當一個人得了失智症,開始時一定是不知所措的,因為原本可以自我掌握的生活變了樣,有些東西就是找不到、生活中開始出現不認識的人事物,講出來其他人卻可能覺得你很奇怪;面對許多自己搞不清楚又難以解釋的事,開始發脾氣就理所當然。

而當我們知道自己的親人得了失智症,隨之而來的將是兩種層面的衝擊。第一個層面是,面對腦部功能受損、時時可能不按牌理出牌的親人,光用想的就知道照顧他有多困難。第二個層面是,他是曾與你朝夕相處的親人;我們都沒有辦法接受最親的家人,突然之間變得如此陌生。

因此,與其說是照顧失智症的親人,不如說是彼此互相照顧:我們負責照料好病患的生活起居,也要積極延緩病況;病情發展愈緩慢,從照顧者的角度來看,「逝去」的部份就愈少,「擁有」的部份就愈多。你將體會到,看著病人仍能正常生活、與你像過往一樣互動,是多麼療癒、讓你不斷堅持下去的力量。

照顧失智患者也顧好自己的10個方法



Q1:我們該如何讓患者擁有正常的生活?

A:正常生活的關鍵,其實就是儘量不去改變原有的生活。人們都有安土重遷的習性,老人家更常常傾向留守在自己熟悉的環境,因為「改變」不但需要重新適應,更會產生不安全感。失智症患者從病情初期開始,就已經會因為自己的病況感到疑惑,也會因此產生不安全感,因此讓患者的生活儘量維持原狀,並且每天規律作息,讓患者熟悉環境、知道接下來要做什麼,就可以感到安心。

Q2:看著患者手腳開始不靈活,腦袋也不靈光,自己心情就變很差,真不知該怎麼辦?

A:失智症患者雖然可能會失去一些過往引以為傲的經驗或手藝,但還是有很多日常生活中要做的事,依然還能游刃有餘;我們與其停留在為「逝去」而感傷,不如換個角度欣賞當下患者把事情做好的事實,並適時給予鼓勵;其實,這個鼓勵不僅針對患者,無形中也是針對照顧者自己。

Q3:我還是很擔心讓患者自己處理事情會很不順利,還是讓患者靜靜坐著看電視就好?

A:如同前面所說,讓患者有事做,是正常規律生活的一部份,可以降低不安全感;如果又是患者自己想做的事,自然就會提昇正面情緒。我們也知道,必須不斷刺激大腦、活絡腦細胞活動,才能促進腦部不斷成長,這正是與失智症賽跑的不二法門。因此,患者能做的事就讓他自己完成,例如能夠自己進食,就不該要別人餵食。

Q4:如果是這樣的話,其實一整天時間還很多,我可以請患者幫忙做點別的事,一樣可以健腦嗎?

A:用最簡單的話來講:讓腦袋整個動起來,就是健腦。況且失智症雖然會造成部份記憶與認知功能受到影響,但其他部份卻還是有正常運作的機會。在《失智症照護指南》中,就提到一個例子,有位太太經常要求有失智症的丈夫騎機車載她去買菜,雖然因為失智症讓他記不得路,但是騎車的能力並未受損。此外,失智症患者還是有學習新事物的能力,雖然效果可能不好,但持續下去,就能達成刺激大腦進而健腦的目的。

Q5:我發現有時候請患者幫忙做事,他都會好高興。可是如果有時跟其他親人談起病況,他卻不太高興的樣子。所以我應該避談這些話題嗎?

A:患者學習到新能力後,就跟常人一樣,一定會覺得很有成就感,對患者本身與照顧者而言,都是莫大的鼓勵。而有自己的生活目標,也可以感受到自己仍然是重要的、有用的,這些都可以維護患者的尊嚴,讓他們能更愉快地面對新的一天。相對來說,當面講起失智症的種種,自然會讓人覺得不快,畢竟,失智症患者並非所有能力都失去,他們也會跟常人一樣,不喜歡別人講自己生病的種種。

Q6:所以我就常常發現,每次他不高興後,就很難照顧他,好像鬧彆扭一樣,這個不要那個不要,真的很煩!

A:失智症患者的腦部功能受損,與人互動的反應已經跟其他人不一樣了,因此,照顧者往往沒有辦法講道理,而是先順著患者的意思行事,之後再想辦法。如果當下與患者起衝突,對方當然不會與你合作,增加了照顧的困難度。且由於記憶功能受損,往往早就忘了是什麼事產生衝突,但不高興的情緒卻還存在,變成「不知道在氣什麼」的樣子。

下一頁告訴您更多照顧失智患者的心法!

Q7:我瞭解順著患者的意思很重要,不過常常會覺得講了很多話,患者好像都沒有聽到一樣,這該怎麼辦?

A:有可能是因為視覺、聽覺等受損,真的沒有聽到,或是我們講的話太長、太複雜,患者無法應付。因此,



  1. 先確定患者真的有接收到訊息,比方站在視線所及的地方,確定他有看到照顧者,或是呼喚他的名字引起注意。


  2. 把要講的事情拆成一個一個步驟,例如「時間到了,我們去換件衣服,出門去找叔叔吃飯」,就不需要講「時間到了」,先說「我們去換件衣服」,衣服換完再說「出門去找叔叔」。


  3. 說話的時候搭配手勢、身體姿勢、圖片等,幫助患者瞭解。講話速度放緩、音調降低。


  4. 多用肯定句,少用否定句。如果認知功能已經受損,則不要問問題,以肯定句代替。




Q8:雖然這樣做有效,但是有時候,還是有些話就是說不通,或是患者總是堅持一定要做什麼,毫不妥協啊!

A:照顧者要面對的情境很多種,但具備「拖延」、「轉移話題」的技巧,往往可以解決許多問題。例如大半夜卻堅持要出門,可以先說「好」,然後說要去換衣服,並請患者先看電視等一下,十分鐘後,患者往往就忘了要出門的事了。

Q9:不過就算在家裡,也常常會因為一些不存在的人事物,或是被自己的鏡中影像嚇到,或是認不出來那是誰。我該把鏡子都收起來嗎?

A:錯覺與幻覺都是可能發生的。不僅是鏡子,窗戶的反射影像也可能有同樣的效果,如果情況嚴重的話,當然可以把鏡子、窗子等遮起來。至於幻覺部份,如果患者說他看到什麼,可以引領他用手去碰觸他看到的東西,如此一來,兩種感官得到的結果是抵觸的,幻覺就會消失。

Q10:有件事覺得很困擾,明明都有照三餐照顧患者,但左右鄰居卻說我都不給他飯吃,可是我實在不想跟外人講這些,覺得很丟臉耶!

A:相信如今的社會,對於失智症的來龍去脈都已經有一定認識,也都知道要照顧一位失智症患者有多辛苦,講出來不會丟臉,相反地,因為大家都感同身受,是可以互相協助的。《失智症照護指南》中就提到一位老伯伯以前是里長伯,失智後家人並未避諱,鄰居都知道,當老伯伯在附近迷路後,鄰居就幫忙帶他回家,無形之中,更多人一起來幫忙照顧失智者了。

When a person gets dementia, he must be at a loss when he starts, because the life that can be self-mastered has changed. Some things are not found, people who do not know in life begin to appear, and others may I feel that you are very strange; in the face of many things that you are unclear and difficult to explain, it is only natural to start losing your temper.

And when we know that our loved ones have dementia, there will be two levels of shock. The first level is that in the face of a family member whose brain function is impaired and may not be licensed according to the brand at all times, it is difficult to take care of him. The second level is that he is a relative who has been with you for the day and night; we have no way to accept the closest family, and suddenly become so strange.

Therefore, it is not so much to care for the dementia's relatives, but rather to take care of each other: we are responsible for caring for the living conditions of the patients, but also actively delaying the disease; the slower the disease develops, from the caregiver's point of view, "death The less the part, the more "ownership". You will realize that watching the patient still can live normally, interact with you as in the past, how he healed, and the power that keeps you going.

Take care of the demented patients and take care of their own 10 methods

Q1: How do we get patients to have a normal life?

A: The key to normal life is to try not to change the original life. People have the habit of relocating, and the elderly tend to stay in their familiar environment, because "change" not only needs to adapt, but also creates insecurity. From the early stage of the illness, patients with dementia will already be confused by their own conditions, and they will feel insecure. Therefore, keep the patient's life as normal as possible, and work regularly every day to familiarize the patient with the environment and know what to do next. If you do anything, you can feel at ease.

Q2: I don’t knowlaennec what to do when I watch the patient’s hands and feet start to be inflexible, my head is not good, and my mood is very bad.

A: Although people with dementia may lose some experience or craftsmanship that they have been proud of in the past, there are still many things to do in daily life, and they still have a lot of work; we stay with the sentiment of being "dead" and not as good as it is. From another angle, appreciate the fact that the current patient is doing things well, and give encouragement at the right time; in fact, this encouragement is not only for the patient, but also for the caregiver himself.

Q3: I am still worried that it will be very unsatisfactory for the patients to handle things themselves, or is it better for the patient to sit and watch TV quietly?

A: As mentioned above, letting patients do something is part of normal regular life, which can reduce insecurity; if it is what the patient wants to do, it will naturally raise positive emotions. We also know that we must constantly stimulate the brain and activate brain cells to promote the growth of the brain. This is the only way to race against dementia. Therefore, what the patient can do is to complete it himself. For example, if he can eat himself, he should not be fed by others.

Q4: If this is the case, in fact, there is still a lot of time in the whole day. Can I ask the patient to help me with other things, can I have a brain?

A: In the simplest words: let the whole brain move, it is a brain. Moreover, although dementia may affect some of the memory and cognitive functions, other parts still have the opportunity to function normally. In the Guide to Dementia Care, an example is given. A wife often asks a demented husband to ride her on the plane to buy food, although he is unable to remember because of dementia, but cycling The ability has not been compromised. In addition, people with dementia still have the ability to learn new things, although the effect may not be good, but to continue, it can achieve the purpose of stimulating the brain and then brain.

Q5: I find that sometimes I ask the patient to help me, and he will be very happy. However, if he sometimes talks to other relatives about his condition, he is not very happy. So should I avoid talking about these topics?

A: After learning new abilities, patients will feel a sense of accomplishment just like ordinary people. It is a great encouragement for both the patient and the caregiver. With your own life goals, you can also feel that you are still important and useful. These can maintain the dignity of the patients and make them more happy to face the new day. Relatively speaking, it is naturally unpleasant to talk about all kinds of dementia. After all, dementia patients do not lose all their abilities. They will be like ordinary people and do not like others to talk about their illness.

Q6: So I often find that every time he is not happy, it is very difficult to take care of him. It seems like awkward, this is not to be the one, it is really annoying!

A: The brain function of patients with dementia is impaired, and the reaction with people has been different from other people. Therefore, the caregiver often has no way to reason, but first acts according to the patient's intention, and then finds a way. . If the current conflict with the patient, the other party will certainly not cooperate with you, increasing the difficulty of taking care. And because of the impaired memory function, it is often forgotten what is causing conflicts, but the unhappy emotions still exist and become "don't know what is in the air".

The next page tells you more about the mentality of taking care of people with dementia!

Q7: I understand that it is very important to follow the patient's meaning, but I often feel that I have heard a lot of words. The patient does not seem to hear the same. What should I do?

A: It may be because the vision, hearing, etc. are damaged, I really didn't hear it, or the words we said were too long, too complicated, and the patients could not cope. therefore,

First make sure that the patient actually receives the message, for example, standing in the sight of the place, to determine whether he has seen the caregiver, or calling his name to attract attention.

I will split the things I want to talk into one step. For example, "When time is up, let's change clothes and go out to find an uncle to eat." You don't need to say "Time is up," first say "Let's change clothes", clothes change After that, I said, "Go out and go to the uncle."

When talking, use gestures, body postures, pictures, etc. to help patients understand. The speech speed is slow and the pitch is lowered.

Use affirmative sentences and use negative sentences less. If the cognitive function has been compromised, don't ask the question and replace it with a positive sentence.

Q8: Although it works, sometimes there are still some words that don't make sense, or patients always insist on doing something, no compromise!

A: There are many situations in which caregivers have to face, but the skills of “delaying” and “shifting topics” can often solve many problems. For example, in the middle of the night, I insisted on going out. I can say "good" first, then say that I have to change clothes, and ask the patient to watch TV first. After ten minutes, the patient often forgets to go out.

Q9: But even at home, I often get scared by some non-existent people, or by my own mirror image, or who I can't recognize. Should I put the mirrors together?

A: Both illusions and hallucinations can happen. Not only the mirror, but also the reflection image of the window may have the same effect. If the situation is serious, of course, the mirror, the window, etc. can be covered. As for the illusion part, if the patient says what he sees, he can lead him to touch the things he sees. As a result, the results of the two senses are contradictory, and the hallucinations disappear.

Q10: Some things are very troublesome. I obviously take care of the patients according to three meals, but the neighbors say that I don't give him food, but I really don't want to talk to outsiders, I feel very shameful!

A: I believe that today's society has a certain understanding of the ins and outs of dementia. I also know how hard it is to take care of a person with dementia. It is not a shame to speak out. On the contrary, because everyone feels the same, it is possible Help each other. In the Guide to Dementia Care, it is mentioned that an old uncle used to be a long-term uncle. After the loss of wisdom, his family did not evade. The neighbors knew that when the old uncle lost his way around, the neighbor would help him take him home, invisible. Among them, more people come together to help take care of the losers.

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