一位患有重度阿茲海默症的82歲女性目前住在長期照護機構中。在傍晚時分，她提著一個行李箱走向護理站，看起來非常焦慮。她懇求說：「請馬上幫我開門！天快黑了，我必須趕快回家煮晚餐。我的三個小孩子剛從學校放學回家，他們現在一定快餓扁了！」而在現實中，她的孩子們都已經成功邁入 60 幾歲的年紀。護理師的哪項介入完美示範了對於此認知缺陷的「確認療法（Validation Therapy）」？
An 82-year-old female resident with advanced Alzheimer's disease resides in a long-term care facility. During late afternoon, she approaches the nurses' station clutching a suitcase and appearing visibly distressed. She pleads, "Please open the door immediately! It's getting dark, and I need to severely rush home to cook dinner. My three young children just got back from school and they must be starving!" In reality, her children are all successfully in their 60s. Which nursing intervention exemplifies the use of validation therapy for this cognitive deficit?
- A“It sounds like you love your children very much and being a mother is important to you. Tell me, what is their favorite dinner that you cook?”✓ 正解「聽起來您非常愛您的孩子，當母親對您很重要。告訴我，您做的他們最喜歡的晚餐是什麼？」
- B“I understand you want to cook, but the kitchen here is closed. Why don't you watch some television until your children come visit you?”「我知道您想煮飯，但這裡的廚房已關閉。在您孩子來看您之前，不如看些電視吧？」
- C“You seem very confused right now. Let me take you back to your room and administer your prescribed calming medication.”「您現在似乎很困惑。讓我帶您回房間，並給予您處方的鎮靜藥物。」
- D“You don't need to cook. You have lived in this nursing home for five years, and your children are all married adults now.”「您不需要煮飯。您在這家安養院住了五年，您的孩子現在都是已婚成年人了。」
本題測驗老人精神科對於晚期失智症的溝通手腕：「確認療法（Validation Therapy）」。大腦已產生不可逆萎縮的失智症病患，其時空經常被困擾在過去的某個充滿安全感或責任感的年代。對於這類病患實行「現實導向（Reality Orientation）」，例如粗暴地戳破他們並告知時間與地點（選項D），會讓病患感到錯亂、悲傷與極端憤怒，因為他們的大腦已經無法處理現在的現實。確認療法的精神是：「不爭辯其現實的對錯，而是深掘並驗證隱藏在這個記憶背後的情感意義」，並藉此溫和轉移其焦慮。選項A完美地抓住了該病患想扮演母親照顧小孩的深層情感價值，透過引導她回憶晚餐細節，能有效轉移她『急著想出門』的焦慮，這是安撫重度失智症病患的黃金標準。
This question tests gerontologic psychiatric communication techniques for clients with late-stage dementia, specifically Validation Therapy. Clients with dementia who have already developed irreversible brain atrophy are often emotionally stuck in a past era full of safety or responsibility. Applying reality orientation to such clients, for example by bluntly contradicting them and informing them of the current time and place (option D), can cause confusion, sadness, and extreme anger, because their brain can no longer process the present reality. The spirit of validation therapy is: "Do not argue about the rightness or wrongness of the client's reality, but instead dig deeper and validate the emotional meaning hidden behind that memory," and use that to gently redirect anxiety. Option A perfectly captures the client's deeper emotional value of wanting to play the role of mother caring for her children, and by guiding her to recall details of dinner, it can effectively redirect her anxiety about wanting to leave. This is the gold standard for soothing clients with advanced dementia.
台美在對待 Dementia 阿茲海默的長者推廣著高度一致的「Validation Therapy(確認療法/同理療法)」。不再硬碰硬地告訴阿嬤她的兒子已經死很久了，而是順著她的思路「兒子不在，那我陪你泡茶好嗎」是安養機構全球統一標準。