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什么因素有助于或阻碍晚期痴呆症患者在家中生活直至生命终结?一项使用家庭护理人员、全科医生和个案经理回溯性访谈的定性研究。

What Facilitates or Hampers Living at Home With Advanced Dementia Until the End of Life? A Qualitative Study Using Retrospective Interviews Among Family Caregivers, General Practitioners, and Case Managers.

机构信息

Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands.

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University, Amsterdam, Netherlands.

出版信息

J Appl Gerontol. 2023 Jul;42(7):1404-1413. doi: 10.1177/07334648231153722. Epub 2023 Jan 29.

Abstract

This study provides insight into circumstances that facilitate or hamper living at home with advanced dementia until the end of life. Interviews were held with 11 bereaved family caregivers, two general practitioners, and nine case managers, related to a total of 12 persons with advanced dementia who had recently died. Persons with dementia who lived at home until the end of life often had family caregivers that received timely support from professionals and their social network. In the cases where the person with dementia could not live at home until the end of life, safety issues, severely challenging behavior, and high care dependency of the person with dementia played key roles. Case management and a continuous process of advance care planning will improve the chance that the end-of-life setting is in accordance with the key values and needs of both the person with dementia and family caregivers.

摘要

本研究深入探讨了有助于或阻碍患有晚期痴呆症的人在家中生活直至生命终结的各种情况。我们采访了 11 名丧亲的家庭护理人员、2 名全科医生和 9 名个案经理,他们与总共 12 名最近去世的患有晚期痴呆症的人有关。在家中生活直至生命终结的痴呆症患者的家庭护理人员通常会及时得到专业人员和社交网络的支持。在那些患有痴呆症的人无法在家中生活直至生命终结的情况下,安全问题、严重挑战性行为以及患者的高度护理依赖是关键因素。病例管理和持续的预先护理计划过程将提高临终环境符合痴呆症患者和家庭护理人员的关键价值观和需求的机会。

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