痴呆症患者抗拒护理:挑战、责任和未满足的需求

Jane Pritchard, K. Dening
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引用次数: 0

摘要

对护理的抗拒在痴呆症患者中很常见,可能包括主动抵抗,如大喊大叫,也可能包括被动抵抗,如肌肉僵硬或拒绝张嘴。抵抗发生在复杂的法律和道德背景下,护理人员必须考虑同意、精神能力、最佳利益和护理义务等问题。阻力也存在于强大的护理文化中,护理人员必须抵制以任务为导向、不承认痴呆症患者人格的非人性化护理。护理人员不应接受抗拒是痴呆症的预期组成部分,而应更仔细地、带着好奇心寻找根本原因和未满足的需求。生物心理社会方法有助于发现这些需求,并有助于构建以人为本的反应。
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Resistance to care in people with dementia: challenges, responsibilities and unmet need
Resistance to care is common in people with dementia and can involve active resistance, such as shouting, or passive resistance, such as stiffening of muscles or refusing to open the mouth. Resistance occurs within a complex legal and ethical backdrop, where care staff must consider issues of consent, mental capacity, best interests and duty of care. Resistance also sits within powerful cultures of care, where care staff must resist task-orientated, dehumanising care that fails to acknowledge the personhood of people with dementia. Rather than accepting resistance as an expected part of dementia, care staff must look closer and with curiosity for underlying causes and unmet need. A biopsychosocial approach can be useful in uncovering these needs, and in allowing the structuring of a person-centred response.
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