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3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia课程教案、知识点、字幕

同学们大家好

今天为大家介绍老年期痴呆症智能康复

我们都知道

老年期痴呆

是一种获得性的智能损害的综合征

其临床表现主要为记忆力

注意力 理解力 定向力

执行功能等多种认知功能损害

老龄化社会的到来

伴随的是痴呆人数的急剧增长

现今老年期痴呆

已经成为21世纪威胁老年人健康的

最为严重的疾病之一

近年来

智能康复在痴呆治疗中越来越受到重视

系统的智能康复在延缓痴呆病情进展

增强痴呆患者的自我照顾能力

提高生活质量

减轻照顾者负担等方面

均具有重要的实用意义

那么智能康复疗法的模式有哪些呢

老年期痴呆症智能康复

主要采取以下两种模式

第一种为智力激发疗法

也称为3R疗法

第二种称为ABAB疗法

3R疗法主要通过回忆往事

现实定向

和再激发

三部分内容实现智能康复

ABAB疗法

则将智能康复时间分为四个时期

并在四个时期内向患者实施身体感知

音乐和运动以及肢体的功能活动

三种物理康复疗法的训练内容

常用的智能训练疗法包含哪些呢

第一记忆力康复方法

老年性痴呆患者近期记忆受损

但大部分的远期记忆仍然保存

通过有意识的反复的记忆训练

可以延缓衰退

促进智力的康复

具体的方法包括

瞬时记忆

训练者可以

念一串不按顺序排列的数字

从三位数字起

每次增加一位

例如

123

2344

53642

念完后立即让患者复述

直至不能复述为止

短时记忆

给患者出示几件物品

例如手机 钥匙 苹果 铅笔等等

然后马上收起来

让他回忆刚才看到的是什么东西

物品的数量可由少到多

逐渐增加

观看的时间可以由长到短

长时记忆

时不时的让患者

回忆一下家里的亲戚朋友

原来工作单位同事的姓名或岗位名称

前几天看过的电视或新闻内容

家中发生的事情等等

第二部分注意力的康复训练方法

注意障碍的康复

是认知康复的中心问题

虽然它只是认知障碍的一个方面

但只有纠正了注意障碍

记忆 学习 交流

解决问题等认知障碍的康复

才能有效地进行

一 示范训练

训练者将要展示的活动

通过多种感觉方式显示在患者眼前

并加以语言提示一遍患者集中注意力

如打太极拳

一边让病人看到舒展流畅的动作

一边可以用抑扬顿挫的语调

讲解动作的要领

使病人视觉 听觉调动起来

以加强注意力的训练

二 分类训练

分类训练的目的是

提高患者不同难度的注意力

操作方式多以纸笔联系形式为主

要求患者按照指示完成规定的图案描绘

或对录音带 电脑中的指示

执行适当的动作

分类训练内容还可按照注意力的分类

分别进行持续性 选择性 交替性

及分别性注意项目的训练

第三部分计算能力训练

主要为数字大小

多少的概念和计算能力的训练

如将筷子分成两堆

让患者比较哪堆多

哪堆少

还可以让患者进行一些简单的

家庭消费账目计算

如去商场购买一些日用品

让她们算一算

每样物品各花费了多少钱

共消费了多少钱

还剩下多少钱

第四部分语言训练

对老年期痴呆患者来说

语言功能受损是个大问题

针对受损程度的不同

策略和目的也不同

对非常重的

比如发音不清楚

应教会其发简单的单词

尽量发清楚

也可以给他看物品

比如拖鞋 茶杯

让他说出名称

对用词很贫乏的患者

可以教他日常生活的简单用词

表达想法的简单用词

只要能慢慢接受就好

对简单的谈话尚可

但会忘词或词不达意者

家属不妨多鼓励病人适当地

多讲

不要怕讲错

总之一定要鼓励患者多交流

多表达 多理解等等

这是尽量修复语言能力的关键

不能操之过急

方法和进度要因人而异

循序渐进

第五部分 其他有益的智力训练

智力活动内容其实是非常丰富的

如逻辑联想

思维的灵活性能力

分析和综合能力

理解表达能力

社会适应能力等等

常用的训练方法有

逻辑联想 思维灵活性训练

可以从儿童玩具中

去寻找一些有益于智力的玩具

如按照图纸用积木搭出各种造型

分析和综合能力训练

经常让患者对一些图片

实物 单词作归纳和分类

比如拿出一些小孩用的图画卡片

让患者将植物 动物

生活用品等分开归类

理解和表达能力训练

给患者讲一些猜谜类的事情

讲完后可以提一些问题让患者回答

第六部分 日常生活活动训练

对于日常活动的训练

主要融入在衣食住行中

例如更衣 饮食 如厕 出行 服药等

应尽量让患者独自完成各种任务

如果患者能独自完成制定的任务

再要求患者尽量缩短完成任务的时间

循序渐进

在智能康复训练中

应注意的问题及解决方法

首先要避免或减少

患者在智能训练中的焦虑和依赖情绪

患者常常会因为记忆功能减退

所学的东西往往记不住

认识的朋友又想不起名字来等等

从而产生了焦虑的情绪

此时要求训练者多对患者实施鼓励和表扬

同时为避免患者

对家人的精心照顾产生依赖

训练中

凡患者能够自己去做的一些事情

尽量让患者自己去完成

以便使患者从中获得信息及满足感

此外应保持痴呆患者居住环境的温馨和安静

避免家庭的摆设复杂化

墙壁和地板避免选用迷乱 复杂的图案

再者应经常与患者保持良好的沟通

鼓励患者多表达自己

尽可能地让患者了解外部的信息

多培养 鼓励患者参加各种兴趣爱好

和兴趣活动

不要使其处在封闭的生活环境中

好了

以上就是今天的全部内容

谢谢大家

Gerontological Nursing课程列表:

CHAPTER 1: General Introduction to Geronological Nursing

-1.1 Human Life Expectancy and Age Classification of the Elderly

--Human Life Expectancy and Age Classification of the Elderly

--【Vedio Recommendation】 How do we measure life expectancy ?

-1.2 Population Aging

--Population Aging

--【Literature Recommendation】World Report on Ageing and Health: 2015

-1.3 Influence and Countermeasures of Population Aging

--Influence and Countermeasures of Population Aging

--【Literature Recommendation】World Population Ageing Highlights:2019

-1.4 Goals and Principles of Elderly Care

--Goals and Principles of Elderly Care

--【Book Recommendation】Evidence-Based Geriatric Nursing Protocols for Best Practice

-1.5 Theories Related to Elderly Care

--1.5.1 Personality Development Theory and Life Review

--1.5.2 Disengagement Theory and Activity Theory

--1.5.3 Self-efficacy and Chronic Disease Management

--【Vedio Recommendation】8 Stages of Development by Erik Erikson

--【Literature Recommendation】Activity Theory, Disengagement Theory, and Successful Aging

--【Book Recommendation】Self-Efficacy in Changing Societies

--【Literature Recommendation】Obstacles and Policies of the Social Capital Participates in the Combination of Medical Care and Pension: A Literature Review

-1.6 Elderly Support and Elderly Care

--1.6.1 Concepts of Elderly Healthcare, Elderly Support and Elderly Care

--1.6.2 Home-based Elderly Care Model

--1.6.3 Institutional Elderly Care Model

--1.6.4 Integrated Medical and Nursing Care Model

--【Vedio Recommendation】Day in the Life of Home Care

--【Website Recommendation】Official Website of the National Institutes of Health

-Concept Map

--【Concept Map】General Introduction to Geronological Nursing

-【Test】CHAPTER 1

-【Case Discussion】CHAPTER 1

CHAPTER 2: Elderly Health Assessment

-2.1 Aging Changes in the Elderly

--2.1.1 Aging of the Respiratory System

--2.1.2 Aging of the Cardiovascular System

--2.1.3 Aging of the Digestive System

--2.1.4 Aging of the Urinary System

--2.1.5 Aging of the Endocrine System

--2.1.6 Aging of the Motor System

--2.1.7 Aging of the Nervous System

--2.1.8 Aging of the Sensory System

--【Literature Recommendation】Exercise Attenuates the Major Hallmarks of Aging

--【Book Recommendation】Hazzard's Geriatric Medicine and Gerontology

-2.2 Comprehensive Health Assessment of the Elderly

--Comprehensive Health Assessment of the Elderly

--【Literature Recommendation】Instruments to evaluate mental well-being in old age: a systematic review

-2.3 Principles of Elderly Health Assessment

--Principles of Elderly Health Assessment

-2.4 Assessment of the Functional Status of the Elderly

--Assessment of the Functional Status of the Elderly

--【Literature Recommendation】The Lawton Instrumental Activities of Daily Living (IADL) Scale

-2.5 Assessment of Cognitive Function in the Elderly

--Assessment of Cognitive Function in the Elderly

-2.6 Assessment and Adjustment of the Living Environment for the Elderly

--Assessment and Adjustment of the Living Environment for the Elderly

--【Literature Recommendation】Age-friendliness of living environments from the older person’s viewpoint: development of the Age-friendly Environment Assessment Tool

-Concept Map

--【Concept Map】Elderly Health Assessment(1)

--【Concept Map】Elderly Health Assessment(2)

-【Test】CHAPTER 2

-【Case Discussion】CHAPTER 2

CHAPTER3: Elderly Mental Health and Mental Health care

-3.1 Overview of the Psychological Characteristics of the Elderly

--Overview of the Psychological Characteristics of the Elderly

-3.2 Influencing Factors of Psychological Changes in the Elderly

--Influencing Factors of Psychological Changes in the Elderly

-3.3 Common Psychological Issues and Their Management in the Elderly

--3.3.1 Common Psychological Issues and Their Management in the Elderly (1)

--3.3.2 Common Psychological Issues and Their Management in the Elderly (2)

--【Book Recommendation】Development Through the Lifespan

-3.4 Depression in the Elderly

--3.4.1 Overview of Depression in the Elderly

--3.4.2 Clinical Symptoms of Depression in the Elderly

--3.4.3 Caring for Elderly Patients with Depression

--【Website Recommendation】

--【Documentary Recommendation】Depression:Out of the Shadows

--【Literature Recommendation】Management of depression in older adults:A review depression in older people

-3.5 Elderly Patients with Dementia

--3.5.1 Identification of Dementia Symptoms in the Elderly

--3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia

--3.5.3 Safety Care of Elderly Patients with Dementia

--【Website Recommendation】The Global Voice on Demaentia

-Concept Map

--【Concept Map】Elderly Mental Health and Mental Health Care

-【Test】CHAPTER 3

-【Case Discussion】CHAPTER 3

CHAPTER4: Elderly Daily Care

-4.1 Precautions for Daily Care of the Elderly

--Precautions for Daily Care of the Elderly

-4.2 General Care of Elderly Skin

--4.2.1 Characteristics and General Care of Elderly Skin

--4.2.2 Skin Itching and Its Management in the Elderly

--【Website Recommendation】American Academy of Dermatology

-4.3 Clothing Hygiene for the Elderly

--Clothing Hygiene for the Elderly

--【Literature Recommendation】The Design Methods of Functional Clothing for the Elderly

-4.4 Dietary Care for the Elderly

--4.4.1 Nutritional Needs of the Elderly and Influencing Factors of these Needs

--4.4.2 Dietary Care for the Elderly

--【Book Recommendation】Nutrition Care of the Older Adult: a Handbook for Dietetics

--【Website Recommendation】Nutrition for older persons

-4.5 Sleep Guidance for the Elderly

--4.5.1 Sleep Characteristics of the Elderly

--4.5.2 Sleep Guidance for the Elderly

--【Book Recommendation】An Occupational Therapist's Guide to Sleep and Sleep Problems

--【Website Recommendation】American Academy of Sleep Medicine

-4.6 Exercises Guidance for the Elderly

--4.6.1 Evaluation of Exercise Intensity in the Elderly

--4.6.2 Precautions Elderly Undertaking Exercises

--【Website Recommendation】American College of Sport Medicine

--【Book Recommendation】Handbook of Activities for the Elderly

-Concept Map

--【Concept Map】Elderly Daily Care

-【Test】CHAPTER 4

-【Case Discussion】CHAPTER 4

CHAPTER5:Medication Safety and Care for the Elderly

-5.1 Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly

--Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly

--【Website Recommendation】How Drugs Work In the Elderly

-5.2 Common Adverse Drug Reactions and Their Causes in the Elderly

--Common Adverse Drug Reactions and Their Causes in the Elderly

-5.3 The Principles of the Use of Medications in the Elderly

--The Principles of the Use of Medications in the Elderly

--【Literature Recommendation】The American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

-5.4 Prevention of Adverse Drug Reactions in the Elderly

--Prevention of Adverse Drug Reactions in the Elderly

--【Literature Recommendation】Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies

-5.5 Medication Compliance in the Elderly

--Medication Compliance in the Elderly

-Concept Map

--【Concept Map】Medication Safety and Care for the Elderly

-【Test】CHAPTER 5

-【Case Discussion】CHAPTER 5

CHAPTER6:Nursing Care for the Elderly with Common Health Problems and Diseases

-6.1 Falls in the Elderly

--6.1.1 Epidemiological Characteristics of Elderly Falls

--6.1.2 Risk Factors for Falls in the Elderly

--6.1.3 Prevention of Falls in the Elderly

--【Website Recommendation】CDC STEADI(Stopping Elderly Accidents, Deaths & Injuries Tool Kit)

-6.2 Dysphagia in the Elderly

--Dysphagia in the Elderly

-6.3 Urinary Incontinence in the Elderly

--Urinary Incontinence in the Elderly

-6.4 Constipation in the Elderly

--Constipation in the Elderly

--【Literature Recommendation】Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management

-6.5 Dry Mouth in the Elderly

--Dry Mouth in the Elderly

--【Website Recommendation】Academy of Nutrition and Dietetics

-6.6 Elderly Nutritional Deficiencies

--Elderly Nutritional Deficiencies - emaciation

-6.7 Visual Impairment in the Elderly

--Visual Impairment in the Elderly

--【Website Recommendation】Senior Eye Exams

-6.8 Senile Deafness

--Senile Deafness

-6.9 Elderly Delirium

--Elderly Delirium

-6.10 Elderly Frailty

--Elderly Frailty

--【Literature Recommendation】Frailty in elderly people/Frailty in older people

-6.11 Pneumonia in the Elderly

--Pneumonia in the Elderly

-6.12 Hypertension in the Elderly

--Hypertension in the Elderly

--【Literature Recommendation】2018 Chinese Guidelines for Prevention and Treatment of Hypertension

-6.13 Stroke in the Elderly

--Stroke in the Elderly

-6.14 Stable Angina in the Elderly

--Stable Angina in the Elderly

--【Literature Recommendation】2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes

-Concept Map

--【Concept Map】Nursing Care for the Elderly with Common Health Problems and Diseases

-【Test】CHAPTER 6

-【Case Discussion】CHAPTER 6

CHAPTER7 Hospice Care for the Elderly

-7.1 Concept of Hospice Care

--Concept of Hospice Care

--【Website Recommendation】 Definition of Palliative Care,WHO

-7.2 Death Education

--7.2.1 Death Education (1)

--7.2.2 Death Education (2)

--【Book Recommendation】The Meaning of Death by Herman Feife

-7.3 Nursing for Pain in the Dying Elderly

--Nursing for Pain in the Dying Elderly

--【Journal Recommendation】

-7.4 Nursing for Major Bleeding in the Dying Elderly

--Nursing for Major Bleeding in the Dying Elderly

-7.5 Nursing for Delirium in the Dying Elderly

--Nursing for Delirium in the Dying Elderly

-7.6 Nursing for Dyspnea in the Dying Elderly

--Nursing for Dyspnea in the Dying Elderly

--【Website Recommendation】The Hospice and Palliative Nurses Association,HPNA

-7.7 Psychological Problems and Nursing in the Dying Elderly

--Psychological Problems and Nursing in the Dying Elderly

--【Book Recommendation】On Death and Dying ,by Elisabeth Kübler-Ross

-7.8 Grief Counseling for the Widowed Elderly

--Grief Counseling for the Widowed Elderly

--【Book Recommendation】I Wasn't Ready to Say Goodbye,by Noel·Brook,Blair·Pamela

-Concept Map

--【Concept Map】Hospice Care for the Elderly

-【Test】CHAPTER 7

-【Case Discussion】CHAPTER 7

FINAL EXAM

-Final Exam

3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia笔记与讨论

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