Elderly health and management

The core of health management for the elderly has never been to pursue "all normal indicators" by relying on strict dietary restrictions and high-intensity health care, but to make personalized and dynamic adjustments around the three dimensions of the elderly's physiological state, psychological needs, and social support. The ultimate goal is to maintain the elderly's ability to take care of themselves and improve their quality of life as much as possible, rather than to be "completely disease-free."

I have been doing elderly health services in the community for almost 8 years, and I have seen too many examples of things that go astray. The most typical one is Aunt Zhang, who came to me for consultation last month. She is 72 years old. Last year, she started to follow the short video blogger to learn "hardcore health care". She couldn't walk 10,000 steps a day, only ate half full, and kept half a cupboard of health products. As a result, after half a year, her knees were so worn that it hurt even when walking down the stairs. Her stomach also suffered from acid reflux due to eating supplements indiscriminately. There were three more abnormal items on the physical examination report than before.

Nowadays, there are actually two voices that are very noisy about the health management of the elderly. One is completely medical-oriented. They believe that as long as the indicators are abnormal, they must intervene. They want to make the elderly eat, drink and eat according to the standard card. I have met an Uncle Li who suffers from type 2 diabetes. He was so controlled by his children that he could not even touch a mouthful of watermelon. Last summer, he secretly ate half a piece of watermelon while no one was at home. The blood sugar level was measured to be 8.2. His daughter who came back from get off work said a few words and hid on the balcony and cried for half an hour. Later, we adjusted his diet plan and told him to only take one or two bites of something sweet if he really wanted to, and just reduce the size of his bowl of rice by half. Now he doesn’t have to worry about eating a popsicle occasionally, and his blood sugar is much more stable than before when he was tight every day. The other is a complete "happiness priority". I feel that I am comfortable as I get older, regardless of the indicators. This kind of problem is also prone to problems. Uncle Wang in the community has been suffering from high blood pressure for 10 years. He felt that he didn't need to take medicine if he didn't feel dizzy. As a result, he suffered a cerebral hemorrhage at home last winter. Although he was rescued, half of his body was still weak. He couldn't go to the flower and bird market he used to visit every day.

To be honest, these two ideas are too extreme. When we create health records for the elderly in the community, we will not only record the values ​​​​of blood pressure, blood sugar, and blood lipids. We will also specifically mark whether he has the habit of going downstairs to play chess with his old friend every day, whether he is serious about love, whether he likes to eat pickles, whether his wife is in good health, and whether his grandchildren are with him. There used to be a 76-year-old Grandma Liu who always said that she was flustered and couldn't sleep well. She went to a large hospital to check her heart condition several times and there was no problem. Later, when I chatted with her, I found out that her only daughter had married away in Guangzhou and hadn't come back for almost half a year. She didn't even have anyone to talk to. Later, I took her to a handicraft class in the community, where she made sachets and knitted Chinese knots with some old sisters. After just over a month, she told me that she hadn't had the problem of panic for a long time, and she was sleeping much better. In fact, many of the "minor problems" experienced by the elderly are not physical problems at all, but are caused by being suppressed by no one to accompany them. This part is also the most easily ignored part of health management.

There is also an interesting phenomenon. Nowadays, many young people are filial and buy a bunch of smart health watches and home monitors for the elderly at home. They also install cameras to watch them remotely, for fear that the elderly may forget to take medicine or drop or touch them, which may have the opposite effect. There used to be an Aunt Chen in our community. Her son installed a monitor with a voice reminder for her. As long as he didn't see her taking medicine at the right time, he would shout on the phone. Later, Aunt Chen got annoyed and deliberately unplugged the monitor, and secretly stopped taking the medicine for half a month, which almost caused problems. Later, I gave her son some advice. Instead of asking "Did you take medicine today?" and "What's your blood pressure?" when she called her, ask more about "Are the peaches in the market downstairs sweet today?" "Did you learn new moves in the square dance with your old sisters recently?" By the way, "If you ate something sweet today, remember to take half a pill more." Now Aunt Chen is not only willing to take the initiative to measure blood pressure, but also take the initiative to share the new things she encountered today with her son. The relationship between mother and son has improved a lot.

I have been doing this for so long, and my deepest feeling is that "management" in elderly health management is never about "controlling" the elderly, but about helping the elderly take the initiative. If you tell him, "You must not eat this," he always wants to take a bite secretly. If you tell him, "It's okay if you want to eat it, let's walk an extra 20 minutes today, or just eat one less bite of rice." On the contrary, he is willing to cooperate. There are also many people who think that thinness means health for the elderly. In fact, muscle loss occurs quickly in old age, which is clinically called sarcopenia. On the contrary, it is easy to lose stability and fall, which is much more troublesome than being slightly obese. We now advise the elderly to eat more eggs and milk, and practice squatting against the wall when there is nothing to do. It is not much more useful than taking health supplements every day.

Last week, our community held a health market for the elderly, and I met Aunt Zhang again. Her knees were almost healed. Now she dances with the square dance team for 20 minutes every day, and she no longer forces herself to walk 10,000 steps. She has also stopped taking health care products for most of her life. She recently signed up for a calligraphy class in the community. I saw her holding the four characters "Fu Shou Kang Ning" she had just written in her hand, and she smiled very happily. She said that although there are still a few minor problems in the physical examination, she eats well and sleeps well every day, and is much more comfortable than before when she was worried about looking at the indicators every day. In fact, for the elderly, being able to live every day comfortably is better than anything else.