LeClerc C M, Wells D L
Veterans Affairs Canada, Toronto, Canada.
Geriatr Nurs. 1998 Sep-Oct;19(5):261-7; quiz 268. doi: 10.1016/s0197-4572(98)90099-4.
Self-feeding behavior is often the first of a chain of self-maintenance skills to deteriorate in people with Alzheimer's-type dementia and is a major determinant of institutionalization. Moreover, nurses working in geriatric settings report the feeding of patients as a most difficult management problem. Of the various features of Alzheimer's-type dementia that can affect a person's ability to feed him- or herself, ideational apraxia can explain the loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects necessary for feeding. In this article, a systematic process is used to review the research literature to develop substantive content for nurses caring for people with feeding problems related to ideational apraxia. Ideational apraxia is a condition in which an individual is unable to plan movement related to an object because he or she has lost the perception of the object's purpose. The specific abilities necessary for feeding that are threatened by ideational apraxia are identified. A tool to assess these abilities is described, and nursing interventions aimed at enhancing or preserving existing abilities, preventing excess disability, or compensating for lost abilities are presented.
自我进食行为往往是阿尔茨海默病型痴呆患者一系列自我维持技能中最先恶化的，并且是患者是否会被送进养老院的一个主要决定因素。此外，在老年护理机构工作的护士报告称，给患者喂食是最难处理的管理问题之一。在阿尔茨海默病型痴呆的各种特征中，观念性失用症可以解释患者丧失概念化、计划和执行涉及使用进食所需工具或物品的复杂运动动作序列的能力。在本文中，我们采用系统的方法回顾研究文献，为护理有与观念性失用症相关进食问题的患者的护士制定实质性内容。观念性失用症是一种个体因丧失对物体用途的认知而无法计划与物体相关运动的病症。确定了受观念性失用症威胁的进食所需的具体能力。描述了一种评估这些能力的工具，并提出了旨在增强或保留现有能力、预防过度残疾或补偿丧失能力的护理干预措施。
