斜槓醫師:一位身兼作家、媒體人的全面醫師

(2021/01/06 ) 文藻WHC-USR教師社群活動於一月六日邀請長庚醫院陳乃菁醫師蒞校演講，講題為「素人醫師如何主持節目與認識失智照護」。陳醫師原來是計畫與大家分享她推廣失智照護的理念和經驗，可是當天會場有太多慕名而來的本校老師，他們有些家中有失智的長輩，有些人的親人就是陳醫師的病患，對於失智的醫療養護常識求知若渴，陳醫師為了回應大家的要求，於是先對有關失智的常識，做了扼要的說明，才正式進入主題。

失智是大家較為陌生的議題，但是在台灣進入老年化社會的今日，這個議題已不可迴避。這也是陳醫師由一個從醫的醫生，跨足到媒體當主持人，同時也當起了作家的原因。台灣社會對失智瞭解得太少，一旦遭此家變，大家措手不及，所引發的衝突、無奈，實在是數不勝數。為了解決這些問題，陳醫師義無反顧的投身著書立說和媒體人的工作。

在陳醫師的演講中，大家瞭解到，在輕度認知功能障礙的病患中，大約只有四分之一會發展成嚴重失智，其餘的四分之三，只要能有居家的照顧，其實是可以正常生活的。而這個工作必需深入社區、深入家庭，才能有效完成。一般患者在出院後，進入日常生活大約有三種情況，一是由家人照顧，二是由外傭照料，三是進入療養院。其中由家人照顧最為理想，但也常引發家庭的衝突，對家庭造成沉重的負擔。陳醫師建議，家庭中應由成員共同來照顧患者，不要由一個人來承擔。在過去的案例中，她發現有不少獨立承擔的照顧者，竟都比患者先行病倒，阿媽照顧阿公，結果阿媽先往生，未出嫁的女兒照顧媽媽，結果女兒先病倒了。這樣的例子不勝枚舉。失智者的異常表現，對照顧者是一種很大的負擔，對於疲憊的承擔者而言，這些異常的表現常讓人覺得可惡而無奈，但是一旦由整個家庭來照顧失智者，這些異常的表現也常讓人覺得可愛。

在三種情況中，進入療養院常是最不好的選擇，因為目前台灣的療養院人手普遍不足，夜間的看護與病患比常約是一比九十，這樣是無法得到較完整的照顧的。至於外傭，在溝通上又普遍存在著困難。因此陳醫師非常肯定本校USR小螺絲釘服務團隊， 小螺絲釘的成員進入醫療場域，有效協助解決溝通的問題 ，真的是為社會盡一份力。

至於原來要演說的自身主持節目及寫作的經驗，陳醫師只是非常客氣的點到為止，但我們在簡短的說明中，也可以瞭解到陳醫師的用心和悲憫。她有五個孩子，自身家庭已忙到不行，但是為了更廣泛的服務大眾，推廣對失智者照顧的正確觀念，不辭辛勞的寫作、投稿、作節目、當主持人，這些對於一位素人醫師而言，都是一項項的考驗。目前陳醫師從第一本書「因為愛所以看見」到現在已陸續有多本書問世，在youtube頻道上也輕易可以找到陳醫師的視頻，陳醫師對失智患者的照顧，已由病房擴展到社會，由社會而深入人心。

Slash Career of a Doctor: Many-faced Life of a Doctor, Writer, and Media Person

(2021/01/06 Written by Chien-hsun Lin and translated by Yolanda Chi) On January 6, 2021, WHC-USR teachers’ community invited Dr. Nai-ching Chen of Chang Gung Hospital for a lecture on “How a Doctor Hosts a TV program as an Amateur Media Person and What We Need to Know about Dementia Care.” Dr. Chen originally intended to share her ideas and experience of promoting dementia care, but since numerous fans from our faculty came seeking for guidance on helping elders at home who suffer from dementia, and some of whom have already been Dr. Chen’s patients. In response to the requests, Dr. Chen first made a brief introduction to dementia before she got into the theme of her talk.

According to Dr. Chen, dementia is a less known topic but an inevitable issue in Taiwan’s aging society. This is the reason why Dr. Chen has crossed over her medical discipline to become a media host and a writer. People of Taiwan know so little about dementia that once it occurs in a family, most members do not know how to deal with it, thus causing countless conflicts and evoking feelings of helplessness. To solve these problems, Dr. Chen decisively dedicated herself to advocating proper awareness through words and multimedia.

In the lecture Dr. Chen pointed out that only a quarter of the patients suffering from mild cognitive impairment will develop dementia, while the remaining cases are actually capable of living normally as long as they are well taken care of at home. The work has to go deep into the community and into the patients’ families. After being discharged from the hospital, patient return to normal life in three different conditions; namely, they taken care of by (1) family members, (2) foreign domestic helpers, or (3) by caregivers at nursing homes. The best choice would certainly be under the care of family members, but that is often the cause of conflicts or an increase in family burdens. Dr. Chen suggests that in a family all members should share in common the responsibilities instead of placing the workload solely on an individual. In previous cases, a lot of the individual caregivers collapsed even before the patients. Examples include such that a grandma took care of a grandpa but then she passed away first, or that an unmarried daughter took care of her mother but she tumbled down. The abnormal behaviors of the dementia patients create a big burden to the caregivers, and especially to exhausted caregivers. These behaviors may often be so obnoxious that lead to the mood of hopelessness and helplessness in the caregivers. However, if the patients are taken care of by the whole family, these abnormal behaviors may appear somewhat cute or lovable.

Among the three conditions, staying in nursing homes is the worst choice. Due to the shortage of human resources that presently occurs in Taiwan’s nursing homes, especially at midnight shift with a one-to-9 or one-to-10 nurse-patient ratio, comprehensive care would not be possible. As for employment of foreign domestic helpers, communication problems normally exist. Therefore, Dr. Chen recognized greatly the efforts of WHC-USR contributed to the society by entering the healthcare-related sites to assist in effective communication to solve such problems.

As for the talk about experience of hosting TV programs and writing books, Dr. Chen only made a brief remark, from which we audience witnessed her zeal and empathy. Although she has five children and is kept busy in family life, she is willing to serve the general public and promote proper awareness for dementia care by diligently writing articles, submitting them to publication, producing programs, and becoming a program host. To an amateur like her, all these are challenges. Starting from her first book To See Because of Love to its sequels and to her videos easily accessible on YouTube, Dr. Chen’s care for dementia patients has extended from hospital wards to corners of the society, delving deep into the human hearts.