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自主性、身份认同与健康:界定老年人的生活质量

Autonomy, identity and health: defining quality of life in older age.

作者信息

Heide Sara Kate

机构信息

School of Medicine, New York Medical College, Valhalla, NY 10595-1524, USA

出版信息

J Med Ethics. 2022 May;48(5):353-356. doi: 10.1136/medethics-2020-107185. Epub 2021 Mar 19.

Abstract

Defining quality of life is a difficult task as it is a subjective and personal experience. However, for the elderly, this definition is necessary for making complicated healthcare-related decisions. Commonly these decisions compare independence against safety or longevity against comfort. These choices are often not made in isolation, but with the help of a healthcare team. When the patient's concept of quality of life is miscommunicated, there is a risk of harm to the patient whose best interests are not well understood. In order to bridge this gap in understanding and unite seniors with their caretakers as a cohesive team, we need to establish a definition of quality of life. In this paper, my personal experiences with the elderly will be analysed along with five essays on the topic of ageing. These sources provide clear evidence that quality of life for seniors is majorly determined by the ability to preserve one's lifelong identity. When making difficult decisions in geriatric healthcare, this greater understanding of the determinants of life quality will allow treatments to best serve the elderly. Defining quality of life allows healthcare providers to shift the focus from minimising disability toward maximising ability. I believe this shift would provide seniors with better health outcomes and properly enhance the quality of their years.

摘要

定义生活质量是一项艰巨的任务,因为它是一种主观的个人体验。然而,对于老年人来说,这种定义对于做出复杂的医疗相关决策是必要的。通常这些决策会在独立性与安全性之间,或者寿命与舒适度之间进行比较。这些选择往往不是孤立做出的,而是在医疗团队的帮助下做出的。当患者的生活质量概念被错误传达时,就有可能对那些未被充分理解其最大利益的患者造成伤害。为了弥合这种理解上的差距,并将老年人及其照顾者团结成一个有凝聚力的团队,我们需要确立生活质量的定义。在本文中,我将分析我与老年人相处的个人经历以及五篇关于老龄化主题的文章。这些资料提供了明确的证据,表明老年人的生活质量主要取决于保持个人终身身份认同的能力。在老年医疗保健中做出艰难决策时,对生活质量决定因素的更深入理解将使治疗能够更好地服务于老年人。定义生活质量能让医疗服务提供者将关注点从最小化残疾转向最大化能力。我相信这种转变将为老年人带来更好的健康结果,并切实提高他们的生活质量。

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