Daily care essentials for the elderly

There has never been a unified standardized list of the core points of daily care for the elderly. The essence is to "focus on the individual tolerance of the elderly, giving priority to avoiding safety risks, secondly improving physical comfort, and finally retaining the autonomy of life as much as possible." This is the conclusion that I have worked as a front-line nurse in a community elderly care service station for 6 years and have interacted with nearly 300 elderly people.

When many people first start taking care of the elderly, they always like to search for "100 things you must do in caring for the elderly" and follow them rigidly, but in the end they end up doing bad things with good intentions. I met a 72-year-old Aunt Zhang before. Her knees have been degenerative for many years. Her children read on the Internet that elderly people need to walk 8,000 steps a day to be healthy. They forced her to go downstairs and walk around the community for an hour every day. After walking for half a month, she developed synovitis. After lying down for two months, her muscles atrophied a little, and she became less active than before. Do you think it was a loss?

There are actually two completely different views in the industry regarding fall prevention, which is the highest priority in home care. One is to advocate "all-scenario barrier-free renovation": all sharp corners in the home should be edged, the floor should be covered with non-slip mats of more than 3 centimeters, handrails should be installed from the bedroom to the bathroom, and even slippers should be fully wrapped in anti-slip models to completely eliminate the possibility of falling. The other is the "moderate retention disorder" school, which believes that the home is too "safe" and the elderly cannot adapt to the situation with steps and no handrails when they go to the public environment outside, making them more likely to have accidents.

Both of these statements are actually supported by actual cases: 83-year-old Uncle Li had a mild cerebral infarction before, and his left limb was a little unfavorable. His home was completely changed according to the first plan. He has never fallen at home in three years of living. However, the last time he stayed at his son's house, the bathroom did not have handrails. When he stood up, his legs softened and he almost fell in. He broke out in a cold sweat. After that, he did not dare to go to a strange place casually when he went out. The 78-year-old Aunt Wang is still in good health, but she is a bit presbyopic. She only has handrails in the bathroom, bedside and entrance hall. There is a 2cm small threshold on the balcony. She has to lift her feet every day when entering and leaving. Her sense of balance is much better than that of the elderly of the same age. The last time the community organized a physical test for the elderly, she could stand on one foot longer than many 70-year-olds. In the final analysis, there is no absolute right or wrong. If the elderly already have balance disorders, sequelae of cerebral infarction, or severe osteoporosis, priority must be given to complete transformation to ensure safety. ； If the body is still strong, there is really no need to transform the home into a "sterile cabin", which will destroy the elderly's original mobility.

After controlling the visible risks, the most important thing is actually for the elderly to feel comfortable. Many family members tend to ignore this point and always adopt the mentality of "I am doing this for your own good" without asking the elderly about their true feelings. Grandpa Chen, who I used to take care of at home, was 85 years old and had mild urinary incontinence. At first, his family members were greedy for convenience and bought thickened diapers, saying they would absorb more and could be changed twice a day. As a result, he developed large eczema on his buttocks in the summer. He was so itchy that he couldn't sleep all night. He got angry and refused to wear diapers, peeing everywhere, and his family members blamed him for being ignorant. Later, I gave them a heads up and changed into thin breathable diapers, changing them every two or three hours, and applying some diaper cream every time. The eczema disappeared within a week, and Grandpa Chen stopped making trouble. He was still willing to go downstairs and play two games of chess with his old friend every day.

There is also the issue of eating, and there is a lot of quarrel on the Internet now. One group says that the elderly should eat absolutely light food, with less oil and salt, and it is best to eat whole grains and vegetables. The other group says that since you have lived to this age, you can eat whatever you want, and don't wrong yourself. 92-year-old Grandpa Liu has no other problems except for mild high blood pressure. He used to be very strict with his children and did not allow any fat to be touched. He ate boiled vegetables with multigrain porridge every day, which made him tired of eating. He lost ten pounds in half a year. Later, we discussed with his children that we would cook braised pork for him twice a week, cutting it into two or three pieces each time, and adding less salt. Now, almost a year later, his blood pressure has not soared, and his face has become much rosier. He can still carry a vegetable basket to the gate of the community to buy vegetables every day. In fact, this degree can be adjusted flexibly. If you have serious underlying diseases such as diabetes and gout that require strict dietary restrictions, you must follow the doctor's advice. ； If there are no major health problems, there is really no need to be so stuck. Eating happily is much more important than controlling those few grams of oil and salt.

To be honest, when many people take care of the elderly, they regard the elderly as a "porcelain doll" who needs all-round care, but forget that he is an adult with independent consciousness. Try not to rush to help him do things that he can do by himself. The 86-year-old Grandma Zhang fell once before. After her arm recovered, her children did not let her do anything. They did not let her wash the dishes or clean the table. They even had to help her get dressed. As a result, she sat on the sofa in a daze every day and talked a lot less. Later, we told her children that we should change her to a non-slip plastic bowl and let her wash a few of her own bowls and wipe the dining table every day without making her work too hard. With just such a small adjustment, Grandma Zhang's energy has improved significantly. She takes the initiative to clear the table after dinner every day, and tells everyone she meets that she can still help with the family's work and is not a useless burden. In fact, it is the same as when a child is learning to walk. If you always hold him, he will never learn to walk. The same goes for the elderly. If you help him with everything, his original functions will gradually deteriorate. He still feels that he is a burden on the family. How can he feel better?

I have been doing this for almost 7 years, and I really feel that there are no universally applicable nursing care points. Just look at the neatly listed lists on the Internet, and don’t force them on your own elderly family members. The core thing is actually to observe more, sit down and ask the old man how he feels. He feels comfortable, at ease, and has a bright future, which is better than the standards given by experts.