外文翻译

从疗养院到绿屋:美国养老概念的改变 Meika Loe,Crystal Dea Moore 应用老年学杂志,2012(31),p756-763 在长期照护的社会模式下,绿屋在美国增益了发展的势头。由William Thomas,医学博士,一个自称为“废除养老院死刑的国家”,和社会老年学专家Judith Rabig设想,活动侧重于长期护理小房子模型关注于老年人的活力,尊重,自主,尊严(Thomas,2003)。这个活动大约是为周围长期护理造成了熟练的护理替代传统的养老院结构和文化的变化。不同于传统的养老院中医院般的感觉,绿屋被描述为“非 制度 关于办公室下班关闭电源制度矿山事故隐患举报和奖励制度制度下载人事管理制度doc盘点制度下载 化”照料设施。他们是牧场风格的家,还是小的,独立的房子,能容纳12个或更少的居民。它们的特点是私人房间和设施齐全的浴室,允许老人的隐私和个性化(老人装饰自己的房间)。每个房子有共享的家庭式的公共空间,包括一个壁炉,用餐区和设备齐全的厨房。截至2010年3月,共有79绿房子在14个州和一个额外的132正在另外12个州建设中(LaPorte,2010)。绿屋酒店项目,从欧洲的护理模式中获得最初的灵感,目前只存在于美国。 绿屋模型是基于一定的人性化的指导原则共同代 表 关于同志近三年现实表现材料材料类招标技术评分表图表与交易pdf视力表打印pdf用图表说话 pdf 了长期护理的“文化变革”(Koren, 2010)。这些原则包括人格的尊严,自主性,舒适性,选择,隐私,和居民的安全;提供有意义的活动,促进居民的最大功能的能力,促进情感和精神福祉,并认识,鼓励和重视老年人和工作人员的个性,而这种相互惠的关系出现在这个制度下的照顾中(Koren,2010; Rabig,Thomas,Kane,Cutler,& McAlily,2006;绿屋项目,第二,Thomas,2003)。在使用诸如在那些隶属于绿屋活动老人直接进入到新的尊重生命阶段。以前的研究(Kane 等人,2007)揭示了居住在绿房子老居民拥有积极的健康和有质量生活的结果。 绿屋是一个需要技能的护理设施。注册护士助理(CNA),由国家授权的直接护理工作者,在这些护理环境完全适用。他们扮演的角色“万能工”从食物,衣物,个人护理,康复(成长和机会),并普遍推广的生活老年人的素质。CNA是一直在现场的居民,而护士,医生,治疗师和其他专业人士包括来访的临床支持团队。不同于传统的养老院的环境下,CNA 是在照顾层次结构的底部,在绿房子他们才是最终每天负责满足居民的需要。护士,在传统的护理模式的中心,现在担任客座和咨询能力。在烹饪艺术,痴呆护理和康复两百个小时的 训练巩固这个角色的变化,并准备的CNA发挥的作用“shabazim”或“elderhood的助产士”。这是一个相当大的作用转变这些工人。传统上,CNA职位的特点是高周转率低工资,低地位的工作(Dawson,2007)。在绿屋中,Shabazim作用已升高的重要性,并CNA工资水平已经上升。 From Nursing Home to Green House: Changing Contexts of Elder Care in the United States Meika Loe and Crystal Dea Moore Journal of Applied Gerontology ,2012(31),p756-763 A social movement in long-term care, the Green House, is gaining momentum in the United States. Conceived by William Thomas, MD, a self-described ―nursing home abolitionist,‖ and social gerontologist Judith Rabig, the movement focuses on a small-house model of long-term care centered on elder vitality, respect, autonomy, and dignity (Thomas, 2003). This movement is about structural and cultural changes surrounding long-term care resulting in a skilled nursing alternative to the traditional nursing home. Unlike a traditional nursing home with a hospital-like feel, Green Houses are described as ―deinstutionalized‖ caregiving facilities. They are ranch-style homes, or small, self-contained houses that house 12 or fewer residents. They feature private rooms and full bathrooms, allowing for elder privacy and personality (elders decorate their own rooms). Each house has shared family-style communal spaces, including a hearth, dining area, and full kitchen. As of March 2010, there were 79 Green Houses in 14 states, and an additional 132 are being constructed in another 12 states (LaPorte, 2010). The Green House project, initially inspired by European care models, currently only exists in the United States. The Green House model is based on a number of humanistic guiding principles that together represent the ―culture change‖ in long-term care (Koren, 2010). These principles include supporting dignity, autonomy, comfort, choice, privacy, and security of residents; offering meaningful activities and promoting maximum functional abilities of residents; fostering emotional and spiritual well-being; and recognizing, encouraging, and valuing the individuality of elders and staff, and the reciprocal relationships that emerge in this unique context of care (Koren, 2010; Rabig, Thomas, Kane, Cutler, & McAlily, 2006; The Green House Project, n.d.; Thomas, 2003). The use of terms such as elder and elder hood among those affiliated with the Green House movement refers directly to a newly respected life stage. Previous research (Kane et al., 2007) reveals positive health and quality of life outcomes for elder residents living in Green Houses. A Green House is a skilled nursing facility. Certified nursing assistants (CNAs), direct care workers who are licensed by states, are central figures in these care environments. They play the role of ―universal workers,‖ attending to food preparation, laundry, personal care, habilitation (growth and opportunity), and general p romotion of older peoples’ quality of life. CNAs are always on-site with the residents, whereas nurses, physicians, therapists, and other professionals comprise a visiting clinical support team. Unlike in the traditional nursing home environment, where CNAs are at the bottom of the care hierarchy, in Green Houses they are the ones ultimately responsible for meeting residents’ needs on a daily basis. Nurses, who were at the center of the traditional care model, now serve in a visiting and consultative capacity. Two hundred hours of training in culinary arts, dementia care, and habilitation cements this role change, and prepares CNAs to play the role of ―shabazim,‖ or ―the midwives of a new elderhood.‖ This is a considerable role shift or these workers. Traditionally, CNA positions are low-paid, low-status jobs characterized by high turnover rates (Dawson, 2007). In the Green House, the Shabazim role has elevated importance, and CNA pay rates have shifted upward. 社区合作伙伴计划: 明尼苏达的一个小镇为体 弱老人建立社区 Kirsten Cruikshank 美国社会老年杂志,2013(14),p62-64 社区合作伙伴,生活在家/街道护理项目在明尼苏达州进行,帮助老年人独立生活在自己家中通过组织邻里志愿者提供支持服务,以及卫生所和社会服务之间的协调。社区合作伙伴公司的目标是加强社区的承诺,两个港口区的老年居民,为老年居民提升生活品质。 该计划开始于2000年,现在提供服务协调,志愿服务,照顾者支持和社区教育。12名成员组成的志愿者领导该项目。兼职人员包括项目总监,一个志愿者协调和照顾者咨询。此外,兼职办公室助理是根据高级社区服务就业计划聘用。 一系列的服务 每年计划提供至少250老人及家庭照顾者的直接服务,以及多达1000人的健康促进,宣传和教育活动。志愿者每年提供平均5000小时的服务。超过100个家庭照料者登记在照顾者支持计划,提供个人和团体的照顾者咨询会议和临时护理。我们的人不单独工作;社区合作伙伴与当地的医院,诊所,人性化服务办公室,退伍军人服务人员,家庭健康服务提供者,以及其他协调服务。 据黛安拉夫,全州生活在家庭网络的主任,“像家里/街道护士程序构建身边的人在同一时间,通过涉及家庭,志愿者,邻居,专业人士,以及最重要的社会,涉及老年人在球队的中心”。 项目不仅提供了创建社区意识所需要的协调,他们还提供具体的服务和转介,帮助人们住在家里更长。这包括使用筛查工具,评估风险和制定计划(www.mnlivewellathome.org),转介护理,家庭保健和看家,转介个人紧急响应计划等科技设备,协助过渡,并与通信长距离家庭成员。 有41明尼苏达家/街道护士课程服务地铁和农村地区。每个程序是根据指导原则形成的,但旨在满足特定的居委会或小城镇的需求(有关详细信息,请访问www.lahnetwork.org)为基础的独立的非盈利组织。 讲故事,进行连接 通过我们的服务协调,义工,以及照顾者支持计划,工作人员和志愿者能够帮助艾伦(参见附文本页上)和其他像他一样的人生活在社区。它是一种特权,告诉艾伦的故事和别人的故事。每个人都有一个故事,每个故事可以让我们与他人连接。 被子也提供了保证,社会各界关心他的身体,心理和精神的 健康。 我们建立连接的另一种方式是通过社区团体,如当地的“和平缔造者”绗缝组灵光路德教会在两个港口工作。我们很幸运地获得超过30被子给当地老人。 大部分的棉被已在该地区给予没有家人的老人。例如,弗雷德(化名)有严重的健康问题,并在公寓独居。他住院,后来转移到托管中心进行康复。因为不满他的位置,他解除自己对医生的建议,回家去了。他很快就回到了急诊室,随后住院治疗。当社工代替我们的办公室在关爱中心拜访他,我给他带来了一床被子,并告诉他这是多么重要的回国前,必须得到力量。它帮助,他一直呆到医生的排放。 被子身体提供温暖,舒适和颜色。但是,当我可以告诉弗雷德(和其他人),他的被子是由一些令人惊异的当地妇女对他的关爱,它也提供了保证,社会各界关心他的身体,心理和精神的健康。 通过志愿服务,加强债券 正规的医疗护理是帮助人们保持独立的重要组成部分。我们的志愿者的驱动程序有助于使人们在接触他们的医生。由美国老人部分资金,该程序依赖于共享的成本,但有人无法支付仍然可以打电话寻求帮助。我们相匹配的驱动程序是单对单与参与者。 志愿者经常会在一个星期抽出三天的时间,提供人们他们的癌症治疗或透析会议。这是安妮怎么遇见玛西娅的。安妮,92岁,需要乘坐每周三次洗肾中心26英里远。她可能已经转移到一个设备更接近洗肾中心,但她想留在她的公寓,她一直住在社区,她的朋友和邻居超过二十年。玛西娅是能够舒适的驾驶在冬季的几个月里,所以她去年冬天提供了安妮超过一百单程乘坐。他们成了很好的朋友,共享笑声和泪水,在冬季玛西娅与安妮成为密友,与她谈即将结束生命为她的担忧。其他车手渐渐接近和欢迎安妮,并有满足她的需要乘坐的问题。The Community Partners Program: A Small Minnesota Town Creates Community for Frail Elders Kirsten Cruikshank GENERATIONS – Journal of the American Society on Aging Winter 2013_14 ? Vol. 37 .No. 4,62-64 C ommunity Partners, the Living At Home/ Block Nurse Program of Two Harbors, Minnesota, helps older adults live independently in their homes by organizing neighborhood volunteers and providing support services and coordination between health and social services. Community Partners’ vision is to strengthen community commitment to older residents of the Two Harbors area and enhance the quality of life for older residents and their caregivers. The program began in 2000, and now offer service coordination, volunteer services, caregiver supports, and community education. A twelve-member volunteer board of directors leads the program. Part-time staff include a program director, a volunteer coordinator, and a caregiver consultant. In addition, a part-time office assistant is employed under the Senior Community Service Employment Program. An Array of Services Annually the program serves at least 250 elders and family caregivers with direct services, and up to 1,000 people with health promotion, outreach, and educational events. Volunteers provide an average of 5,000 hours of service annually. More than 100 family caregivers are registered in the Caregiver Support Program, which provides individual and group caregiver consultation sessions and respite care. Our people don’t work alone; Community Partners coordinates services with the local hospital, clinic, county human services office, a veterans service officer, home health providers, and others. According to Diane Raff, director of the statewide Living at Home Network, ―A program like the Living at Home/Block Nurse Program builds community around people one person at a time, by involving family, volunteers, neighbors, professionals, and, most importantly, involving the older person in the center of the team.‖ Programs not only provide the coordination needed to create a sense of community, they also provide concrete services and referrals to help people live at home longer. This includes the use of screening tools to assess risk and make plans (www.mnlivewellathome.org), referrals for nursing, home healthcare and housekeeping, referrals for personal emergency response programs and other technology devices, help with transitions, and communication with long-distance family members. There are forty-one Living at Home/Block Nurse Programs in Minnesota serving metro and rural areas. Each program is an independent nonprofit organization formed on a foundation of guiding principles, yet designed to meet the needs of a specific geographic neighborhood or small town (for more information, visit www.lahnetwork.org). Telling Stories, Making Connections Through our service coordination, volunteer, and caregiver support programs, staff and volunteers are able to help Allen (see sidebar on this page) and others like him live in community. It is a privilege to tell Allen’s story and the stories of others. Everyone has a story to tell, and each story helps us make connections with others. The quilt also provides reassurance that the community cares about his physical, mental, and spiritual health. Another way we build connections is by working with community groups such as the local ―Peacemakers‖ quilting group at Emmanuel Lutheran Church in Two Harbors. We have been fortunate to receive more than thirty quilts from the group to give to local elders. Most of the quilts have been given to people without family in the area. For example, Fred (not his real name) had serious health problems and lived alone in an apartment. He was hospitalized and later transferred to the care center for rehabilitation. Unhappy about his placement, he discharged himself against medical advice and went home. He was soon back in the emergency room and subsequently hospitalized. When the social worker asked our office to visit him at the care center, I brought him a quilt and told him how important it was to gain strength before returning home. It helped—he stayed until the physician’s discharge. Quilts offer physical warmth, comfort, and color. But when I can tell Fred (and others) that his quilt was made by some amazing local women who are concerned for him, it also provides reassurance that the community cares about his physical, mental, and spiritual health. Strengthening Bonds through Volunteerism Regular medical care is an important part of helping people to remain independent. Our volunteer driver program helps keep people in touch with their doctors. Funded in part by the Older Americans Act, the program relies on sharing costs, but someone unable to pay can still call for help. We match drivers one-on-one with participants. Volunteers often will give rides up to three days a week, delivering people to their cancer treatments or dialysis sessions. This is how Annie met Marcia. Annie, age 92, needed rides three times a week to the dialysis center twenty-six miles away. She could have moved to a facility closer to a dialysis center, but she wanted to stay in her apartment where she had lived in community with her friends and neighbors for more than twenty years. Marcia was comfortable driving in the winter months, so last winter she provided more than a hundred one-way rides for Annie. They became good friends, shared laughs and tears, and over the winter Marcia became a close confidant Annie could talk with about her end-of-life concerns. Other drivers grew close to Annie as well, and there were no problems in meeting her need for rides.