Precautions and measures for daily care of the elderly

First, the individual situation of the elderly should always be put before all standard guidelines. Second, the input-output ratio of pre-risking is much higher than that of post-remediation. Third, the importance of psychological needs and physiological care are completely equal, accounting for at least half.

I have been working as a nursing supervisor in a community nursing home for almost 4 years. I have seen too many family members who followed online strategies and ended up with problems in caring for the elderly. Let me tell you something I just encountered last week: 72-year-old Aunt Zhang has mild degenerative knee arthritis and her son has short hair. The video said that the elderly should walk more and take large doses of calcium supplements to prevent osteoporosis. They forced her to walk 10,000 steps a day and took two imported calcium tablets at a meal. As a result, her knees swelled like steamed buns in less than half a month. When she came to our inn for physical therapy, she shed tears from the pain.

Regarding the issue of exercise and calcium supplementation for the elderly, there have always been two different views in the academic community: one group advocates "moving up" and believes that 150 minutes of moderate-intensity exercise per week for elderly people over 65 years old can effectively reduce the risk of sarcopenia and osteoporosis.； The other group advocates "sparing use", especially for the elderly with basic bone and joint diseases. Excessive exercise will accelerate joint wear and tear, which is not worth the gain. In fact, both statements are correct. What is wrong is to apply the standard regardless of the condition of the elderly - Aunt Zhang's bone density T-score was measured to be -1.2, which is only mild osteopenia and does not require large doses of calcium supplements. The knees are already worn and worn, and walking 10,000 steps a day is just adding insult to injury.

Speaking of which, I have to mention another pitfall that many family members are prone to: always waiting until something goes wrong before repairing the hole. The 78-year-old Uncle Wang we served before was usually in good health, but he had a bit of orthostatic hypotension. He told his children several times that he felt dizzy when he stood up at night, but no one took him seriously. They thought he was just dazed by sleep and just said a few words. As a result, he slipped and fell at night last month and fractured his femoral neck. After the operation, he lay down for three months. His muscles have atrophied due to disuse, and now he has to rely on a walker when going out.

Regarding risk prevention and control for the elderly at home, there are now two completely different ideas in the nursing community: one is "all-in-one", where all furniture in the home is wrapped with anti-collision strips, the floor is covered with anti-slip mats, handrails are installed on the bedside and toilet, and night lights are installed all the way from the bedroom to the toilet, and even try to limit the elderly's independent activities.； The other is "moderate white space". On the premise of taking basic protection, leave a certain space for the elderly to move independently. For example, do not put all commonly used things within his reach. Occasionally let him get up and take two steps to get them. On the contrary, it can exercise balance ability and avoid rapid muscle degeneration. When we make home care plans for the elderly, we usually make a compromise based on the elderly's physical condition. If they are strong and have good balance, we should leave more room for movement. If they have poor balance and have a history of falls, we should provide adequate protection. It is never one-size-fits-all.

What many people don’t know is that the above-mentioned problems are all visible, and the invisible psychological needs of the elderly are the most easily ignored. 81-year-old Grandma Li lives alone after her wife leaves. Her son and daughter are doing business in other places. She pays a lot of money every month, buys the best food and supplies, and hires a live-in nurse to take care of her. However, she was admitted to the hospital three times last year. Each time, her blood pressure soared inexplicably, and no matter how she adjusted the medicine, it was useless. When we visited her home for follow-up, she moved a small bench and sat at the door to choose food. She said that the happiest thing every day was when the courier guy came to deliver things and he could chat with her about their family affairs. Later, we invited her to join the hand-knitting group at the inn, and we would come here every Tuesday and Thursday to do handicrafts and chat with other elderly people. Now, more than half a year has passed, and her blood pressure is very stable, and she has even reduced her antihypertensive medication by half. Some family members have complained to us before, saying that it is useless to spend so much money to take care of their lives, but in fact, existing clinical data shows that the risk of coronary heart disease and stroke is 32% higher for the elderly who have been lonely for a long time than those with stable social interactions, and the risk of Alzheimer's disease is 40% higher. To put it bluntly, a good mood is the most cost-effective health product.

Oh, by the way, let me talk about some of the high-frequency pitfalls I have encountered in the past few years. You can avoid them in advance: Don’t just buy those internet-famous constant-temperature foot bath buckets for the elderly, especially the elderly with diabetes. Many of them have peripheral neuropathy and are not sensitive to temperature. I met an old man the year before last. He soaked his feet up to 48 degrees and didn’t feel anything. When his feet were hot and blistered, he said the water was not hot. He ended up with a secondary infection and was hospitalized for half a month.； Don't rush when feeding an elderly person with dysphagia. The more you push him, the more eager he will be. It is easy for the food to enter his lungs and cause aspiration pneumonia. In severe cases, he may suffocate. ； Also, don’t just give the elderly all kinds of “health supplements” and “hyperglycemic and blood pressure-lowering miracle drugs” of unknown origin. You must ask your community doctor before taking them. I have seen people who took so-called “sugar-lowering miracle medicines” and ended up in ketoacidosis and were sent to the ICU before. It’s not worth it.

In fact, after working in our industry for a long time, we know that there is really no standard answer to caring for the elderly. No matter how good other people's experience is, it is not as good as spending two extra days to observe the habits and status of your own elderly. If he likes to eat soft food, don't force him to eat whole grains to maintain his health. If he likes to sit at the door and bask in the sun, don't force him to go out for exercise. Comfort, happiness, and safety are better than any standard.