British hospitals are having a dementia-friendly makeover. Simple changes can have big benefits for patients with dementia.
英国医院正在做有利于痴呆症患者的改造——简单的改变对痴呆患者有很大的好处。
THE three inpatient wards that take up the ninth floor of St Thomas’ Hospital in London look like children’s quarters. The walls and doors are brightly coloured. Large pictures of showers and toilet bowls on some doors make it easy to guess what is behind.There are hardly any written signs. Instead, giant arrows matching each room’s colour point the way.But these wards are not for toddlers: this is the hospital’s Older Persons Unit. The layout and decor have been designed for dementia patients.
伦敦St `Thomas医院九楼的三个住院病房看起来像幼儿园： 有着色彩鲜艳的墙壁和门，一些门上还挂着淋浴和抽水马桶的大幅标识，让你很容易猜出每个房间的作用。这里鲜有文字标识，与每个房间颜色相匹配的巨大箭头指向了房间的方向。不过这些可不是孩子的幼儿园，这是医院的老年人病房。它的布局和装饰都是为痴呆症患者准备的。
In recent years, dozens of other hospitals around Britain have refurbished wards and other areas to make them dementia-friendly. Other countries are looking to Britain, already a leader in dementia care and research, says Hugo de Waal, an academic clinician at the Julian Hospital in Norwich.St Thomas’ recently hosted a tour for health officials from Australia and Singapore.
近年来，英国已经有其他几十家医院为了痴呆症患者翻新了病房和其他区域。Norwich的Julian医院的学术临床医生Hugo de Waal说，其他国家密切关注在痴呆症治疗和研究领域领先的英国。 澳大利亚和新加坡的卫生官员们最近就参观了St Thomas 的成果。
Going into hospital is stressful for anyone. But for people with dementia, even in a mild form, admission can cause extreme distress, for three reasons. First, the clutter and bustle in a typical hospital ward can be overwhelming. This often leads to agitation, fear and aggressiveness—signs of delirium, which is the reason for most admissions of people with dementia to begin with. Another problem is that the featureless corridors in a typical ward make dementia sufferers feel lost. And many get anxious about being confined to their rooms because dementia increases their desire to explore and walk around.
住院对任何人来说都是一种压力，但是对于病情轻微的痴呆症患者来说住院会极度痛苦，原因有以下三点：首先，传统的医院病房里的杂乱和喧嚣可能会让他们不堪重负。这常常导致焦虑、恐惧和侵略性——这都是精神错乱的迹象，这也是大多数痴呆症患者开始接受治疗的原因；另一个问题是传统病房里中规中矩的走廊让他们感到迷茫； 第三个问题就是痴呆症让他们想他们四处探索和走动， 许多人担心被限制在自己的房间里。
Layout and design can alleviate all three problems. A common alteration to make a ward calmer is replacing the nurses’ station—hub of activity and chatter—with several small reception desks. Bright lighting throughout is another popular change, not only because it helps older people see better. Light pooling causes shadows and dark corners, which may look scary. The lights at the St Thomas’ dementia-friendly unit are adjustable, which helps with sleep. “It becomes much quieter when we dim them,” says Darlene Romero, the unit’s matron.
布局和设计可以缓解这三个问题：用几个活动和闲聊的小接待处取代护士站可以使病房相对安静；明亮的灯光也十分受欢迎，不仅因为它帮助老年人看得更清楚，而且不够亮的光还会产生可怕的阴影和死角；另外可调灯光也有助于睡眠，“调暗灯光时，病人们变得安静多了”，该单位的负责人Darlene Romero说。
Several tweaks can prevent confusion. Dementia patients sometimes refuse to walk on shiny floors because they think they are wet. Patterns or colour changes may appear as steps or holes to them。Matt finishes and uniform colours are therefore reassuring.Different room colours and unique pictures above each bed help with way-finding.To accommodate restless patients, new layouts have small socialising areas, such as a couple of chairs near the nurses’ desks, or eating areas made to look like home kitchens. A few hospitals with ground-floor wards have added gardens where patients can wander safely. St Thomas’ has dog therapy to improve patients’ mood.
还有几处调整可以让病人思路清晰：他们有时候不愿在反光的地板上行走，认为这时自己的身体是湿的；地面图案或颜色变化对他们来说可能是台阶或洞。因此，哑光饰面和统一的颜色让人放心。不同的房间颜色和床上不同的图片有助于他们找到病房。对于躁动不安的病人还设置了新的布局：一些精妙的社交区域，比如靠近护士办公桌的几把椅子、看起来像家庭厨房的饮食区域、一些有底层病房的医院还增加了花园，病人可以在那里无忧无虑的闲逛。 此外St Thomas 医院还有独特的有狗狗疗法改善病人情绪。
The effects of decor can be dramatic. At the Julian Hospital, three months after dementia patients were moved into a redesigned ward in 2012, use of antipsychotic medication fell by nearly 40%. A study of ten sites in England published in 2015 by the King’s Fund, a think-tank, found that incidents of aggression fell after dementia-friendly spruce-ups.Such changes are becoming pressing for British hospitals. A quarter of the patients on their wards have dementia. In 2025 Britain will have 25% more people with dementia. The bright, pleasant wards and their calming effect on patients also boost staff morale, helping to attract and keep nurses and doctors in dementia care. In the past, people with dementia were usually relegated to the worst bits of hospitals; now their wards are beginning to look like the cheeriest.
这些装饰的效果是惊人的：2012年，在痴呆症患者搬进重新设计的病房三个月后，精神病药物的使用率下降了近40%。King’s 基金在2015年公布的一项针对英国十个网站的研究发现这样的特定装修使得侵犯事件有所减少。由于四分之一的住院病人患有痴呆症，到2025年，英国将有25%的痴呆症患者， 英国医院越来越急需这种变化。此外明亮、舒适的病房及其给对患者的平缓也提升了医护人员的士气，有助于扩大并保持痴呆护理相关的医护人员岗位。在过去痴呆症患者通常被送到最糟糕的医院，但现在他们的病房看起来是最舒适的。
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