A study for developing a nursing care skill model of end of life for elderly with dementia about nurses at the long term care welfare facilities

本研究以长野县老年痴呆症长期护理机构的336名护理人员为研究对象，探讨老年痴呆症临终护理技能的提高模式。47.9%的护士回答了这个问题。老年痴呆患者临终护理技能需求为15项。临终关怀技能模式的课程在一年中创建了11次。模式建立的目的是为了提高护理人员的护理技能能力，旨在提高机构中老年痴呆症患者的临终护理质量。并将其作为临终关怀的课程进行，形成临终关怀的指导方针。临终关怀课程每年进行11次。参与者共有18名护士。将临终关怀指南（Q & A）印制成5 0页共7部分的小册子，该模式可作为提高机构老年痴呆患者临终关怀质量的有效途径。特别是，该模式改变了护理人员的看法和价值观，被拒绝照顾老年痴呆症在机构。此外，本研究亦提示护理人员之照护技巧提升，对于提高失智症老人临终照护品质具有重要意义。

The purpose of this study was to clarify the model of toward improving nursing care skill for end of life of elderly with dementia about nurses at the long-term care institution.The subjects were nurses (n=336) working at the long-term care institutions for the elderly with dementia in Nagano prefecture. Forty-seven and nine% of nurses answered the question. Their needs of nursing care skill for end of life of elderly with dementia were 15 parts. The courses of end of life care skill model were created eleven times in year. The aim of model creation was aiming at development of the care skill capability of nurses aiming at improvement in the quality of end of life care of the elderly people with dementia in institution. And it was carried out as the courses of end of life care, making up the guideline of end of life care. The courses of end of life care were carried out eleven times in year. The totals of participants were 18 nurses. The guideline (Q and A) of end of life care was printed as the booklet that was 50pages of 7 parts.The model may be an effective way to development of the care skill capability of nurses aiming at improvement in the quality of end of life care of the elderly people with dementia in institution. Especially, the model had changed the perception and values of nurses who were rejected care of the elderly people with dementia in institution. Furthermore, this study has suggested that it was important to focus on care skill-up of nurses in the quality of end of life care of the elderly people with dementia.