Research Centre of the CHU of Quebec, Quebec City, QC; Quebec Excellence Centre on Aging, St. Sacrement Hospital, Quebec City, QC; Department of Family and Emergency Medicine, Laval University, Quebec City, QC.
Can J Public Health. 2018 Jan 22;108(5-6):e639-e642. doi: 10.17269/cjph.108.6217.
To improve the care of seniors living with dementia, current initiatives typically target better identification and treatment of the patient. Our recent survey, however, shows we should also focus more on the needs of the informal caregivers who care for this population in primary care settings. This three-round Delphi survey sought caregivers' views on the most frequent and difficult decisions that seniors with dementia, their informal caregivers, and health care providers face in primary care settings in the province of Quebec. Respondents consisted of 31 health care professionals, informal caregivers, managers, representatives of community-based organizations devoted to these seniors, and clinical researchers involved in the organization of care or services to seniors with dementia. When we asked respondents to rank 27 common but difficult decisions involving benefit/harm trade-offs, 83% ranked the decision to choose an option to reduce the burden of informal caregivers as one of the five most important decisions. Choosing a treatment to manage agitation, aggression or psychotic symptoms followed closely, with 79% of respondents selecting it as one of the five most important decisions. Our results point to the importance of attending to the needs of informal caregivers and improving the management of behavioural and psychological symptoms of dementia.
为了提高老年痴呆症患者的护理水平，目前的举措通常侧重于更好地识别和治疗患者。然而，我们最近的调查显示，我们还应该更加关注在初级保健环境中照顾这一人群的非正式护理者的需求。这项三轮德尔菲调查旨在了解护理者对魁北克省初级保健环境中痴呆症老年人、他们的非正式护理者以及医疗保健提供者最常面临的、最困难的决策的看法。受访者包括 31 名医疗保健专业人员、非正式护理者、管理人员、专门为这些老年人服务的社区组织代表以及参与组织痴呆症老年人护理或服务的临床研究人员。当我们要求受访者对涉及利弊权衡的 27 个常见但困难的决策进行排名时，83%的人将选择减轻非正式护理者负担的方案作为五个最重要决策之一。选择治疗方案来管理激越、攻击或精神病症状紧随其后，有 79%的受访者将其作为五个最重要决策之一。我们的研究结果表明，关注非正式护理者的需求和改善痴呆症的行为和心理症状的管理非常重要。
