认知症特色化居家适老化改造——评估工具与改造后效研究  

Dementia-friendly Home Modification--Assessment Tool and Post Modification Effect

作　　者：李佳婧[1] 贾琴心 秦岭[1] 毛宏达 邵明珊 LI Jiajing;JIA Qinxin;QIN Ling;MAO Hongda;SHAO Mingshan

机构地区：[1]清华大学建筑学院 [2]北京建筑大学城市与规划学院 [3]上海尽美长者服务中心 [4]北京元页文化传播有限公司

出　　处：《城市环境设计》2025年第2期40-47,共8页Urban Environment Design

基　　金：国家自然科学基金青年项目:“以人为中心的照护”理念下认知症照料设施空间环境评价指标体系与优化策略研究(批准号:52108002);北京市高等教育学会2024年立项面上课题:社区适老化改造需求下的老年人居住环境课程建设研究(MS2024215)。

摘　　要：我国已迈入深度人口老龄化阶段,认知症患病人数正在快速增长。当前,绝大多数认知症老年人为居家照护,对空间的安全性、可识别性有较高要求。已有居家适老化改造相关政策、研究与实践对认知症老年人特殊需求考虑较少。本研究依托认知症老年人家庭适老化改造公益项目,开发了《认知症特色化居家适老化改造入户评估工具》,通过对老年人的日常活动能力、认知状态及居家环境风险进行评估,为其匹配适宜的改造方案。对250户家庭的改造前后数据进行分析的结果显示,该工具能有效评估老年人的身体状況并为之匹配适宜的改造措施。在改造后效方面,扶手类和消防类辅具使用率高,而记忆辅助类和生活类辅具使用率低,辅具使用率与老年人的身心功能衰退程度正相关。研究认为认知症老年人居家适老化改造中辅具选型设计应考虑安装便利性、简洁易懂性和美观性,安装后需增强工作人员的演示与引导,对不同认知障碍程度的老年人需提供差异化改造。未来还需进一步提高家庭照护者的辅具使用及学习意愿,通过宣传培训提高公众对认知症居家环境改造的认识,提升其居住环境质量,更好地支持认知症老年人的日常生活,减轻照护者负担。China has entered an advanced stage of population aging,with a rapidly increasing population of people with dementia.The majority of people living with dementia in China are cared for at home,necessitating higher standards for the safety and identifiability of home environments.Existing policies and practices related to home modification for older adults have not addressed the special needs of people living with dementia.This study,based on a public welfare project for home modification in people living with dementia,developed the"Dementia Friendly Home Modification Assessment Tool."By assessing the daily activity capabilities,cognitive status,and home environmental risks of older adults,it matches them with appropriate renovation plans.Data from 250 households before and after the modification revealed that the tool effectively evaluates the physical conditions of older adults and matches them with suitable renovation measures.Post-modification survey indicated high usage rates for handrails and fire safety aids.In contrast,signage and daily living aids saw lower usage,with aid usage rates positively correlating with the degree of physical and cognitive decline in older adults.The study suggests that in home modification for individuals with dementia,the selection of assistive device should consider ease of installation,simplicity,comprehensibility,and aesthetics.Following installation,it is essential to provide detailed demonstrations and guidance by social workers and offer different modification plans for individuals with varying degrees of cognitive impairment.Future efforts should also aim to enhance the willingness of family caregivers to use and learn about assistive device and improve public awareness of dementia-friendly home modification through education,thereby enhancing living environment quality,supporting the daily lives of individuals living with dementia,and alleviating the burden on caregivers.

关 键 词：居家适老化改造 认知症 评估工具 日常活动能力 认知障碍程度 

分 类 号：TU241[建筑科学—建筑设计及理论]