Abstract:

Objective This study aimed to describe the behavioral and environmental patterns of getting lost among community-dwelling older adults with dementia. Methods Using the phenomenology method,we conducted semi-structured interviews on 16 family caregivers of older adults with dementia who got lost and 9 volunteers with experience of searching for lost dementia patients. Then,we analyzed the interview data using a Colaizzi’s phenomenological approach. Results We identified several behavioral patterns related to getting lost,including the elderly wanted to go back home/companies/other meaningful places or they got excited easily before straying and getting lost,and the elderly were in an activated state,following others while walking,got injured,dressed untidy,and acted illegally when they were lost. Moreover,environmental factors were also identified in this analysis,including caregiver factors（caregivers were sleeping or busy with other things）and place factors （the place tended to have a complex transportation system or the elderly changed their apartments）. Conclusion To prevent the elderly from getting lost,caregivers need to identify their abnormal behaviors and take control of these factors to prevent their getting lost. If straying happens,caregivers and volunteers may search for the elderly in a purposeful way by behavioral and environmental patterns.

Key words: Dementia, Aged, Lost, Behavioral Patterns, Environmental Patterns, Caregiver, Qualitative Research, Nursing Care

摘要：

目的 探索居家痴呆老年人走失前后的行为特征及情境因素,旨在为预防痴呆老年人走失或为走失后的搜救行动提供指导。 方法 采用现象学研究,2018年1月—2021年3月选取16名走失的居家痴呆老年人的亲属照顾者和9名搜救机构志愿者进行半结构访谈,运用Colaizzi现象学7步分析法分析收集的资料。 结果 居家痴呆老年人走失前表现为要去某个有特殊意义的地方和处于精神亢奋状态;走失过程中表现出精神状态持续亢奋、走路尾随他人、交谈时思维混乱、有磕碰外伤、外表不整洁和做出违法行为等行为特征。走失时的情境因素包括照护者处于睡眠状态、照顾者被其他事情转移精力、交通复杂的环境及变换居住地点后。 结论 护理人员应指导照护者识别异常先兆,并加强风险时段和环节的监管,预防居家痴呆老年人走失的发生;走失发生后可参考走失过程中的行为特征,提升搜救效率。

关键词: 痴呆, 老年人, 走失, 行为特征, 情境因素, 照护者, 质性研究, 护理