Ando Takashi, Sato Kyoko, Ishiguro Hiroshi, Karino Mayumi, Ito Chisako, Shinagawa Toshihito, Takao Masaki, Miyamori Tadashi
Kawasaki Total Care Center, Municipal Ida Hospital, City of Kawasaki.
Gan To Kagaku Ryoho. 2010 Dec;37 Suppl 2:204-6.
In case of home care patient's health gets deteriorated, an admission is often requested due to a nursing care need rather than a medical need. However, it is often inevitable to transfer a patient to other nursing home, or to observe the patient at home, is caused by a limitation of medicalre sources and the capacity of the patient to adapt environmental changes. It may be criticized that a medical care of the elderly at home is left unattended as a consequence of the oversight of critical pathophysiologic changes. We have experienced a case diagnosed as Creutzfeldt-Jakob disease, which was not suspected at the initial visit of our ER unit. A grave hidden disease was recognized by next day's emergency visit and a follow-up elaboration examination at our hospital. Such cooperation may have a potency maintaining a home medical treatment level by grasping the precise pathophysiology of home elderly patients.
对于接受家庭护理的患者，若其健康状况恶化，通常是由于护理需求而非医疗需求而要求住院。然而，由于医疗资源的限制以及患者适应环境变化的能力，往往不可避免地要将患者转至其他养老院，或者让患者在家中接受观察。由于对关键病理生理变化的疏忽，居家老年人的医疗护理可能会受到批评。我们曾遇到一例最初在急诊科就诊时未被怀疑为克雅氏病的病例。通过次日的急诊就诊以及在我院进行的后续详细检查，发现了这一严重的隐匿性疾病。这种合作可能具有通过掌握居家老年患者的精确病理生理学来维持家庭医疗水平的潜力。
