??????,??(??

1
???????-??????????
2
??????,??(????)?????????????????????,???????????
?????????????????,???????????,????????????????????
?(U.S. Congress Office ofTechnology Assessment
)??,?? 180 ????????????,??? 100 ?? 500
??????????????????????????(Alzheimers
Association )???,???????? 400 ???????????? 2040
?,?????????????????? 600 ??? 65 ???,????? 5
?,????????????????,??85 ????? 85
?????,??????????????????
3
??????
4
??????? 1. ????? 2. ?????????
???????????????????????????? ??????????? 3.
????
5
???? ????????? 1. ?? 2. ???? 3. ??(?????) 4.
?????? 5. ??
6
???? 1. ??? 2. ??? 3. ???????
7
???? 1. ???? 2. ???? 3. ???? ??
????? ???? 4.
????? 5. ?? ?? ??
8
??????????? I 1. ????????????????. ??????? 2.
?????????, ??, ??, ????????? 3. ??????? 4.
???????, ??????? 5. ?????????????, ????????.
9
??????????? I 1. ????Avoid loud noise 2.
???????avoid overstimulation 3. ????avoid new
place 4. ????????????? 5. ??????????????
when family are very business in the house
when patient has difficulties with activity
when patient have difficulty to communicate 8.
?????????keep familiar face, place, setting
10
??????????? II 9. ???????????????? 10.
?????????????? 11. ??????praise 12. ?????
a. ??????????? b. handrail
c. ????? d.??????,???? 13.
????????? 14. ???????????, ???????, ???
???????????
11
??????????? III 15. ?????,????????????? 16.
????????,??????,?? 17. ???????? (???????????) 18.
?? a. ??????????? b.
??????????????,??????
??,??????AZ???????????
??,????????,?????,?????
??????,?????????,?????
???,????????. c. ???? d.
?????????(simple task) e. ??????,??????
12
??????????? IV 19. ??????(Wandering) a.
eliminate factors b. keep good sleep at
night 20. ???????? 21. ???????Agitation
a. ??????????????? b. ???????
c. ??????????? d. ????????????????????,
????????
13
??????????? V 22. ?????? a. at night,
avoid caffeine, fluid b. at day,
increase activity, exercise 23. ???????
a. ???????simple, short phrase b.
????,??,?????, No yelling c. ?????
d. ???? e. ?????????,?????????,
???etc f. ???yes/no
question g. Ask close end question
h. ?????????????
14

• ??????????
• ???? Estrogen, NSAID, Ginko/Vit E, ASA,
• Homocystein (B12 Folate),
  Huperzine A
• Intellectual stimulation
• ????Diet Avoid cholesterol, fat, sodium, sugar,
  
• caffein
• ??Exercise
• ????Cognitive challenge
• ????Mental exercise (? 3-step task)
• ????
• ????

15
???????? ???? AchE Inh (Aricept, Excelon,
Reminyl) NMAD Inh (Namenda) Atypical
antipsychotics Typical antipsychotics Mood
stabilizer Antidepressant Anxiolytics
16

• ????????
• ?2030?,?????,?????20?????65?, ???????????
• ?,???????, ???????????65?????????10, ??
• ???85???????47, ??????85?????????????
• ?????.
• ??????????????????????????????????
• ????,(???????)?
• - Burden????behavior???, ???memory, patient age,
  ??????
• - ??????????,?????
• - ????????????????, ??63???
• - ???????,
• high burden level caregiver tend to have more
  difficulty of bereavement,
• increase after care depression
• - ????????????????????????
• (1) ????immune
• (2) ??depression 18-47 up
• (3) ?????cardiovascular disease

17

• ??Caregiver?????
• ??????
• ??????????(Firm Directive)
• ??
• ???????
• ???????????
• ????Family support (Frequent visit from other
  family member)
• ?????Strong social network (????)
• ??,???????
• ????????protect your personal time
• ??,?,????
• ??after care hobbie and planning in future
• ???????
• active coping strategy ??????????????
• increase need for nursing home or home health
  ?????stress and
• burden