| 特集名 | 後期高齢透析患者の看護のあり方を再考する | |
|---|---|---|
| 題名 | 後期高齢透析患者の看護の実践事例 (1) 療養生活支援 | |
| 発刊年月 | 2016年 03月 | |
| 著者 | 三上 裕子 | 岡山済生会総合病院腎臓病・糖尿病総合医療センター・看護師 |
| 【 要旨 】 | 夫婦二人暮らしで在宅を希望した後期高齢者に，80歳で腹膜透析（PD）ファーストで透析導入し，経過よく在宅医療としてのPD療法を継続していた事例を経験した．しかし，年齢とともに加齢による体力低下がみられた導入10年後から，在宅支援が必要となった．まず食欲不振に対して，点滴を実施するために訪問看護を導入した．その後，患者・家族は在宅を希望したため，PD管理のできる往診専門の訪問医による訪問診療となった．最後まで在宅を継続し，皆に囲まれて在宅での看取りとなった．高齢PD患者に在宅支援をするためには，導入期・外来での維持期・終末期のそれぞれにおいて患者・家族と十分なコミュニケーションをはかることで，思いを受け止め調整することが重要である． | |
| Theme | Reconsidering caring of 75 years of age or older dialysis patients | |
|---|---|---|
| Title | A research example of a late elderly couple who was on peritoneal dialysis -- My experience in supporting an elderly couple with home health care | |
| Author | Hiroko Mikami | Department of Nursing, Center for Kidney and Diabetic Diseases, Okayama Saisekai General Hospital |
| [ Summary ] | I saw a case where an elderly couple started the husband's undergoing peritoneal dialysis (PD) in his 80s, and continued PD as home health care for a long time. However, they needed support 10 years later, because of his decreased strength due to aging.Mbr />At first, we appointed a home nurse to administer a drip to him due to his lost appetite. Then, we organized a home doctor who managed his PD. The home health care was continued until his death. To support elderly patients on PD, it is important to understand their feelings and wishes by communicating with them and their families throughout, from the beginning of their visit to the outpatient department, till the end. |
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