臨牀透析 Vol.35 No.3(3-9)


特集名 慢性腎臓病の看護実践をリフレクションする
題名 実践報告 (9) 後期高齢透析患者の看護―最期に過ごす場所を調整する
発刊年月 2019年 03月
著者 米村 朋代 六甲アイランド甲南病院看護支援センター・慢性疾患看護専門看護師
【 要旨 】 単独世帯の高齢透析患者が増加している.患者はフレイルや認知症の発症により,独居生活が困難になる.本事例は,独居高齢透析患者がフレイル状態となり生活が困難になったため,新たな生活を再決定した事例である.フレイル状態となった患者は,ケアマネジャーにケアマンションの退去を勧められ,転居の話が進んでいた.看護師は患者が転居に納得できていないことを知り,多職種カンファレンスを設けた.各専門職の立場から患者を分析し,最善の方法を提示した.家族・本人も納得し転居に同意した.看護師は,早い段階から患者に残された時間をどのように過ごしたいかを確認し,関係者と連携し患者が望む過ごし方ができるように支援することが重要である.
Theme "Reflection" of nursing practice to chronic kidney disease patients
Title Nursing of older dialysis patients
Author Tomoyo Yonemura Department of Nursing, Rokko Island Konan Hospital / Certified Nurse Specialist in Chronic Care Nursing
[ Summary ] The number of older dialysis patients living alone is increasing. One patient had multiple diseases, and, due to reduction in ADL and onset of dementia, living alone became difficult. Because the ADL of the older dialysis patient living alone decreased in this example, and life became difficult, it is an example that I open with in many job conferences;the patient ultimately rebuilt a new life. As for the patient whose ADL decreased, withdrawal was advised by the care manager, and a story of the moving advanced. The nurse knew that a patient could not understand moving and made many types of job conference. I analyzed a patient based on the situation of each employment situation and showed the best method. The person understood about family, and that led to moving. I confirmed what the nurse wanted to do at an early stage in the patient's condition and supported it to make it possible to determine how to spend that time based on what the patient expected in cooperation with the concerned person.
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