Wojnar J
Leiter des Psychiatrischen Dienstes im Landesbetrieb Pflegen und Wohnen in Hamburg.
Z Gerontol. 1993 Nov-Dec;26(6):459-65.
"Health" in the elderly describes an instable balance that exists between physical, psychological, and social factors as they pertain to the individual. The disruption of this balance can render the patient incapable of taking care of himself, thus requiring comprehensive care either at home or in an institution. Even the circumstance under which a transfer to an institution is made can have a negative effect on the subjects health; a careful analysis should be made of these factors before a decision to transfer is made. The following factors are critical in preventing or limiting the negative impact of either home or institutional care: architectural structuring of the environment organization of patient care type of medical care required type of physical therapy required It is a primary importance that the parties involved (patient and immediate family) be allowed to make and/or influence the decision on care and that they retain a feeling of personal responsibility for what happens. When a patient is institutionalized, he should be given the chance to continue his individual lifestyle whenever possible; his private sphere should be maintained. Disturbances that are caused by inappropriate changes in these structural factors should not be considered symptoms requiring psychopharmacological therapy.
老年人的“健康”描述的是身体、心理和社会因素与个体相关时所存在的一种不稳定平衡。这种平衡的打破会使患者无法自理，从而需要在家中或机构中接受全面护理。甚至转至机构这一情况也可能对患者健康产生负面影响；在做出转院决定之前，应对这些因素进行仔细分析。以下因素对于预防或限制家庭护理或机构护理的负面影响至关重要：环境的建筑结构、患者护理的组织方式、所需的医疗护理类型、所需的物理治疗类型。至关重要的是，应允许相关各方（患者及其直系亲属）做出和/或影响护理决策，并让他们对所发生的事情保持个人责任感。当患者被安置在机构中时，应尽可能让他有机会继续其个人生活方式；应维护其私人空间。由这些结构因素的不适当变化所引起的干扰不应被视为需要心理药物治疗的症状。
