血管性痴呆护理人员的应对策略
作为一个照顾患有 血管性痴呆(VaD), you may face difficult challenges as you try to provide care and understand the behavior changes of the person you are caring for. 了解VaD患者的行为可以帮助减轻这些困难.
VaD患者可能表现出以下行为:
- Problems with thinking, walking and performing everyday activities are the most prominent symptoms. 许多VaD患者还患有抑郁症, which can result in less motivation to perform their usual activities or a lack of interest in the world around them.
- 对日常生活极度焦虑, which may be exhibited by asking questions and repeating information about once familiar events and/ or people, preparing for appointments/day care well ahead of time and using notes and reminders endlessly.
- Apathy or a lack of initiative about tasks that used to be routine, though now feel overwhelming. 例如, the person who always enjoyed puzzles but no longer does them because they are too overwhelming and require skills he/she no longer possesses.
- Frequent agitation may occur as people become less able to interpret their environment and control or express their feelings. 例如,患有VaD的人可能会攻击他们的照顾者.
应对策略
以下策略可以帮助你照顾VaD患者:
有现实可行的目标吗. 经常, 照顾者试图让一切都好起来,并努力实现不切实际的目标, 尽管最后筋疲力尽,沮丧. 也许你的目标是确保你的病人干净、舒适、吃得好. 然而, accepting that success may be only 80 percent will allow you to enjoy time you might have otherwise spent fretting about not reaching these goals. 虽然困难, try being comfortable with a less than perfectly groomed spouse or perfectly organized home.
控制血管危险因素. While there is no current treatment to change the effects of VaD, preventing risk for additional 血管损伤, particularly stroke, can be an effective way to lower someone's risk of worsening dementia. 这可以通过鼓励锻炼来实现, 戒烟, drinking alcohol in moderation and possibly changing diet to reduce salts and saturated fats. It is also important that people with VaD have their blood pressure checked and their blood fat levels measured at least once a year. 除了, 中风的一些危险因素, 比如高血压, 心脏病, 糖尿病和高胆固醇可以用药物控制. 不要犹豫,与你的十大赌博平台排行榜讨论这些选择. 如果血管危险因素没有得到适当的关注, 可能会出现反复发作的中风和恶化的痴呆症状.
预期的误解 由你的病人. 患有VaD的人可能不再能够准确地解释语言或非语言提示, 哪些会让你和你的病人都感到焦虑和沮丧. Try to be clear and concise in your communications—repeating things as needed using the same words or message. 当你试图沟通时,减少不必要的噪音和干扰. Do not use confusing pronouns, such as he, she or it, but rather names and specific titles.
记住,所有的行为都有目的. 许多专家认为,VaD患者表现出的一些行为症状, 比如大喊大叫或三击不中, 有意义. 虽然这个人通常不打算破坏事物或伤害某人, 他们确实想要被注意到,也许会传达一个没有被满足的需求. 除了, 重要的是要记住,虽然这些行为是有意义的, 他们不是故意的,这个人也不是“故意的”,“但更有可能是试图传达一种他们无法用语言解释的信息. 慢下来, trying to see the world through their eyes and trying to respond to the "feeling" behind the behavior, 而不是行为本身, 可以防止情绪危机吗.
享受美好时光. Many people with VaD remain physically fit and retain their ability to be comfortable and involved in social situations quite late in the disease. 因此, 继续社交, 旅行, be physically active and participate in activities that are enjoyable to both you and your patient. 经常, familiar activities will continue to be enjoyable for a person with VaD and should be encouraged. 然而, trying to learn new tasks or starting new hobbies may be frustrating or overwhelming.
回忆过去 and encourage discussions about people and places that are familiar and evoke pleasant feelings for both you and your patient. 从遥远的过去的记忆通常不会受到影响,看家庭录像, looking at photographs or reviewing 旅行s from the past can allow you and your patient to continue to share experiences and feelings. Allow your patient to share the history they remember with family members, grandchildren and friends. 这对每个人来说都很有趣,并帮助你的病人感到与他们所爱的人联系在一起.
是灵活的. 记住VaD是一种进行性疾病. 病人的症状和需求会随着时间的推移而改变. 如果笔记或提醒等策略不再起作用,就不要使用它们. 在一个阶段成功的干预可能在另一个阶段变成挫折和灾难. 寻求帮助,寻求建议,并向有类似经历的人学习. VaD患者更具挑战性的行为症状, such as resisting care or being aggressive can be particularly difficult for a caregiver and often require a very individualized approach. Talk to your doctor about treatment approaches, both pharmacological and non-pharmacological.
安全
病人的安全是最重要的. 随着病情的发展, their memory and judgment becomes impaired and they are often unable to anticipate or avoid dangerous situations. This can be an overwhelming responsibility for a caregiver and requires creative strategies for coping. 以下建议可能有助于确保患者的安全.
监督 may become a greater need for a person with VaD as they become more forgetful and their judgment decreases. It is best to assess each situation individually and gradually increase your patient's level of supervision as needed. 这将帮助他们保持尽可能多的独立性和自主权, 在尽可能安全的环境下. It is often difficult to determine the level of supervision needed and involves evaluating the risks and consequences of your patient's current and potential behavior and the ease/discomfort involved in protecting your patient.
在评估病人是否需要监督时,需要审查的行为包括:
- 在无人监督的情况下处理紧急情况的能力
- 能够安全使用电器
- 独自一人时能够安全地接听电话或开门
- 流浪倾向. This may occur in later stages when patients are confused about where they are or are trying to find a familiar person or place. 如果有人担心这个, 应该考虑让你的病人加入安全返回计划. 这个程序, 是由阿尔茨海默病协会管理的吗, provides national registration and identification of people with VaD to assist in locating them should they wander away or become lost.
监管策略可能包括:
- 简单的药物提醒电话
- 门上的警报器防止离开
- 个人监督,以防止身体伤害或伤害
修改环境 to limit your patient's exposure to potentially dangerous situations can allow them to continue to be independent and safe. 尤其是在VaD的早期阶段, 提醒和提示在你的病人的环境可能足以确保他们的安全. 例如, posting the steps involved in a task or labeling where things are kept may be extremely helpful to your patient.
在疾病的后期阶段, you may need to employ strategies that limit your patient's exposure to potentially dangerous situations, such as installing childproof handles on cupboards containing potentially dangerous materials.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.