谵妄是一个具有挑战性的医学问题,特别是在家庭护理环境中,并极大地影响患者和家庭护理人员。当谵妄没有立即发现和有效管理时,各种结果都受到不利影响。本报告描述了一个年长的居家男性的谵妄,并提供了在家庭护理环境中检测和管理谵妄的策略。患者是一名虚弱的86岁男性,患有多种医疗合并症,并在全科医生诊断为支气管炎后功能下降。在支气管炎的诊断和后续治疗之后,在正常的日常活动中,患者的认知和身体功能严重下降。医学筛查显示混乱,冷漠,极度疲劳。使用功能独立性措施和谵妄观察筛查量表(DOSS)的评估工具,发现存在功能下降和谵妄症状。通过多学科合作,开始了治疗计划。它包括按照固定的时间表进行水合,适应营养,糖尿病前期的临时调整用药计划,和锻炼计划。没有给出具体的药物。随着时间的推移,病人完全康复了。当身体或精神状况恶化的老年患者出现时,所有专业和非正式的护理人员都应该意识到谵妄的潜在存在。必须对谵妄和可能的潜在疾病进行良好的诊断。充分的治疗,在营养师等护理人员的帮助下,物理治疗师,等。必要时必须提供。
Delirium is a challenging medical problem, particularly in the home care setting, and greatly affects both patients and family caregivers. When delirium is not immediately detected and effectively managed, various outcomes are adversely affected. This report describes delirium in an older home-bound man and offers strategies for detecting and managing delirium in a home care setting. The patient is a frail 86-year-old man with multiple medical comorbidities and functional decline after bronchitis that was diagnosed by a general practitioner. Following the diagnosis and subsequent treatment of bronchitis, the patient suffered a major decline in cognitive and physical functioning during normal daily activities. Medical screening revealed confusion, apathy, and extreme fatigue. Using the assessment tool of the Functional Independence Measures and Delirium Observation Screening Scale (DOSS), the presence of functional decline and delirious symptoms were found. Through multidisciplinary collaboration, a treatment plan was initiated. It consisted of hydration following a fixed schedule, adapted nutrition, a temporary adapted medication schedule for pre-diabetes, and an exercise plan. No specific pharmaceuticals were given. The patient made a full recovery over time. All professional and informal caregivers should be aware of the potential presence of delirium when an older patient with a deteriorating physical or mental condition presents itself. Good diagnostics for delirium and possible underlying diseases are necessary. Adequate treatment, with the help of paramedics such as dieticians, physiotherapists, etc. must be provided when necessary.