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分享看護老人的心得
Sharing the Know-How In Caring For the Elderly

□    吳如璧.吳果海    文
By Nhu Bich & Maria Ngo

(接上期)
乙、經驗分享
二、人員
7.工作人員加入工作時,即應開始訓練。各個老人院的管理、經營方式不同,所以新進人員都應受良好訓練,以減少錯誤發生,例如:
☆如何保持整個設施的清潔,無蚊蟲;應使用何種清潔劑及存放何處(如上了鎖的櫥櫃)?
☆如何使用各種設備:洗衣機、烘乾機、門上警鈴、料理台、冷凍櫃、冰箱等。要知道放在冰箱及冷凍櫃裡的食物,是無法永久保持新鮮的。他們可以存放多久?如何,以及何時,使用暖氣爐或冷氣機?
☆如何照顧每一位所分派的住客:多久淋浴或盆浴,換洗衣服,帶去上廁所;如何換裝尿片;如何送食﹙早、午、晚餐和點心應供應何種飲料及食物﹚;如何照料每位住客的藥物;幫助臥床住戶轉換地方,做運動例如走路、有氧活動等等的技巧。
☆如何燒菜、上菜、餵食。
☆如何時時保持房子的清潔、美觀及安全。
☆歡迎訪客、調查投訴的官員、執照調查員的接待程序。
☆處理緊急狀況的辦法與程序:緊急通知的電話號碼、打911時所要說的話﹙打電話人、地址、簡單情況的說明、受害者的處理狀況﹚、通知家屬。
☆其他適當的訓練及後續教育。

丙、住客
托您照顧的有各種各樣的老人,條件、情況、行為、好惡都不相同。以下介紹最常見的情況和應對之道:
1.經常有家屬來訪者,或者帶住客去兜風、或到冰淇淋店等:您應盡量配合家人,把住客做好妥當的外出準備,包括適當的衣服、尿片、已先如廁等。
2.無家屬而受郡政府監護者:很少訪客,可能一個月只一次,因為照顧他的社會工作者,通常工作負擔重。對這種寂寞的老人,應該盡力幫助他過好的生活,讓他有愛、有溫暖的感覺。
3.非臥床者:不須靠走路架子、輪椅,能自行走動者。腦筋清楚或者有點迷糊。有的評析師將「非床臥」解釋為「不須旁人協助,可自行離開者」。
4.臥床者:靠走路架子或輪椅者,家庭式老人院不收無法下床的住客。對臥床住客要特別費心,須餵食、洗身、更衣、或帶去如廁。
5.失禁者:膀胱無法控制的老人,應用尿片,隔一段時間﹙通常兩小時﹚就帶去上廁所。尿濕的衣單應先清洗後,再放入洗衣機。可選用小便器、或室內便器給某些住客用。
6.大部分老人有便祕:便祕會造成許多疾病,因此越早解決越好。補救的方法是多喝流質,提供適當的飲食或能軟便或幫助消化的食物。多給一些菜蔬。
7.老人須要運動:健康和天氣條件許可時,在後院或附近公園散散步是有益的。讓他們稍稍晒晒太陽,但不要晒過頭了。對身體好或該運動的老人,每天做室內活動也是好的。您可以放有氧運動的電視節目,讓他們健身。

→待續

(Continued from last issue)
II. Sharing the Experience
B. Staffing the Facility
7. Training should commence as soon as the worker begins work. Not all care homes are managed or operated the same way. Therefore, the new worker must be well-oriented and trained in order to minimize mistakes:
- How to keep the facility clean and free of insects; what kinds of detergents can be used; where are they stored (in a locked closet for instance).
- How to use the household appliances: washer and dryer, door alarm, cooktop, freezer, refrigerator, etc. Learn that food placed in the refrigerator or the freezer does not last forever: how long should it stay; how and when to use the heater or air conditioner.
- How to care for each resident assigned: how often to give a shower or a bath, change clothes, take to the toilet bowl; how to place and remove a diaper; how to feed the resident (what kinds of liquids and food should be given at breakfast, lunch, dinner, snacks); how to administer medication to each resident; skills for helping non-ambulatory residents during transfer from one place to another, physical exercise such as walking, aerobics, etc.
- How to cook the food, serve the meals, and feed the residents.
- How to keep the premises clean and attractive at all times, and make the house free of hazards.
- Procedures in welcoming visitors, ombudsmen, and licensing analysts.
- Rules and procedures in cases of emergency: telephone numbers to call, what to say when 911 is called (name of caller, address, brief description of what has happened and what has been done to assist the victim), informing the family.
- Other forms of training and continuing education as appropriate.

III. The Resident
Placed under your care is a wide variety of older persons whose conditions, situations, behaviors, likes and dislikes, are all different. The following describes a number of the most commonly encountered conditions and situations, and how to cope with them.
1. The resident has a family that makes frequent visits, or takes him out for short rides, visits to the ice cream parlor, etc.: Try to accommodate the family in the best possible manner; have the resident ready to go out by dressing him with the appropriate clothing and diapers, taking him to the bathroom beforehand, etc.
2. The resident has no family and may be under the guardianship of the county government. Visits in this case are rare, maybe once a month, because the social worker in charge usually has a heavy caseload. For such a lonely person, try your best to make his life as nice as possible; make him feel surrounded by love and compassion.
3. The resident is ambulatory, which means that he can move around without the aid of a walker or a wheelchair. He may be clear-minded, or somewhat confused. Some analysts define "ambulatory" as "able to leave the facility unassisted."
4. The resident is non-ambulatory, which means that he must use a walker or wheelchair. A Residential Care Home cannot accept people who are bedridden. A non-ambulatory resident requires more care. He must be fed, washed, changed, and taken to the toilet.
5. The resident is incontinent, meaning he cannot control his bladder. Use diapers, and take him to the toilet periodically, normally every two hours. Clothes and towels soiled with urine must be rinsed before being placed in the washing machine. For certain residents, you can use a urinal or commode placed in the room.
6. Most of them have constipation. Constipation is the origin of many illnesses; therefore, it is very important to eradicate this condition, the sooner the better. The remedy is to give enough fluids and an appropriate diet, which may include certain kinds of food that soften the stools or facilitate digestion. Serve more vegetables.
7. Seniors need exercise. If health conditions and weather permit, a walk in the back yard or in the neighboring park is good. Have them stay in the sun for a short duration, without exposing them to sunburns. Indoor daily exercise is also good for those elderly who are strong enough and for whom exercise is recommended. You can use the TV's aerobics for fitness.

→To be continued

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