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优化养老院的居家临时护理:当前问题及通往更美好未来的解决方案。

Optimising residential respite care in nursing homes: Current problems and solutions for a better future.

作者信息

Willoughby Melissa, Ibrahim Joseph Elias, Ferrah Noha, Bugeja Lyndal

机构信息

Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Vic., Australia.

出版信息

Int J Older People Nurs. 2018 Jun;13(2):e12180. doi: 10.1111/opn.12180. Epub 2017 Nov 23.

Abstract

AIM

To examine whether residential respite care increases the risk of harm to older people and suggest directions for future research and policy.

BACKGROUND

Respite care is a vital part of the aged care system that supports dependent older people and their caregivers to continue residing in the community. There is little research determining whether an older person experiences harm from residential respite.

METHODS

This commentary considered conceptual research and existing empirical evidence to determine whether the risk of death was greater during residential respite care for older people.

RESULTS

Evidence on the mortality in contemporary respite care is extremely limited with the majority of studies published almost 20 years ago and focussing on planned respite admissions. The evidence available has limitations in design and lacks comparison groups and key variables relevant to outcome and risk stratification. Nonetheless, it provides a theoretical basis supporting that the potential for harm and mortality may be increased during a residential respite care admission.

CONCLUSIONS

The question of whether residential respite care presents significant risks to older people remains unanswered. Substantial changes in practice since the last century make the existing empirical evidence redundant. However, there is much to learn by reflecting on omissions of important details from these studies.

IMPLICATIONS FOR PRACTICE

A full and objective understanding of the harm associated with residential respite care for older people requires reopening and re-examining this area with robust research. Informed professional nursing practice and policy requires an empirical evidence basis to residential respite care.

摘要

目的

探讨居家短期照料是否会增加老年人受到伤害的风险,并为未来研究和政策提供方向。

背景

短期照料是老年护理体系的重要组成部分,它支持依赖他人的老年人及其照料者继续居住在社区。关于老年人是否会因居家短期照料而受到伤害的研究很少。

方法

本评论考虑了概念性研究和现有实证证据,以确定老年人在居家短期照料期间死亡风险是否更高。

结果

当代短期照料中死亡率的证据极为有限,大多数研究发表于近20年前,且集中于计划性短期照料入院情况。现有证据在设计上存在局限性,缺乏对照组以及与结果和风险分层相关的关键变量。尽管如此,它提供了一个理论基础,支持在居家短期照料入院期间伤害和死亡的可能性可能会增加。

结论

居家短期照料是否会给老年人带来重大风险这一问题仍未得到解答。自上世纪以来实践中的巨大变化使得现有实证证据不再适用。然而,通过反思这些研究中重要细节的遗漏,仍有许多可学习之处。

对实践的启示

要全面、客观地了解与老年人居家短期照料相关的伤害,需要通过有力的研究重新审视这一领域。明智的专业护理实践和政策需要以居家短期照料的实证证据为基础。

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