone without anyproblems has a strong desire to manage his/heraffairs. Even if a patient does not want to contacthis/her children or relatives, a nurse should providean opportunity for the patient to contact his/herchildren or relatives according to the situation.(3) Elder-to-elder nursingBecause an elderly couple who have lived alonewithout any problems do not want to disturb theirchildren, they sometimes work too hard. Childrenalways want to believe that their parents stayhealthy and strong.(4) Living situation at homeA patient who has lived alone without anyproblems does not want to be supported by others.It is a problem that because information on apatient?s actual situation is difficult to obtain fromthe patient, the patient?s living situation cannot besufficiently understood.(5) Medication adherenceFor home recuperation, continuous oraltreatment is required in many cases. Thereare cases in which the amount of medicine isinsufficient and whether the patient lost medicineshould be assessed according to cognitive ability.The situation of oral administration at home canbe assessed by checking the amount of leftovermedicine. These cases should be used to improvemedicine use management.4) Care after recognizing dementiaBecause of the core symptom of dementia andBPSD, patients with dementia face difficulties intheir daily lives. Therefore, nursing-care servicesbased on dementia are required.(1) Primary disease and dementiaThe increase in the number of elderly dementiapatients has been observed in many places. Forexample, the number of elderly outpatients withdementia has markedly increased. Even if a? 247 ?