多數的失智症患者都需要照顧者的協助才能完成日常生活活動。此研究的目 的在於探討曰常生活活動提示訓練對於失智症病患的曰常生活活動表現以及照顧 者生活品質的影響。 此研究以隨機分派方式進行，33位阿茲海默型失智症病患（平均78.8±8.2歲） 與其照顧者參與，接受每月1次為期4個月的介入訓練或普通照顧訓練，並藉由 盥洗、穿衣、購物、服藥這四種日常生活活動擇一作為介入訓練的項目，提供四種 結合口語、視覺與手勢的提示介入。本研究使用失智症功能障礙評估量表(Disability Assessment for Dementia, DAD)評估日常生活活動功能的改變，並且以照顧者負擔 量表(Caregiver Burden Inventory, CBI)和 SF-36 生活品質量表(36-Item Short-Form Health Survey, SF-36)分別評估照顧者負擔和生活品質。 48位失智症病患接受初評，接受4個月的訓練之後，共33位(68.7°%)完成後 測。相較於控制組（17人），介入組的患者（16人）在DAD基本日常生活活動 (Basic Activities of Daily Living, BADL)項目的退化少且達顯著(p=0.04)，且其照顧 者在 SF-36 的生理項目（Physical Component Summary, PCS)有明顯的進步(^=0.009)。 兩組在 DAD 的工具性日常生活活動(Instrumental Activities of Daily Living, IADL) 項目(p=0.29)、SF-36的心理項目(p=0.95)與CBI (p=0.60)則無顯著的改變。 本研究顯示藉由提供提示調整活動需求對於失智症患者的BADL障礙以及照 顧者的生理健康有立即的成效。此介入方式可做為提供失智症患者與其照顧者服 務的參考。

Many older adults with dementia require constant assistance from caregivers when completing activities of daily living (ADL). This study aimed to determine the effects of ADL training consisting of the use of supporting prompts on ADL performance of patients with dementia, as well as the quality of life (QoL) of caregivers. A randomized controlled trial was designed for patients with Alzheimer’s disease (AD) and their family caregivers. The intervention was conducted in sessions once a month over a 4-month training program, or during a usual care group. One task was chosen, from grooming, dressing, shopping and medicine use, as the focus of an ADL training session, which then provided supporting skills in terms of verbal, visual, gesture, or physical prompts. The Disability Assessment of Dementia (DAD), Caregiver Burden Inventory (CBI) and 36-Item Short Form Health Survey (SF-36) were used to assess changes in ADL function, caregiver burden and QoL, respectively. Thirty-three (68.7%) community-dwelling older adults with AD completed the whole study, including the final assessments. The treatment group (n=16) exhibited a significant delay in decline according to the DAD-basic ADL score (p=0.04), and optimal improvement in the SF-36 Physical Component Summary (PCS) score was observed for caregivers in the treatment group (p=0.009) in comparison with the control group (n=17). There was no significant change in the scores of the DAD-instrumental ADL (p=0.29), SF- 36 MCS (p=0.95) or CBI (p=0.60) after the intervention. We demonstrated that an intervention in which caregivers were taught to modify activity demands using prompts had immediate effects in terms of alleviating basic ADL disabilities in patients and perception of better physical health of caregivers. Thus, our study provided suggestions in terms of designing and implementing supportive intervention services for community-dwelling patients with dementia and their caregivers.