Daily care tips for the elderly

There is no perfect standard that is universally applicable. Prioritizing the safety bottom line of "no falling, no choking, no pressure ulcers" and then making fine adjustments based on the elderly's long-term living habits is far more effective than forcing the elderly to change their habits against the so-called "standard health answers".

Speaking of falls, falling is the number one concern for many families. I was doing a follow-up visit to the community last week and came across what happened to Aunt Zhang’s family: The children said that walking 8,000 steps a day can prevent osteoporosis. Aunt Zhang, who already had degenerative disease in her knees, had to walk downstairs for an hour every day. As a result, she slipped and fell within half a month. She lay down with a fractured coccyx for three weeks, but she moved less than before. In fact, the industry has always had different views on exercise intensity for the elderly: mainstream geriatric medicine guidelines do recommend a total of 150 minutes of moderate-intensity activity per week, but many colleagues in geriatric rehabilitation will place more emphasis on "individualization" - if the elderly have poor joints and weak cardiopulmonary function, they would rather pace at home for 10 minutes three or four times a day instead of cramming in steps. ； Even for the elderly who have been bedridden for a long time, it is safer to help lift their arms and bend their legs and move their joints every day than to force them to walk. If you really want to prevent falls, it is better to close the wires on the floor at home and install anti-slip mats and handrails in the bathroom. It is much more effective than forcing the elderly to exercise.

Another pitfall that everyone easily steps into is the issue of eating. I met 82-year-old Grandpa Li before. His swallowing was a little slow after he had a mild cerebral infarction. His children were afraid that he would choke and kept holding the bowl to feed him. As a result, after half a year, Grandpa Li couldn't even hold chopsticks steadily and his whole body became wilted. Regarding whether the elderly should be fed when they eat, the opinions of different nursing directions are quite different: most teams doing cognitive impairment intervention advocate "never feed them if they can eat by themselves". Even if the rice is scattered all over the table, it is still exercising hand-eye coordination, which can delay cognitive deterioration. ； However, the swallowing rehabilitation team will make it clear that if you have been diagnosed with moderate to severe dysphagia, you must not only feed the person, but also mix the food into a thick puree to prevent thin food from being choked into the lungs and causing aspiration pneumonia. Later, we performed a swallowing assessment on Grandpa Li. We found that his function was only mildly reduced, so we suggested that our children cut the food into small pieces that were easy to pick up, wear a waterproof bib for him, and stay out of the way even if he ate for half an hour. After just over two months, Grandpa Li was already able to hold a bowl and drink soup by himself.

Oh, by the way, there’s really no need to be too fussy about taking a shower. There was an old man who was forced by his children to take a bath twice a week in the winter. As a result, the bathroom was not kept warm, and his cold turned into pneumonia and he was hospitalized for more than half a month. The amount of oil secreted by the skin of the elderly is less than one-third that of the young. Washing too frequently will damage the skin barrier, making it dry and itchy so that you can't sleep. Many elderly people I have met in the north are used to taking a bath once every half month. They usually wipe their face, neck, and lower body every day, and change their underwear every day. This is totally fine. There is no need to impose the hygiene standards of young people on the elderly. If the elderly are really immobile and unable to take a bath, they can just wipe it clean with disposable bath foam. There is no need to move to the bathroom.

Speaking of the elderly who are bedridden for a long time, many people know that they need to turn over frequently to prevent pressure sores. However, a family member previously set an alarm clock to turn the alarm for the elderly every two hours, even if the elderly were sleeping soundly. In fact, there is now a new consensus on the frequency of turning over: if you use a professional pressure-reducing mattress, the elderly are in good nutritional status and have good skin elasticity, and it is no problem to turn over every 4 to 6 hours. There is no need to interrupt the elderly's sleep at the two-hour limit. On the contrary, the elderly should be fed more high-protein foods such as eggs and milk. This will keep their skin in good condition and prevent them from developing pressure sores.

There is also the issue of medication. Don’t believe those health products that claim to be able to “cure high blood pressure” or “reverse diabetes.” This is the bottom line. Many elderly people like to pack up a week's worth of medicines and put them in small medicine boxes. This method is really convenient. However, if there are medicines that need to be protected from light and refrigerated, do not just put them in transparent medicine boxes and leave them at room temperature, as they may become ineffective. As for formal nutritional supplements such as calcium, vitamin D, and protein powder, if the elderly usually eat less and don’t get enough sun, appropriate supplements are indeed useful. Don’t beat them to death by saying that they are all IQ taxes.

In fact, after having worked in elderly care for so many years, my biggest feeling is that the elderly should not be regarded as "problem objects" that need to be corrected. They have lived at their own comfortable pace for most of their lives. As long as they do not touch the bottom line of safety, following the rules is better than anything else. You think it's good to drink milk every day, but he likes to drink millet porridge made by himself. As long as the nutrition is sufficient, what's wrong with drinking millet porridge? Nursing is never about ticking off a list. It is more useful to check whether the elderly are comfortable than any common sense.