緊急医療サービスにおける認知症の高齢者の治療の選択に関する情報
Lauren R Pollack1,2, Danae G Dotolo1,2, Anna L Condella1,2,3
1Division of Pulmonary Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA.
Journal of the American Geriatrics Society
|September 4, 2025
まとめ
緊急医療サービス (EMS) の提供者は 認知症の高齢者の治療好みを文書化するのに苦労します 家族との直接的なコミュニケーションは,これらの患者の目標に一致するケアを改善することができます.
科学分野:
- ゲロントロジー
- 緊急 医療
- 認知症のケア
背景:
- 緊急医療サービス (EMS) は,深刻な健康問題を抱える高齢者にとって不可欠です.
- 認知症の人は 快適な終末期ケアを好みます
- 認知症患者のEMSでの治療選択の伝達に関する理解は限られている.
研究 の 目的:
- 認知症の高齢者に対する EMS 対応時の治療選択に関するコミュニケーションを分析する.
- この集団における目標に一致する介護の障壁と促進者を特定する.
主な方法:
- 認知症の65歳以上の患者のEMS事件報告の質的内容分析
- 含有基準:EMS評価,入院 (2011-2021年),重症 (国家早期警告スコア ≥7).
- 文書化された治療の好み,コミュニケーションの障壁,ファシリテーターの特徴.
主要な成果:
- 患者の報告は171件 介護施設の報告は51%でした
- 必要なものを伝えられるのは23%で,家族がいるのは24%でした.
- 治療の好みは27%の報告で記録され, 介護者とのコミュニケーションの困難が課題でした.
結論:
- EMSの提供者は 認知症の重症高齢者の 治療選択を促すのに 大きな課題に直面しています
- 障壁には,専門の介護者とのコミュニケーションの困難と,二手情報への依存が含まれます.
- 代理の意思決定者,特に家族との電話による直接のコミュニケーションは,目標に一致するケアを容易にする.
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