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一、失能判定工具:

◆工具一:日常生活活動功能評估ADLs (台灣常用的是巴氏量表)

◆工具二:工具性日常生活活動功能評估 IADLs

◆ 失能狀況判定:

輕度失能 1~2 項 ADLs 失能者 或僅 IADLs 失能的獨居老人

中度失能 3~4 項 ADLs 失能者

重度失能 5 項以上 ADLs 失能者

二、失能者日常照護技巧:

 

 1.定期帶失能者做健康檢查

失能者的健康是照顧上的第一要點,家屬應與醫生討論預防再次失能的用藥,和要做哪些健康檢查,例如:大腸癌篩檢、子宮頸抹片、乳癌篩檢、骨質疏鬆篩檢等等。疾病早期發現早期治療,健康檢查能幫助失能者與家屬了解目前的病況並擬定因應的措施。

 

2.定期帶門診持續的追蹤與治療

家屬記得不要只拿藥而不回診,唯有定期回診,才能讓醫療團隊實際了解失能者目前的病況變化,讓醫師能針對近況「對症下藥」。並且能將照護期間所遇到的困難與擔心,與醫療或照護團隊討論。

 

3.遵照醫生指示用藥

有任何服用藥物的問題,例如身體有其他不適、副作用等等,應及時咨詢醫師。此外請遵照醫囑用藥,以確認用藥的療效。

 

4.均衡飲食與適當水分

一般人的用餐進食能帶來身心的快樂與滿足,失能者當然也是。有許多人會說:「他能吃的食物不多。」那麼我們可以在色澤、氣味、擺盤等多做變化,讓感官依舊可以享受食物帶來的趣味,盡可能不要像「做功課」的態度讓失能者用餐。

營養和飲食照護做得好,失能者才有充足的營養和體力,讓自己變得更好。此外,水也不是喝多就代表對健康好,要依目前的情況給失能者水喝。可以進一步與醫療、照護團隊討論,目前病症與病況的飲食照護。

 

5.維護口腔衛生與身體衛生

口腔清潔對於失能者的健康非常重要,一但忽略了,可能會間接導致身體的健康狀況持續下滑。

 

6.保持規律運動習慣

運動的好處我們從小聽到大,對於失能者而言,運動更是好處多多。一開始時,我們可以用漸進與規律的方式增加運動的強度與頻率,循序漸進地誘導失能者維持規律的運動,運動能幫助失能者維持身體健康、避免跌倒和促進大腦健康。

動動手、動動腳、動動肩膀,除了到戶外運動外,即使在室內,也有許多健康操可以運用喔。

 

7.維持規律的作息

培養每天運動、曬太陽的習慣,還有規律的睡眠作息,將有助於失能者改善情緒、生理時鐘與時間睡眠。

 

8.維持與朋友往來,參與各種社交活動

即使目前身體有一些不便,仍要讓失能者持續參加社區舉辦的各種活動,以保持身心活躍。有些失能者會擔心自己的外貌變得不好看,那麼我們可以花一些巧思,除了注重個人衛生清潔的原則外,也可以隱藏尿袋、管路,或是裝飾輪椅等方式。讓失能者獲得自信,了解到:「除了生病,我和其他人沒什麼不同。」

9.照顧心情與情緒

身體的照護需要專業的學習,但心裡與情緒的照護,也是要我們多「練習」喔。

我們可以多用肯定語、不用否定語與失能者溝通,並且經常地鼓勵他、傾聽他,讓他心理的不安可以轉化成前進的力量,給失能者多一些寬容與體貼,無論是對於病況或是我們自己的心情,才能有顯著的提升。有時我們會因一些狀況而忍不住想要指責,我們可以試著深呼吸,不要讓情緒控制場面。

 

10.注意外出安全

原本的騎車或開車出現困難時,可以因失能者的個別需要,調整交通工具,例如從摩托車改成電動車,或是考慮其他交通方式。