STUDY OF CASE MANAGEMENT FOR FALLS AMONG PEOPLE WITH DEMENTIA

针对养老院和一家老年医院中的老年痴呆症患者进行了研究，内容涉及老年痴呆症患者跌倒的次数、跌倒的危险因素以及老年痴呆症患者设施的管理。研究结果澄清了以下几点：[跌倒次数]1.老年痴呆症患者在养老院一年中跌倒的次数占跌倒总数的26%-61%。跌倒中有26%的人受伤，尤其是头部和面部。摔倒主要是由于运动不稳定，以及与他人的沟通问题[导致跌倒的因素]1.许多跌倒是由痴呆症晚期的人造成的。跌倒患者经常出现明显的姿势倾斜、方向偏离和步态节奏不规则。有精神错乱、视力障碍、营养障碍和尿失禁等问题的人跌倒的风险很高。[老年痴呆症设施的管理]1.跌倒的人的活动区域覆盖了整个设施。养老机构的居民白天有80%以上的时间是独自一人的。根据两年的研究结果，护理人员的分配不足以监督行动范围广泛的老年痴呆症患者。编写了《老年痴呆症患者预防跌倒的病例管理政策》手册。

Studies were carried out, targeting aged people with dementia in nursing homes and a geriatric hoslital, concerning the number of falls by aged people with dementia the risk factors involved in falls and management of facilities for aged people with dementia. The results of the studies clarified the following points :[Number of falls]1. The number of falls by aged people with dementia over the course of one year at nursing homes was 26-61% of the total number of falls.2. Injuries were incurred in 26% of the falls, especially to the head and face.3. Falls were mainly due to unstable movement, as well sa communication problems with other people[Factors causing falls]1. Many of the falls were by people with advanced dementia.2. Significant inclinations in posture, divergence in direction and irregularities in the rhythm of gait were frequently observed in the people who experienced falls.3. The risk of falling was high for people with such problems as delirium, visual disorder, nutritional disorder and urinary incontinece.[Management of facilities for aged people with dementia]1. The area of movement for the people who wxperienced falls covered the whole facility.2. Residents at facilities for the aged spent more than 80% of their time during the day alone.3. The allocation of care staff was inadequeate for the supervision of aged people with dementia whose movement covered a wide area.Based on the results of a 2-year study period. we prepared a manual of "Case Management Policies for the Prevention of Falls Among Aged People with Dementia".