Precautions for daily care of the elderly

The first is to put fall prevention at the top of all safety care. The second is to reject the "one-size-fits-all" standardized care plan. All adjustments are based on the elderly's own feelings and tolerance. The third is to pay equal attention to physiological care and emotional needs, and do not equate care with the routine work of "feeding and wiping the body."

I have been doing elderly care in the community for almost 8 years, and I have seen too many elderly people who were originally in good health, but their condition suddenly deteriorated after a fall. Last year, 72-year-old Aunt Zhang in the community was able to shop for groceries and dance squarely. She got up in the middle of the night to fetch a thermos cup from the living room in the dark. Her foot hooked on the edge of the carpet and she fell and fractured her femoral neck. She had severe osteoporosis and was bedridden for less than half a year after surgery before she passed away due to a lung infection. Nowadays, there are actually two completely different nursing ideas about preventing falls: One group advocates "all-scenario protection". All the sharp corners in the house are covered with soft strips, anti-skid mats are spread all over the house, and handrails are installed every meter on the walls. They wish to transform the home into a ward. ； The other group believes that over-protection will cause the elderly to have a psychological suggestion of "I can't move" and actively reduce the amount of activity. This will cause muscle strength to deteriorate faster and make them more likely to fall. Judging from my own experience, there is absolutely no need to go to extremes. Don’t pile up cardboard boxes, slippers and other debris in the commonly used activity aisles. Install two handrails beside the toilet and shower area in the bathroom. Don’t buy the kind of fluffy foam soles commonly worn by the elderly. They are slipperier than ice when wet. Practice the stances and leg-raising movements in Baduanjin with more companions at ordinary times. The strength of the lower limbs will increase, which is much more useful than having anti-collision strips all over the house.

Many people have noticed it in terms of safety, but they have committed the problem of "appropriation" in the care plan. After seeing online statements that "the elderly should eat more grains to control blood sugar" and "drink enough 1500ml of water every day", they forcefully apply it to the elderly at home. Last month, an older sister came to me to complain, saying that her father was diabetic, and she forced the old man to eat multigrain rice. As a result, the old man’s teeth were not in good condition. He had acid reflux after half a month of eating, lost three kilograms in weight, and his blood sugar level was not stabilized. In fact, doctors in endocrinology and geriatrics often have different views here: Endocrinology must strictly control sugar to avoid complications. ； Instead, the geriatric department prioritizes ensuring the nutritional intake and quality of life of the elderly. There is no need to make the elderly suffer from eating every day just for the sake of blood sugar figures. Later, I gave her an idea. I soaked the grains for 4 hours in advance and cooked them with white rice at a ratio of 1:2 until soft. After the meal, I walked downstairs with the old man for 10 minutes. Later, the blood sugar test did not exceed the standard, and the old man ate deliciously. And when it comes to drinking water, don’t stick to the 1500ml standard. Elderly people with prostate hyperplasia should drink less water after 6 p.m. Otherwise, they will not only have trouble sleeping when they wake up three or four times a night, but they will also be more likely to fall when going to the toilet in the dark.

The most easily overlooked thing is actually the emotional needs. Many people think, "I'll hire the best nanny for you, and it's enough to eat and drink well." In fact, this is not the case. There used to be an 80-year-old Grandpa Li in our community. The nanny hired by his children cooked delicious food and kept the house spotlessly clean. As a result, the old man sat bored on the sofa every day without talking. Later I found out that the nanny was afraid that he would be held responsible if he fell downstairs, so she refused to let him play chess with the old man downstairs. There is also controversy over this matter in the industry: One group believes that the first goal of nursing is to ensure the physical safety of the elderly, as long as there are no accidents. ； The other group believes that long-term depression will directly lead to reduced immunity and accelerated cognitive impairment, which is a higher risk than an occasional fall. Later, we equipped the old man with a smart watch with positioning, and also greeted the community security guard, allowing him to go downstairs and sit for an hour every afternoon, playing chess with the old man without going far. During that time, the old man ate a lot more, and he took the initiative to say hello to people he met. It was much "safer" than being locked up at home every day.

There are also some little bits and pieces of experience that have been learned over the years: when buying clothes for the elderly, try to choose cardigans, and don’t buy pullovers. It is particularly difficult to put on and take off when you can’t lift your arms.； Don't always urge the elderly to "eat quickly" or "walk quickly". The elderly are inherently slow to respond, and if you rush them, they are more likely to make mistakes. ； If the old man chokes and coughs during feeding, don't rush to pat him on the back. Ask him to turn his face sideways to cough out the contents in his mouth, otherwise it will be easy for him to choke into his trachea.

In fact, after working in elderly care for so long, my biggest feeling is that there is no perfect "list of things to note". In the final analysis, all the rules treat the elderly as ordinary people with their own preferences, rather than patients who need standardized management. Squatting down more often and asking him what he wants to eat today and whether he wants to go out for a walk is more useful than reading ten nursing guides.