Cuidando de idosos com Demência: um estudo a partir da prática ambulatorial de enfermagem

Abstract

4Rev Bras Enferm 2005 jan-fev; 58(1):44-8. INTRODUÇÃONa última década as enfermeiras da área de saúde do idoso se viram envolvidas e desafiadas, tanto pela equipe multiprofissional, como pelos familiares no atendimento especializado de enfermagem ao idoso com demência e ao suporte familiar/ cuidador. Isto não se deve somente ao aumento do número de casos de demência, mas especialmente pelo compromisso da enfermagem no cuidado humano.A enfermeira é a profissional mais requisitada nos 10 a 15 anos de progressão da doença, orientando a adaptação dos cuidados a progressiva dependência do idoso; a instrumentalização do familiar para o cuidado; e estimulando o autocuidado e a preservação da auto-estima no binômio idoso-família. Portanto se impõe a necessidade de cuidados de enfermagem sistematizados, dando prioridade a aqueles relacionados às atividades de vida diária e à prevenção de incapacidades e complicações, juntamente com a educação dos familiares.A ocorrência das demências aumenta exponencialmente com a idade, dobrando, Iraci dos Santos Doutora em Enfermagem. Professora Titular da FENF-UERJ Célia Pereira Caldas Doutora em Enfermagem. Professora Adjunto da FENF-UERJ.Vice-Diretora da UnATI-UERJ. RESUMO ABSTRACT The care provided by caregivers to elderly people with dementia is investigated having as objectives: to describe the characteristics of sixteen elderly and their caregivers in attendence at the neurogeriatrical ambulatory of Rio de Janeiro during 2004; to identify nursing and care diagnosis used by caregivers, through EDG, MEEM, AIVDs and AVDs applied in nursing assessments

Diagnóstico de enfermagem memória prejudicada em idosos hospitalizados

“…In Brazil, the score of the validated MMSE ranges from 0 to 30 points and has, as an aid in its classification of results, the level of schooling (5)(6)(7)(8) . Thus, the percentage of elderly patients with NDIM who presented low levels of schooling and scored below 18 on the MMSE are very close (approximately 80%), justifying the identification of a direct relationship between cognitive reserve capacity and the level of schooling (11)(12) .…”

“…The result indicates a deficit in the male population 25% higher than the female. Regarding the results of the ADL scale of evaluation of the degree of dependency of the elderly patients in the realization of activities of daily living, it was determined that, conforming to the progression of the letters, the more dependent the elderly patient will be (6)(7)13) . Relating to gender and estimates of the ADL, there were no male participants with the result "A" (totally independent), but 3 (25%) elderly women presented this profile (13) .…”

“…Results from 5 to 7 should be investigated and above 7 indicate probable depression (14) . Although not diagnosed as clinical depression, its occurrence varies between 10% to 25% in the elderly living in the community, between 12% to 16% in elderly residents of long-term care institutions and over 20% to 30% for institutional residents with depressive symptoms (7,9,(14)(15) . Frequency of E lderl y p ati en ts % DC1 -Inability to recall passed or recent events; DC2 -Inability to retain factual information; DC3 -Inability to learn or retain new skills or information; DC4 -Experiences of forgetfulness; DC5 -Inability to determine if an action has been performed; DC6 -Inability to execute a skill previously learned; DC7 -Inability to perform an action at the planned time Among the DCs identified, 24 (100%) patients presented DC7 -forgetting to perform an action at a planned time, observed on the basis of the ADL and IADL scales.…”

“…Among these diseases, dementia syndromes take a position of prominence as they lead to progressive loss in functional capacity (5)(6) . Two main conditions of dementia can be expected, the reversible ones, in which it is still possible to prevent or interrupt the disease course and even reverse the condition, also known as treatable; and a second type, named irreversible, without prevention, and with a inexorable progressive course (7)(8)(9) .…”

“…These can present as primary causes, when an individual is hospitalized due to a deficit in nutrition because of dysphagia, for example; or as secondary, as in the treatment of pneumonia caused by a dysphagic process over a long period (3)(4)7) . An elderly person considered frail, or who presents a risk of developing adverse conditions or geriatric syndromes, often has multiple health problems.…”