| 摘要: | Dementia is a progressive degenerative disorder characterized by impairments in multiple cognitive domains, including memory, executive function, learning, language, attention, perceptual-motor and social cognition impairment.
Approximately 46 million people worldwide had dementia in 2015. Its prevalence has been increasing steadily, which is expected to reach 131.5 million by 2050. The estimated global cost of dementia is USD 818 billion, and the burden of this disease continues to increase as the number of dementia patients increases. Alzheimer disease (AD) is the most common cause of dementia and it accounts for
60–70% of dementia cases. Alzheimer disease (AD) is the most common cause of dementia and it accounts for 60–70% of dementia cases.
Patients with AD and patients with vascular dementia (VaD), the second mót cause of dementia differ slightly in behavioral problems and psychiatric symptoms. For
example, patients with AD have more behavioral problems, including sleep disturbance, nighttime behaviors, appetite changes, aberrant motor behavior, and
wandering behavior than patients with VaD. These behavioral problems and psychiatric symptoms affect their family members and also their family caregivers. Indeed, caregivers would seek for counseling. Nearly 70% of dementia caregivers report subjective burden. Gender, relationship with patients, type of dementia,
and caring hours per day are also correlated with caregiver’s quality of life. Chronic stress and burden of caring dementia patients were correlated with poor physical and mental health, and reduced quality of life in caregivers. Counseling and support system have been proved to be beneficial for both care-givers and patients.
Taiwan national health insurance (TNHI) also provides the counseling fee for caregivers of dementia. This is an unique service which pays for care-givers instead of
patients themselves. However, the benefits of this payment have not been really evaluated.
This retrospective observation study analyzed a dataset at Shuang Ho Hospital explore the benefits of counseling for dementia care-givers. After counseling, the duration of hospitalization decreased from 9.03 days to 6.78 days and the frequency of emergency visit decreased from 0.67 to 0.25 times in two years. The most frequent reasons for hospitalization and emergency department visits including
infections and fall-related injuries, were potentially avoidable.
This study emphasizes the importance of counseling to caregivers for preventing hospital admissions, and emergency visit of people with dementia. |
