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

Current Situation of and Problems with Elderly Patients with Dementia Home Recuperation in Japanpatient has dementia, the patient?s disease must becured. However, it is a problem that in the processof therapy, the patient cannot understand thenecessity of changing the internal medicine.(2) Easy-to-understand explanationBecause it is sometimes difficult to understandwhat an elderly dementia patient wants to explain,a nurse should occasionally confirm whetherthe patient understands his/her explanation. It isnecessary that when a patient interprets a doctor?sexplanation in his/her own way, a nurse shouldexplain again.5) Improvement in dementia care skills as aprofessionalNurses are requested to improve their practicalability of nursing-care services for elderlydementia patients.(1) Acquisition of dementia careNurses are requested to learn the characteristicsof dementia and to acquire the ability to performwhat they have learnt. There are variousopportunities to learn the characteristics ofdementia. For example, a nurse should learnhow to cope with elderly patients with dementiathrough experience.(2) Difficulty in dementia careIt is important for nurses not only to payattention to dementia but also to understand thesituation of each elderly dementia patient. Thereare problems that a nurse cannot receive a signfrom elderly patients with dementia, and it isdifficult to perform dementia care for outpatientsbecause the time for each outpatient is limited.6) The circumstances of a patient’s familyIt is difficult for a person to understand thathis/her family member suffers from dementia.To accept an elderly dementia patient as he/she ismay develop a new family relationship.(1) Family members who do not want to admit thepatient who has dementiaEven if a patient?s family lives with the patient,the family is sometimes not aware of the patient?scognitive decline. There is a case in which apatient?s desire differs from his/her family?s desire.(2) Family?s caring abilityIt is a problem that since a patient?s familymembers have their own lives, the family memberscannot care for the patient because they are toobusy. There is a case in which even if a patient?sfamily works hard to provide care, the familycannot care for the patient with the same level ofquality as professionals.(3) Family members who admit the patient whohas dementiaWhen the family of an elderly dementia patientindependently provides care to the patient, thefamily is capable of collecting information.Ⅳ．DiscussionThe number of elderly dementia patients hasincreased. To continue home recuperation, the roleof an outpatient nurse according to the cognitivecapacity of a patient is important. During theoutpatient consultations that have limited timeduration, a physician is requested to obtain andassess various types of information and to selectnecessary support based on the information. It hasbeen elucidated that evaluation and counselingby the physician is likely to strongly influencepatient and caregiver awareness of dementiaand hopefully slow disease progression 3) .Therefore,“advocacy from nurses”is importantfor nurses to serve as a bridge between patientsand physicians. To advance community-basedintegrated care systems, seamless care for elderlydementia patients must be improved in order tocope with medical needs. Based on a report onan urgent project aimed at enhancing medicaltreatment for dementia and improving qualityof life, systems providing professional nursingcare, including urgent measures against BPSD,are to be evaluated so as to facilitate continuousimprovement of the quality of dementia care inJapan 5) .“The role of an outpatient nurse accordingto the cognitive capacity of a patient”is important? 248 ?