Development and Evaluation of a Training Program for High-Quality Care for Elderly People with Severe Cognitive Disorders

【目的】通过录像观察老年痴呆患者的表情和行为，明确护理方法，鼓励积极表达，减少消极表达。【方法】对集体之家27名失智老年人的表情和行为进行录像。每天录音12小时，分为6次（一次2小时），每人10分钟，一天1小时。每月做三天，为期六个月。【结果】共收集数据342小时，其中与他人的社会相互反应场景252小时，表情数据90小时，对护理类型的反应变化显著。【结论】老年痴呆患者即使有认知障碍，也会给我们各种各样的信号，护理人员应该通过仔细观察老年人的行为和表达来判断护理是否合适，提高护理质量注意这个人特有的情绪反应迹象，并试着在-1级采取行动要注意到这种特殊的迹象，关键是要观察手指的运动，即使是轻微的运动在日常生活行为中可以看到，在日常护理中也可以注意到共享并记录，以提高日后的护理质量即使在严重痴呆的情况下，也有+3级的能力。相信它会给予关怀采取适当的行动对-2级来说是困难的，对-3级来说是极其困难的实践护理的积累是提升失智老年人护理质量的关键。

【Purpose】 Watch the expression and behavior of the demented elderly by use of Video record, and clarify the care method to encourage positive expressions and reduce negative expressions.【Method】 Expressions and behavior of 27 demented elderly residents in the group home were recorded by audiovisual camera. Recording was made for 12 hours a day, divided into 6 sessions (one session 2 hours), 10 minutes for one person, having one hour in one day. It was done three days a month for the period of six months. Data analysis was done by using one zero sampling method and QOL scales, etc.【Result】 Total 342 hours of collected data included 252 hours of social mutual reaction scenes with others and 90 hours of expression data, showing remarkable changes in response to the types of care.【Conclusion】 The elderly with dementia are 'giving us various signs even though they have cognitive disorders, and care givers should be able to judge if the care is appropriate or not and improve the quality of care through careful observation of the behavior and expression of the elderly.1 Notice the sign of emotional response that is peculiar to the person and try to take action at -1 level.2 To notice the peculiar sign, key point is to watch the finger movement even for the slight move.3 Peculiar sign can be seen in daily living behavior and can be noticed in everyday care.4 Share the sign and record it to improve the quality of care in the future.5 Even in the case of serious dementia, there is the ability of +3 level. Trust it in giving care.6 To take appropriate action is difficult for -2 level and extremely difficult for -3 level.7 Accumulation of practical care is the key to upgrade the quality of care for the demented elderly people.