在长期护理居民中认知和功能衰退
Ramtin Hakimjavadi1, Christina Y Yin2,3, Mary Scott2,4
1Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
JAMA network open
|April 23, 2025
概括
严重的障碍,如无法做出决定或沟通,在长期护理 (LTC) 居民中很常见,影响生存. 了解脆弱性轨迹可以改善居民以人为中心的护理决策.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 长期护理 (LTC) 居民的护理决策需要基于脆弱性的方法来提高福祉,并与患者的愿望保持一致.
- 了解严重损伤的发生率和持续时间对于以人为中心的决策在LTC中至关重要.
研究的目的:
- 调查长期护理居民中严重损伤的发生率和生活时间.
- 通过表征脆弱轨迹来告知以人为中心的医疗决策.
主要方法:
- 一项使用加拿大安大略省行政卫生数据的回顾性队列研究,包括在2013年至2018年期间入住LTC的65岁以上居民.
- 随访延长至2023年4月,数据分析从2023年10月到2024年3月进行.
- 结果包括总体照顾依赖的发生率,无法做出决定,无法沟通和失禁,以及生存分析.
主要成果:
- 在120238名LTC居民中,显著比例的人患有严重障碍:20.0%的人无法做出决定,7.7%的人无法沟通,13.4%的人完全依赖护理,32.8%的人失禁.
- 平均存活时间因损伤而异,全身护理依赖的存活时间最短 (45天),失禁时间最长 (356天).
- 年轻的住户和那些在入院时患有痴呆症的人通常经历了更长的存活经历了严重损伤后的发展.
结论:
- 在LTC居民中,严重的永久性损伤很常见,通常发生在生命末期附近,尽管有些人多年来一直生活在这些条件下.
- 这些发现强调了关于脆弱轨迹的共享理解和开放沟通的重要性.
- 促进关于脆弱的自然过程的讨论可以更好地支持长期护理机构中以居民为中心的医疗决策.
相关概念视频
01:30Cognitive Development During Adulthood
23
Cognitive development continues throughout adulthood, undergoing significant shifts across early, middle, and late stages. Individual transition occurs from adolescent idealism to pragmatic and adaptable thinking in early adulthood. During this period, individuals learn to integrate personal beliefs with the recognition that other perspectives are equally valid. Exposure to the complexities of modern society, diverse experiences, and higher education contribute to this adaptive thought process,...
23
01:30Dementia
65
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
The progression of dementia is generally gradual....
65
01:26Alzheimer's Disease: Overview
317
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
317
01:29Documentation in Long-Term and Home Healthcare Setting
817
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
817
01:30Negative and Cognitive Symptoms of Schizophrenia
34
Negative symptoms of schizophrenia indicate a reduction or absence of typical behaviors and emotional responses found in healthy individuals, while positive symptoms reflect an excess or distortion of normal functioning.
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
34
01:19Restorative Care
1.9K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
1.9K