Ounalli Heifa, Mamo David, Testoni Ines, Belvederi Murri Martino, Caruso Rosangela, Grassi Luigi
Institute of Psychiatry, Department of Neurosciences and Rehabilitation (formerly Department Biomedical and Specialty Surgical Sciences), University of Ferrara, 44121 Ferrara, Italy.
Department of Psychiatry, University of Malta, 2080 Msida, Malta.
Behav Sci (Basel). 2020 Nov 24;10(12):178. doi: 10.3390/bs10120178.
Demographic changes have placed age-related mental health disorders at the forefront of public health challenges over the next three decades worldwide. Within the context of cognitive impairment and neurocognitive disorders among elderly people, the fragmentation of the self is associated with existential suffering, loss of meaning and dignity for the patient, as well as with a significant burden for the caregiver. Psychosocial interventions are part of a person-centered approach to cognitive impairment (including early stage dementia and dementia). Dignity therapy (DT) is a therapeutic intervention that has been shown to be effective in reducing existential distress, mood, and anxiety symptoms and improving dignity in persons with cancer and other terminal conditions in palliative care settings. The aims of this paper were: (i) To briefly summarize key issues and challenges related to care in gerontology considering specifically frail elderly/elderly with cognitive decline and their caregivers; and (ii) to provide a narrative review of the recent knowledge and evidence on DT in the elderly population with cognitive impairment. We searched the electronic data base (CINAHL, SCOPUS, PSycInfo, and PubMed studies) for studies regarding the application of DT in the elderly. Additionally, given the caregiver's role as a custodian of diachronic unity of the cared-for and the need to help caregivers to cope with their own existential distress and anticipatory grief, we also propose a DT-dyadic approach addressing the needs of the family as a whole.
人口结构变化已使与年龄相关的心理健康障碍成为全球未来三十年公共卫生挑战的前沿问题。在老年人认知障碍和神经认知障碍的背景下，自我的碎片化与患者的生存痛苦、意义和尊严的丧失相关，也给照顾者带来了巨大负担。心理社会干预是认知障碍（包括早期痴呆和痴呆）以人为本方法的一部分。尊严疗法（DT）是一种治疗干预措施，已被证明在减轻姑息治疗环境中癌症和其他终末期疾病患者的生存痛苦、情绪和焦虑症状以及提高尊严方面有效。本文的目的是：（i）简要总结老年医学护理相关的关键问题和挑战，特别考虑体弱老年人/认知能力下降的老年人及其照顾者；（ii）对认知障碍老年人群中尊严疗法的最新知识和证据进行叙述性综述。我们在电子数据库（CINAHL、SCOPUS、PSycInfo和PubMed研究）中搜索了关于尊严疗法在老年人中应用的研究。此外，鉴于照顾者作为被照顾者历时统一性守护者的角色以及帮助照顾者应对自身生存痛苦和预期悲伤的必要性，我们还提出了一种尊严疗法二元方法，以满足整个家庭的需求。
