Daily care guidance for the elderly

The core of daily care for the elderly has never been the pursuit of "zero-risk" standardized care, but precise adaptation based on the elderly's physical condition and living habits, maximizing the preservation of the elderly's autonomy and happiness while ensuring safety.

In the more than four years I have worked in a community nursing home, I have seen too many families who followed the "standard answers" on the Internet for care but had problems: Aunt Zhang, who had just retired for half a year, was in good health. She almost slipped when she went shopping for groceries. Her children installed handrails in the whole house and removed all the flower stands and potted plants she liked. Her habit of going to the market with her old sisters every day was banned. As a result, within two months, Aunt Zhang's blood pressure soared and she developed insomnia. Finally, we came to adjust the plan and only installed two handrails in the wet area of the bathroom, allowing her to go to the market for half an hour every day. Her condition quickly stabilized.

When it comes to fall prevention and control, there are actually two different ideas in the industry: One school advocates the complete elimination of risk points in the home, retrofitting the entire house for aging, and providing 24-hour escorts to minimize the probability of falls.； The other group advocates "moderate blank space". As long as the elderly's balance ability is acceptable, certain activity challenges should be retained. On the contrary, it can exercise the elderly's reflexes and lower limb strength and avoid rapid muscle degeneration. In actual operations, we generally do not stick to a certain plan. If the elderly have had a history of falling more than twice, or have underlying diseases such as Parkinson's that affect balance, the first plan will definitely be given priority to reduce the risk as much as possible. ； If someone like Aunt Zhang is as agile as she is and only has a small bump occasionally, there is really no need to change her home to look like a hospital ward, which will only kill the old person's enthusiasm for life.

What is easier to go to extremes than safety protection is dietary care. Uncle Li, who used to live across from our inn, had mild high blood pressure, so his children set a "salt-free meal" rule for him. Even soy sauce and fermented bean curd were not allowed to be touched. As a result, Uncle Li couldn't eat more than two bites a day, and secretly hid in the canteen downstairs to eat pickled mustard. Later, we suggested that our son reduce the amount of salt he consumes to one-third less than that of young people, and allow him to eat one or two pieces of his favorite sauced pork elbow every week. Within three months, his albumin level rose from low to the normal range, and he became more energetic. In fact, the current domestic dietary guidelines for the elderly also clearly mention that the daily salt intake of people over 65 years old is within the standard of 5g. The lower is not the better. Many family members are afraid that the elderly will have high cholesterol and will not even touch eggs and lean meat, which may easily cause sarcopenia syndrome. As long as the blood lipid index is normal, one egg, two ounces of lean pork or fish a day is a necessary nutritional supplement.

There is another detail that everyone easily overlooks, which is medication management. Many children buy the weekly pill boxes and smart reminder pill boxes from Internet celebrities. As a result, many elderly people find the smart pill boxes too noisy and turn off the switch directly. Of course, if the elderly are willing to use smart devices, it will definitely be more convenient. Again, what is suitable for the elderly?

To be honest, when many family members provide care, what is most easily overlooked is the emotional needs of the elderly. Grandpa Wang, who was taken in by our inn before, refused to do anything when he first came here. He had to be helped by nurses to get dressed and eat. Later we found out that when we were at home, our children wouldn't let him do anything. They always said, "Just rest and don't make trouble." As time went by, he felt like a burden. Later, we asked him to help pick vegetables and water potted plants every day. He gradually started talking more and even asked to go downstairs twice a day. The "independent supportive care" currently advocated in the industry actually means this. As long as the elderly can still do things by themselves, even if they are slower or not so good, try to let them complete it by themselves. This sense of control over life is more effective than any tonic.

In fact, after working in elderly care for so long, my biggest feeling is that there is never a "universal guide". Every elderly person has different living habits, temperament and personality. When caring for the elderly, asking the elderly "what do you want" is more useful than copying any number of standards. After all, the essence of our care is not to keep the elderly "alive" but to let them live a good life, right?