Mitoku Kazuko, Shimanouchi Setsu
Department of Nursing, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan.
Faculty of Nursing, Hiroshima Bunkagakuen, Kure-city, Hiroshima, Japan.
Open Nurs J. 2014 Jun 13;8:17-24. doi: 10.2174/1874434620140512001. eCollection 2014.
The present study assessed the decision-making and communication capacities of older adults with dementia who required assistance and care and measured the subsequent changes in these capacities. Of 845 older adults who received long-term care between April 2003 and December 2004, about half of them without dementia were excluded and the remaining 448 were finally included in the analyses. These individuals were completed follow-up for assessment for two years. The data were obtained from the Long-Term Care Insurance Certification Committee for Eligibility in Gujo City. A total of 73.7% of people with dementia were somewhat capable of making decisions (32.4% were reported as being "always capable"; 41.3% were reported as being "sometimes capable"). A total of 93.7% were somewhat capable of communicating with others (78.3% were reported as being "always capable"; 15.4% were reported as being "sometimes capable"). The results indicate that older adults with dementia can participate in their own care decisions, even if they require assistance and support in their daily lives. The present study shows, however, that baseline decision-making capacity declined to about half what they were after one year and to about one-third of what they were after two years, suggesting that earlier efforts are needed to ensure that the preferences of individuals with dementia are reflected in their care.
本研究评估了需要协助和护理的老年痴呆症患者的决策和沟通能力，并测量了这些能力随后的变化。在2003年4月至2004年12月期间接受长期护理的845名老年人中，约一半没有痴呆症的老人被排除在外，其余448人最终纳入分析。对这些个体进行了为期两年的随访评估。数据来自郡上市长期护理保险资格认证委员会。共有73.7%的痴呆症患者有一定的决策能力（32.4%被报告为“一直有能力”；41.3%被报告为“有时有能力”）。共有93.7%的患者有一定的与他人沟通的能力（78.3%被报告为“一直有能力”；15.4%被报告为“有时有能力”）。结果表明，老年痴呆症患者即使在日常生活中需要协助和支持，也能参与自己的护理决策。然而，本研究表明，基线决策能力在一年后下降到原来的大约一半，在两年后下降到原来的大约三分之一，这表明需要尽早努力确保痴呆症患者的偏好能够在其护理中得到体现。
