认知症老人机构照护风险控制:理论模型与实践阐释

A Theoretical Model and Practical Explanation of Risk Control in Institutional Care for the Elderly with Noncognitive Symptom

随着人口老龄化程度的加深,我国不断增加的认知症老人对专业认知症照料提出了迫切需求。受认知症病症特征复杂、主体脆弱等因素影响,认知症老人机构照护面临着高照护风险。本文基于SHEL风险控制理论,聚焦人这一核心要素与其他要素间的相互影响,从人-软件、人-硬件、人-人、人-环境四个维度构建认知症老人机构照护风险控制理论模型。结合南京市R机构实例,通过认知症老人机构照护服务体系构建、疗愈空间设计、认知症友好环境打造、照护主体间协同支持等具体措施,阐释如何系统地生成认知症老人机构照护风险控制路径。在此基础上针对各照护风险因素提出四点对策思考:运用智能技术赋能照护服务体系、打造患者-护理一体化照护系统、营造社会认同与自主支持照护环境和协同多主体共建认知症照护屏障,以推进多层面认知症老人机构照护风险控制体系建立。

V With the deepening of population aging,the increasing number of cognitively impaired elderly in China has put forward an urgent need for professional care.Influenced by the complexity of cognitive disorder characteristics and the vulnerability of subjects,institutional care for the elderly cognitive disorder faces high care risks.Based on the SHEL risk control theory,fo-cused on the interaction among the core element of human and other elements,a theoretical model of institutional care risk control for cognitive impaired elderly was constructed from four dimensions of human-software,human-hardware,human-person,and human-environment.Combined with the examples of R institution in Nanjing,how to systematically generate the risk control path of institutional care for the elderly with cognitive disorders was explained through the construction of the care service system,the design of healing space,the creation of a cognitively friendly environment,and the synergistic support of caregiving subjects.Based on which,four countermeasures were proposed for each care risk factor as using intelligent technology to empower the care service system,creating a patient-care integrated care system,creating a care environment with social recognition and autonomy support,and collaborating with multiple actors to build a cognitive care system.