Pancrazi Marie-Pierre, Métais Patrick
Département médico-gérontologique Paris, France.
Psychol Neuropsychiatr Vieil. 2005 Mar;3 Suppl 1:S42-50.
Care for patients with Alzheimer's disease, particularly with severe dementia, requires a global therapeutic strategy integrating pharmacological approach into the environmental dimensions, psychotherapeutics and rehabilitation. The objective is to maintain autonomy as long as possible but also to improve the quality of life by reducing the psychological suffering of patients and families. In severe dementia, behavioral techniques and organization of the environment are possible at home but, actually, most of the patients are institutionalized. Structures having a specific project of life, of care and specific architectural design should be preferred. Education and support for caregivers as well as training of the nursing staff are essential to develop better attitudes toward the patient, improve communication and optimize the quality of life. In spite of the low level of evidence in the evaluation of these strategies on account of the lack of adapted indicators and rarity of specific research, widely spread techniques can confer special purport to this difficult stage for the patients and their family.
护理阿尔茨海默病患者，尤其是重度痴呆患者，需要一种全面的治疗策略，将药物治疗方法与环境因素、心理治疗和康复相结合。目标是尽可能长时间地维持患者的自主能力，同时通过减轻患者及其家人的心理痛苦来提高生活质量。在重度痴呆患者中，行为技巧和环境布置可以在家中进行，但实际上，大多数患者都被安置在机构中。应优先选择具有特定生活、护理项目以及特殊建筑设计的机构。对护理人员进行教育和支持以及对医护人员进行培训，对于培养对患者更好的态度、改善沟通和优化生活质量至关重要。尽管由于缺乏合适的指标以及特定研究较少，在评估这些策略时证据水平较低，但广泛应用的技术可以为患者及其家庭所处的这一艰难阶段赋予特殊意义。
