Aim: Hip fracture implies severe problems to older people;special concerns regard persons with dementia, due either to cognitive impairment, or to behavioral and psychic symptoms. This study illustrates rehabilitative...Aim: Hip fracture implies severe problems to older people;special concerns regard persons with dementia, due either to cognitive impairment, or to behavioral and psychic symptoms. This study illustrates rehabilitative outcomes of these patients discharged by a special care unit ruled by “GentleCare” principles. Method: 54 patients [89% females, aged 82.3 years (range 66 - 94)] followed a post-surgery rehabilitative program carried out by a physiotherapist and an occupational therapist, supported by a psychologist. The multidimensional assessment consisted of cognition evaluation (Mini Mental State Examination, Clinical Dementia Rating, Global Deterioration Scale), functional evaluation (Barthel Index, Tinetti Gait and Balance, Bedford Alzheimer Nursing Severity scale), behavioral evaluation (UCLA Neuropsychiatric Inventory) and comorbidity evaluation (Cumulative Illness Rating Scale). Results: All parameters improved, including the 5 most frequent behavioral and psychic symptoms that usually preclude admission in ordinary rehabilitation units. 24% of improvement in Barthel Index total score was explained by agitation and apathy at discharge, in a multiple linear regression model: better functional levels corresponded to smoother behavioral problems. Most patients improved;70.5% of them were discharged to home. Conclusion: A prosthetic approach enables valuable results in the rehabilitation of severely demented patients with hip fracture also in presence of behavioral symptoms.展开更多
在痴呆负担日益沉重的背景下,痴呆特别照料单元(Dementia Special Care Units,DSCU)作为旨在为阿尔茨海默病等痴呆症患者提供专病照料的有效手段逐渐受到重视。经过长期发展,DSCU在物理空间、人力资源建设、效果评价等方面已经形成成熟...在痴呆负担日益沉重的背景下,痴呆特别照料单元(Dementia Special Care Units,DSCU)作为旨在为阿尔茨海默病等痴呆症患者提供专病照料的有效手段逐渐受到重视。经过长期发展,DSCU在物理空间、人力资源建设、效果评价等方面已经形成成熟的建设策略,实践证明规范的DSCU可以帮助控制痴呆相关精神行为异常(Behavioral and psychological symptoms of dementia,BPSD),使痴呆患者获益。本文就DSCU的发展、建设、展望作一综述。展开更多
梳理了美国20世纪50年代至今失智老年人照料设施以及照料单元空间设计的发展趋势与特点,对比中国失智老年人照料设施照料单元空间设计的现状特点,提出相应的借鉴做法。选取美国不同时期失智老年人照料设施建设的典型案例,发现其发展趋势...梳理了美国20世纪50年代至今失智老年人照料设施以及照料单元空间设计的发展趋势与特点,对比中国失智老年人照料设施照料单元空间设计的现状特点,提出相应的借鉴做法。选取美国不同时期失智老年人照料设施建设的典型案例,发现其发展趋势为:从注重医护效率的“精神病院模式”,到专门的“失智老年人照护单元(SCU)”,进一步发展强调居家氛围的“介助生活Assisted Living”,一直发展到当今进一步强调老人精神和情感需求的“记忆照护单元模式Memory Care Unit”。这一过程体现了从强调“医护效率”到“以老人为中心”的根本转变。对比中国典型失智老年照料设施案例,借鉴中美失智老年人照料单元空间设计特点。中国失智老年人照料设施与照料单元的空间设计可以在建设规模、公共空间、户外环境等方面,借鉴美国的建设发展经验。展开更多
文摘Aim: Hip fracture implies severe problems to older people;special concerns regard persons with dementia, due either to cognitive impairment, or to behavioral and psychic symptoms. This study illustrates rehabilitative outcomes of these patients discharged by a special care unit ruled by “GentleCare” principles. Method: 54 patients [89% females, aged 82.3 years (range 66 - 94)] followed a post-surgery rehabilitative program carried out by a physiotherapist and an occupational therapist, supported by a psychologist. The multidimensional assessment consisted of cognition evaluation (Mini Mental State Examination, Clinical Dementia Rating, Global Deterioration Scale), functional evaluation (Barthel Index, Tinetti Gait and Balance, Bedford Alzheimer Nursing Severity scale), behavioral evaluation (UCLA Neuropsychiatric Inventory) and comorbidity evaluation (Cumulative Illness Rating Scale). Results: All parameters improved, including the 5 most frequent behavioral and psychic symptoms that usually preclude admission in ordinary rehabilitation units. 24% of improvement in Barthel Index total score was explained by agitation and apathy at discharge, in a multiple linear regression model: better functional levels corresponded to smoother behavioral problems. Most patients improved;70.5% of them were discharged to home. Conclusion: A prosthetic approach enables valuable results in the rehabilitation of severely demented patients with hip fracture also in presence of behavioral symptoms.
文摘在痴呆负担日益沉重的背景下,痴呆特别照料单元(Dementia Special Care Units,DSCU)作为旨在为阿尔茨海默病等痴呆症患者提供专病照料的有效手段逐渐受到重视。经过长期发展,DSCU在物理空间、人力资源建设、效果评价等方面已经形成成熟的建设策略,实践证明规范的DSCU可以帮助控制痴呆相关精神行为异常(Behavioral and psychological symptoms of dementia,BPSD),使痴呆患者获益。本文就DSCU的发展、建设、展望作一综述。
文摘梳理了美国20世纪50年代至今失智老年人照料设施以及照料单元空间设计的发展趋势与特点,对比中国失智老年人照料设施照料单元空间设计的现状特点,提出相应的借鉴做法。选取美国不同时期失智老年人照料设施建设的典型案例,发现其发展趋势为:从注重医护效率的“精神病院模式”,到专门的“失智老年人照护单元(SCU)”,进一步发展强调居家氛围的“介助生活Assisted Living”,一直发展到当今进一步强调老人精神和情感需求的“记忆照护单元模式Memory Care Unit”。这一过程体现了从强调“医护效率”到“以老人为中心”的根本转变。对比中国典型失智老年照料设施案例,借鉴中美失智老年人照料单元空间设计特点。中国失智老年人照料设施与照料单元的空间设计可以在建设规模、公共空间、户外环境等方面,借鉴美国的建设发展经验。
