Daily care tips for the elderly

Don’t wait for problems to occur before remediating them. Prioritize the three most common risks of “prevention of falls, prevention of choking, and prevention of pressure ulcers.” At the same time, the comfort of the four basic dimensions of diet, excretion, sleep, and emotion should be taken into consideration. There is no need to overly pursue the standardized requirements of “nutrition” and “exercise more.” The first priority is to adapt to the elderly’s own status.

I have been doing elderly care in the community for almost 8 years, and I have seen too many accidents that could have been completely avoided. To put it bluntly, more than 80% of the causes of non-chronic disease hospitalization for the elderly are inseparable from these three risks. Speaking of falls, Aunt Zhang, who I met in the past two years, is the most typical example. She is usually very strong. She can go downstairs to buy groceries and carry ten kilograms of rice without gasping. She stepped on a half-high stool at home to reach the pickled radish on the hook on the balcony. She slipped on a vegetable leaf that fell to the ground and broke her femoral neck. After lying down for three months, she used to be able to walk in the park by herself. Later, she had to use crutches when going out, and her mental state was greatly reduced. There are actually different views on this point in the nursing community. One group advocates that the elderly should practice more balance skills, walk thousands of steps a day, and practice standing on one leg. The other group believes that the elderly should move less and stand instead of standing when they can sit or lie down instead of sitting. In fact, there is no absolute right or wrong? If you are an elderly person with Parkinson's disease, lower limb muscle weakness, or a history of falls before, don't force yourself to exercise every day. First remove the threshold of your home, remove the wires scattered on the floor, and the small rugs with poor anti-slip properties. Install handrails beside the toilet and shower area in the bathroom, and replace them with a pair of home shoes with non-slip soles. These basic protections are much more effective than forcing you to exercise. ； If your physical condition is really good and you have no underlying diseases, taking a walk every day, practicing Baduanjin, and squatting against the wall for a few minutes can indeed enhance muscle strength and reduce the risk of falling.

In addition to falls, choking is also an easy pitfall for many family members. I always feel that the elderly should eat more whole grains and chewy things to be healthy. Last time, Uncle Li in the jurisdiction ate the handmade sticky bean buns brought back by his grandson. When he swallowed it, it got stuck in the airway. Fortunately, his family knew the Heimlich maneuver, otherwise he almost had a serious accident. There are currently two different care ideas about how elderly people with degraded swallowing function should eat. One advocates eating all mushy foods to absolutely avoid the risk of choking. The other believes that long-term eating mushy foods will accelerate the degradation of swallowing function, which is not good. We now generally recommend that family members take the elderly to have a swallowing function assessment first. For those with mild disabilities, it is not necessary to mash everything. Cook the food until it is soft and mashed, such as stewing ribs until they fall into pieces, boiling thin noodles, and steaming soft pumpkin and sweet potatoes. Feed slowly and slowly every time. Do not turn on the TV or chat while eating. Chew each mouthful 20 times before swallowing. This will retain the pleasure of eating without too much risk. ； If you already have severe dysphagia, then really don’t force yourself to give normal food. Follow the doctor’s advice to eat a homogenized meal or insert a gastric tube. Don’t risk suffocation for the so-called “eating well”.

Another risk that is easily overlooked is pressure ulcers. Many people think that only the elderly who are bedridden for a long time need to prevent them. This is not true. People who have been in wheelchairs for a long time, or even elderly people who can sit but sit still for most of the day, may all suffer from this disease. Grandpa Wang downstairs has been in a wheelchair all year round after becoming paralyzed. His family members are busy, and sometimes they forget to help him move his position in the morning. A stage II pressure ulcer developed on his buttocks. It took more than two months of medication to heal. There used to be a very common misunderstanding about pressure ulcer care. Many people think that they need to apply more talcum powder to keep them dry to prevent them from getting ulcers. This is actually not recommended now. The particles of talcum powder can easily clog pores. If you sweat too much, it will irritate the skin. If used by elderly women, it can easily lead to urinary tract infections. The current common practice is that the elderly who are bedridden should turn over every two hours, and the elderly in wheelchairs should be helped to lift their buttocks once every hour, and wait for 30 seconds before sitting down. If there are already areas that are red due to pressure, cover them with special hydrocolloid dressings, which is more effective than applying talcum powder or sesame oil.

The rest of the daily care is actually not that particular. You don’t always have to listen to what the Internet tells you about how much milk to drink and how many eggs to eat. If the elderly are lactose intolerant and get diarrhea after drinking milk, then switching to Shuhua Milk or taking some calcium tablets and spending more time in the sun to replenish vitamin D is better than forcing them to drink milk. Also, don’t always think that the old man is just pretending to have pain. Grandma Chen in our district always complained of headaches. After a round of examinations, there were no problems. Later, when I asked her, she found out that her children were out of town and only came back once every six months. Later, her granddaughter came to accompany her to the park twice a week and danced in the square for half an hour. After two months, she came for a follow-up visit. She said that her headaches no longer hurt, and even the values ​​of the antihypertensive drugs she usually took had stabilized a lot.

In fact, there is really no one-size-fits-all standard for caring for the elderly. The personality and physical condition of the elderly in each family are different. It is much more useful to observe their habits and ask them about their feelings than to follow the list on the Internet. After all, to put it bluntly, the core of nursing care is never to "not be sick", but to make the elderly comfortable and at ease, right?