Precautions for daily care of the elderly

The core principle of daily care for the elderly is never to copy the "standard care list" and eliminate all risks, but to find a balance between "ensuring physiological safety" and "respecting the elderly's independent wishes". All specific operations must be flexibly adjusted according to the elderly's physical conditions and living habits. There is no universal standard answer.

I have been working in a community nursing home for almost 6 years, and I have seen many examples of people who followed the online list and ended up in a panic. Last year, Aunt Zhang, who lived in Building 3, had a fall. When her children came back, they removed all the carpets in the house. The blue and white porcelain tea cups that had been used for decades were replaced with anti-fall silicone cups. The corners of the table and wall edges were all covered with thick anti-collision strips. As a result, Aunt Zhang lost her temper for a week and lost half a bowl of food. She said that her home was like a nursery and she lived like an incapacitated doll. Later, we came to coordinate and left the old embroidered carpet beside the sofa where she usually sat. It was covered with non-slip tape. We also put the porcelain tea cup back for her and added a non-slip silicone cup holder next to it. This did not increase the risk of falling much, and Aunt Zhang's breath was relieved.

In fact, there have always been two voices in the industry regarding fall prevention and control: one group advocates a "zero-risk environment" and requires that all hidden dangers in the home that may cause collisions and slips be eliminated; the other group advocates "moderate risk exposure" and believes that completely eliminating risks will cause the elderly to lose the opportunity to exercise their reflexes and muscle strength, and will accelerate functional decline. Those of us who do practical work on the front line usually take the middle value: for example, if the sharp edges and corners are in places where the elderly often walk around, there is no need to worry about the corners of the guest rooms that are not often visited. ； The kitchen knives and scissors that the elderly like to use do not need to be locked up. They should be placed in the drawers they are accustomed to using. Do not pile clutter next to them to prevent them from being knocked down. ； The always-recommended all-inclusive and non-slip shoes are not necessary. If the elderly feel that their feet are stuffy after wearing old cloth shoes all their lives, they can put two pieces of anti-slip tape on the soles of the shoes. The effect will not be much different and the elderly will be comfortable.

After talking about the problem of falling, let’s talk about taking medicine. This is also the most common pitfall for many family members. Many children are afraid that the elderly will forget to take their medicines, so they specially buy medicine-dividing boxes, divide the medicines for a week into morning, noon and evening, and watch the elderly people take them when the time comes. To be honest, this method is indeed useful for the elderly who are disabled and have moderate to severe dementia. However, if the elderly have clear consciousness and only have a slightly poor memory, it can easily have the opposite effect. We met 78-year-old Uncle Li before, who has high blood pressure. He secretly throws away the medicine his children give him every time, saying that his children treat him as a fool and have to take care of him even when taking medicine. Later, we asked our son to put the medicine back into the original bottle and use a marker pen to write large characters on the bottle, marking "Take 2 pills in the morning" and "Take 1 pill at night" and let him take it by himself. Instead, he remembered to take it on time every day and never missed it once. I should also mention here that no matter what the situation is, when adjusting medication or adding health supplements to the elderly, you must first ask the attending doctor. Don’t buy them at home just because your neighbors say they are good. Last year, we encountered an elderly person who secretly took the anti-hypertensive health supplements from an internet celebrity, and his blood pressure was so low that he was sent to the emergency room. He was really careless.

There are even more misunderstandings about diet. Many people think that the elderly must be light, boiled vegetables every meal, with less salt and no oil to be healthy. This is not true. In the past two years, the nutritional community was still strictly requiring the elderly to limit oil and salt. In the past two years, the consensus has changed: If the elderly do not have basic diseases such as high blood pressure and kidney disease that require strict salt control, there is really no need to be too stuck. The total daily intake does not exceed 6g, and there will be no problem. The 92-year-old Grandpa Wang of our inn has always been a heavy-mouthed man and loves to eat soy pork elbow. His children did not allow him to eat it before, and he got into tempers every day and could not eat. Later, we agreed to give him one or two pieces of food once a week. Now all the indicators in the physical examination are normal. Every day when he meets people, he says that his children are filial. He is more energetic than many 80-year-old people. Also, don't force the elderly to eat those so-called "highly nutritious" foods. Some elderly people are lactose intolerant. If you don't force them to drink milk, they will suffer from diarrhea. If they drink Shuhua milk or soy milk, their nutritional intake will not be much different.

In fact, what many people tend to overlook when doing nursing care is the emotional value of the elderly. I have seen many families hire live-in nannies for the elderly, but do not let the elderly do any work. As a result, the elderly sit in a daze every day and talk less and less. There used to be a 76-year-old Aunt Chen who was a primary school teacher before retiring. She had been hardworking all her life. When the nanny came, she was not even allowed to pick vegetables and clean the table. She told us every day during that time that she was a useless person. Later, we discussed with the nanny and asked Aunt Chen to help pick a vegetable leaf every time we picked vegetables. We deliberately left a coffee table for her to wipe the table. Within half a month, Aunt Chen became brighter and took the initiative to knit scarves for the children at our post station.

All in all, there really is no one-size-fits-all list of precautions for elderly care. In the final analysis, don’t treat the elderly as someone who needs standardized care. Ask them more about “do you want it” and “do you like it”? Any strategy will work. After all, our ultimate goal in nursing care is never to prevent the elderly from getting into trouble, but to enable them to live their lives comfortably and with dignity.