Daily care standards for the elderly

The core essence of the "Daily Care Standards for the Elderly" is never a set of standardized processes that can be copied and applied; Based on the physiological characteristics, chronic disease conditions and psychological needs of the elderly individual as the core, a personalized plan that dynamically balances the three dimensions of basic care, risk prevention and control, and emotional support , all seemingly trivial operations are essentially to allow the elderly to obtain the highest quality of life and dignity under the premise of safety.

I have been a volunteer in a community elderly care service center for 6 years, and I have seen too many families who have fallen into the pitfalls of "standardization." Previously, a family hired a nurse to take care of Aunt Zhang, who suffered from mild Alzheimer's disease and diabetes. The nurse followed the "universal care list" on the Internet and led the aunt to walk 3,000 steps a day. If she did not walk enough, she would advise "walking more to lower blood sugar is good for the body." It was not until blood marks appeared on the aunt's socks that the family discovered that she had diabetic peripheral neuropathy and her sensitivity to pain was only 1/3 of ordinary people. She did not even notice if her feet were worn. You see, if you don't first understand the physical condition of the elderly, any "correct" standards will be a fool's errand.

Regarding many details of elderly care, there is still no absolutely unified standard in the industry. The most typical one is dietary management. One school is the evidence-based school, which advocates strict compliance with chronic disease management indicators. For example, the daily salt intake of patients with hypertension should be strictly limited to 5g, and patients with diabetes should completely ban added sugar, and make the stability of indicators the first priority. ； The other group is the quality of life group, which believes that as long as the index fluctuations are within a safe range, priority should be given to satisfying the elderly's dietary preferences. After all, the positive effect of pleasant emotions on health is sometimes more obvious than strict mouth control. I met an 82-year-old Grandpa Li who loved to drink sweet sugar water all his life. When he was first diagnosed with high blood sugar, his family did not let him touch it. He lost ten pounds in half a year. He sat on the sofa in a daze every day and did not even leave the house. Later, after discussing with the bedside doctor, He is allowed to drink half a cup of warm rock sugar pear every afternoon, as long as he reduces the amount of staple food by half a tael that day. Now, more than half a year has passed, and his blood sugar has not fluctuated greatly. He can still take the initiative to go downstairs and play chess with his old friend for two hours every day. His condition is much better than before.

Compared with what to eat, the greater safety risks are hidden in the little things that are most easily ignored by everyone. In order to prevent falls, many people are equipped with handrails and anti-slip mats, so they buy a pair of super-soft-soled shoes for the elderly that are said to be "specially designed for the elderly." Little do they know that if the soles are too soft, the friction will be greatly reduced when stepping on spliced ​​carpets and polished tiles. One-third of the fall cases counted by our center last year were related to inappropriate shoes for the elderly. There is also the issue of feeding medicines. It is not about buying a medicine-dividing box and dividing the medicines, and everything will be fine. Many elderly people will take antihypertensive medicines and sleeping pills together, which can easily cause orthostatic hypotension and make them dizzy when they stand up in the middle of the night. It is best to be with them every time they take medicines, and it only takes half a minute.

Many people's understanding of "nursing" is that eating, sleeping and eating well is not dangerous. In fact, what is most easily missed is the care of emotional needs. There is a grandma Chen in the community where I live. She used to rush to help her daughter-in-law clean the table and wash the dishes. Her daughter-in-law stopped her every time because she was afraid that she was tired. As a result, grandma gradually stopped talking and sat on the balcony staring outside in a daze every day. Later, the family listened to the community nurse’s advice and left a few plastic bowls that were not afraid of falling for her to wash every day. During meals, she asked her more about her past work in the factory. Grandma’s energy improved visibly. Don't always tell the elderly, "Don't do it and let me do it." Sometimes, leaving them with a sense of value that "I can still help" is more effective than buying many supplements.

To put it bluntly, there are no "standards" that are universally applicable. Many family members are always like correcting papers for students, stuck with standard answers. As long as they do not meet the standards, they feel that they are doing something wrong. But the elderly are not students, and there are never perfect answers in nursing. All the rules and regulations are not as useful as squatting down and asking the elderly "what do you want to eat today" and "do you want to go for a walk?" Nursing care, in the final analysis, protects "people", not a bunch of cold indicators.