Daily care guidance for the elderly

There has never been a unified standardized template for daily care of the elderly. The three core principles are Give priority to personalized adaptation, pre-risk prevention and control, and moderately retain independent capabilities , any "standard answer care" that is divorced from the actual situation of the elderly is likely to be counterproductive.

During my three years as a nursing supervisor in a community nursing home, I have seen too many families that have gone astray: 72-year-old Aunt Zhang has mild diabetes and osteoarthritis. Her children set a strict schedule for her according to the "Elderly Care Guide" on the Internet. She must walk 8,000 steps a day, rice is measured by the gram, and she is not even allowed to touch her favorite sweet-scented osmanthus cake. As a result, the aunt is so bored every day that she secretly hides in the house. I was sharing snacks with my old sister downstairs, but her blood sugar went up and down. Later, we helped adjust the plan and allowed her to go to the ticket office to sing Peking Opera for two hours every Wednesday afternoon. The number of steps was reduced to 4,000 steps. As long as the staple food avoided refined sugar and the glycemic index was controlled within a reasonable range, it was no problem to occasionally eat a piece of sucrose-free osmanthus cake. After only half a month of adjustment, her blood sugar was stable and she smiled when meeting people.

To be honest, there are a lot of controversies about elderly care right now, and the issue of diet alone has been quarreling for many years. Most academic nutritionists advocate "precise dosage control" and calculate daily sugar, salt and oil intake based on body weight and basal metabolism. This is especially true for the elderly with metabolic diseases. ； But when we work in front-line nursing care, we actually prefer "emotion first" - there is really no need to make eating an experiment for the elderly over 80 years old who are not seriously ill. I have seen 91-year-old Grandpa Liu who has been eating soy pork elbow for 30 years. He must eat less than half a bowl at noon every day. All blood lipid and blood pressure indicators are normal than many middle-aged people. If you suddenly stop his hobby, he will not think about food and drink, and his immunity will decline faster. Of course, that doesn’t mean you should ignore it completely. Elderly people with gout should not touch seafood and beer. People with diabetes should not directly eat snacks made of sucrose. Just find suitable substitutes. For example, if you want to eat something sweet, buy small pastries made of erythritol. Take a bite occasionally to make you happy than anything else.

By the way, there is another point that many families tend to overlook: the shoes of the elderly and the non-slip mats in the bathroom are much more important than the tens of thousands of health products you bought. In the past two years, 80% of the cases of elderly people I have dealt with fell because they were wearing thin-soled plastic slippers at home and stepped on water stains in the bathroom. The fall resulted in a fracture of the femoral neck, and the patient was bedridden for three months. It is easy for the patient to suffer from any underlying disease. Speaking of this, there is another controversial point: Is it better for the elderly to exercise more or to rest more? In fact, it really differs from person to person. There are elderly people with severe osteoporosis and lumbar compression fractures. If you force them to climb stairs every day, it will be harmful to them. When they are in bed, help them turn over and massage their calf muscles to prevent blood clots. This is better than anything else. ； If you are an old man with a strong body, don't impose a certain number of steps you must walk every day. He can walk as long as he likes, and it's fine if he likes to grow flowers and write calligraphy at home. There used to be a 76-year-old Uncle Li who used to enjoy raising birds at home every day, but his children insisted on forcing him to dance in the square. As a result, he had a fight with his dance partner over the song selection, and his blood pressure rose to 180 when he came home.

When it comes to chronic disease care, the most common contradiction I have seen is that children think the elderly take medicine indiscriminately, and the elderly think their children are too lenient. Many elderly people like to save medicines. They buy them for themselves after hearing what the old sisters downstairs say about how effective the medicines are. Don’t scold them for spending money in vain. Instead, take 10 minutes once a week to help them sort out their medicine boxes and pack the medicines they need to take in the morning, lunch and evening. By the way, ask them what good things they have heard recently, check the ingredients for them, and ask their family doctors if they can take them. It is much more effective than robbing them of medicines. Also, don’t measure your blood pressure and blood sugar too frequently. An elderly person with stable blood pressure can do it two or three times a week. If his blood sugar is well controlled, he doesn’t need to prick his finger every day. If you test him eight times a day, he will be diagnosed with anxiety even if he is not sick. There is also the issue of health care products. Nowadays, the two groups are quarreling fiercely. Most doctors say that regular health care products are not as good as eating well. Many children think that buying them is a filial piety, and the elderly also feel that they feel at ease after eating them. In fact, as long as they are regular blue hat products and not the kind of MLM products, there is no harm in eating them. Aunt Wang, who I have contacted, has been taking ordinary calcium tablets for three years, and she said that her legs do not hurt after eating them. So what if there is a placebo effect? You have to tell her that "this is all psychological", which will only make her unhappy, which is really unnecessary.

Many people think that caring for the elderly means taking care of their food, drink, and diarrhea. In fact, psychological care is the most easily ignored aspect. If an elderly person is a little forgetful, don't always say "Why did you forget again?" I once met a grandmother with mild cognitive impairment. At first, she only forgot things occasionally, but her children kept asking "Why do you have such a bad memory" every day. Later, she felt like a burden and did not even dare to leave the house, which deteriorated very quickly. Just pretend you haven't noticed and remind me several times that everything at home should be placed in a fixed place and don't change it casually. And don't always let the old man work. If he wants to pick vegetables or sweep the floor, let him do it as long as he is not tired. He feels that he can still help the family, which is better than any tonic - Oh, yes, this matter is also controversial. Some people say that the old man is tired. After a lifetime of suffering, he should live his life without doing anything. Some people say that he should be allowed to use his hands and brain more to prevent dementia. In fact, there is no right or wrong. It all depends on the old man's own preferences. He has been diligent all his life and if you let him lie down every day, he will feel uncomfortable. ； He doesn't like to do housework all his life, and if you force him to give him a rag, he will also get upset.

In fact, caring for the elderly is like tuning an old-fashioned radio. It does not mean that everyone can use it by turning it to the fixed frequency mentioned on the Internet. You have to turn it slowly to find the most comfortable point for him. After all, this is never a scripted task. Squatting down more and listening to what he wants is more effective than any instruction manual. If you really encounter a problem that you are not sure about, don't blindly search for folk remedies on the Internet. Ask a family doctor in the community or the geriatric department of a regular hospital. It is more reliable than anything else.