Fleishman R, Rosin A, Tomer A, Schwartz R
JDC-Brookdale Institute of Gerontology and Adult Human Development, Jerusalem, Israel.
Compr Gerontol B. 1987 Mar;1(1):18-23.
This study sought to determine whether cognitively impaired elderly in long-term care institutions receive a lower quality of care than do the non-impaired. The quality of care for each of 136 elderly in nine units for independent, frail and nursing residents was examined through the tracer method. On the basis of the MSQ test and an assessment by the ward nurse, a composite scale for measuring cognitive impairment was developed. Sixty-one percent of the elderly were found to suffer moderate to severe cognitive impairment. The cognitively impaired patients were found to receive poorer nursing care and staff were unaware of the existence of a greater proportion of their medical problems, compared with the non-impaired. The findings suggest that the lower quality care provided to the cognitively impaired is related to their greater behavioral and social problems such as aggressiveness and apathy. Staff members are apparently less inclined to have contact with patients displaying such problems. Changes of referral policies and training programs for institutional staff on the care of the cognitively impaired elderly are necessary in order to improve care for this group.
本研究旨在确定长期护理机构中认知受损的老年人所接受的护理质量是否低于未受损的老年人。通过追踪法对9个分别收治独立、体弱和护理型居民的单元中的136位老年人的护理质量进行了检查。基于MSQ测试和病房护士的评估，制定了一个用于测量认知障碍的综合量表。结果发现，61%的老年人患有中度至重度认知障碍。与未受损的老年人相比，认知受损的患者接受的护理较差，且工作人员未意识到他们存在更大比例的医疗问题。研究结果表明，为认知受损者提供的较低质量护理与他们更严重的行为和社会问题（如攻击性和冷漠）有关。工作人员显然不太愿意与表现出此类问题的患者接触。为了改善对这一群体的护理，有必要改变转诊政策，并为机构工作人员开展关于照顾认知受损老年人的培训项目。
