Daily care tips for the elderly

Always respect the elderly's independent wishes first, and put the three things of preventing falls, preventing aspiration, and emotional counseling as the highest priority. The remaining details can be flexibly adjusted according to the elderly's living habits for many years. There is no need to rigidly apply standard answers.

I have been working at a community elderly care service station for almost 6 years, and I have encountered too many traps where standards are imposed. A while ago, Aunt Zhang's children read popular science and said that smart toilets with armrests are safer for the elderly. Without saying hello, they dismantled and modified the squatting pit that the elderly had used for 30 years. As a result, Aunt Zhang was used to squatting and could not drain the toilet even when sitting. She slipped when she stood up and fractured her coccyx. It took her two months to recover, but the gain outweighed the gain. You see, no matter how good the care products are, if they are not in line with the habits of the elderly, they are prone to problems.

Speaking of which, we have to mention the fall prevention issue that everyone is most concerned about. Many people think that installing handrails and laying anti-slip mats throughout the house are foolproof. In fact, 80% of home falls occur in small details that everyone ignores. For example, do not move the furniture at home, the positions of commonly used thermoses, and water cups. The elderly's eyesight has deteriorated and their reactions are slow. If the positions they have memorized suddenly change, it is easy for them to trip or knock over. ； There are also small night lights for getting up at night. Don’t install too bright direct-light models, otherwise you will be dizzy when you first wake up, and you will easily miss the light. Just stick a row of soft-light sensor models along the corridor to the corner of the bathroom. For a dozen yuan, sometimes it is more effective than a non-slip mat that costs hundreds of dollars. Oh, by the way, the industry now has different opinions on whether the elderly should wear shoes at home: one group says that they must wear non-slip shoes with a heel to avoid slipping on the soles of the feet. ； Another group of people say that wearing non-slip socks with bare feet can better sense the level of the ground and make it less likely to fall. In fact, it all depends on the individual situation. If the elderly have good balance and do not have diabetic foot problems, it is absolutely fine to wear non-slip socks. If the legs and feet are not tight and the sensory ability has deteriorated, soft-soled shoes with heels are more secure.

Oh, yes, there is another very small thing that many families ignore: When buying clothes and shoes for the elderly, don’t just look at them. Try to choose ones with snaps and Velcro, and don’t choose zippers or shoelaces. The elderly have poor eyesight, and the shoelaces are easy to fall when they are loosened, and zipper jams are troublesome. This little thing can really save a lot of trouble.

Besides, people tend to have no idea about preventing aspiration. Many people think that it is okay for the elderly to choke on their rice. In fact, aspiration is the highest cause of aspiration pneumonia in the elderly, so be careful. I had encountered the situation in Grandpa Li’s family before. The children were filial and always cooked thick rice-treasure porridge for him. He thought it was soft and easy to digest. However, it turned out that grandpa had sequelae of cerebral infarction and had a slow swallowing reaction. One time, he choked on a mouthful of porridge and entered his lungs. He was hospitalized for a week. Currently, there are two different views on the care of elderly people with dysphagia: one group believes that as long as there is a risk of swallowing, nasal feeding should be used to minimize the possibility of aspiration. ； The other group believes that the elderly’s chewing and swallowing function should be preserved as much as possible, otherwise the degradation rate will be 2-3 times faster. In fact, there is a compromise. If the swallowing disorder is only mild, make the food into a thick paste, do not give soup and solid food mixed with crumbs, feed slowly, wait for each mouthful to be completely swallowed before feeding the next mouthful, don’t rush, if it is really serious and cannot eat independently, then consider nasogastric feeding, and choose the most extreme solution if it is not needed. And really don’t feed the elderly liquid food all the time. I have seen several elderly people who could eat on their own, but their children chewed too slowly and fed them porridge. In less than half a year, they even lost the strength to open their mouths and swallow, which made them miserable. If there are no major problems, steamed sweet potatoes, stewed boneless ribs, and boiled vegetables can all be given. It can not only exercise function, but also make the elderly happy eating.

Many people think that nursing care is just about taking care of food and drink and not getting sick. In fact, the impact of emotions on the body of the elderly is much greater than you think. How filial are the children of Grandma Wang whom I have met before? After dinner, she wouldn't even let her put away the bowl, saying she was afraid of being tired. As a result, grandma sat on the sofa every day in a daze, always calling herself a "useless old waste", eating less and less, and always suffering from insomnia. Later, we suggested that her children should leave some "small tasks" that are not difficult for grandma to do every day, such as choosing a dish, folding socks, or even helping to get a remote control. After finishing the task, she would compliment her. Within two months, grandma's condition was obviously improved. After eating every day, she would take the initiative to ask if there was any work to do. Her whole body was in a different state of mind. By the way, there is a lot of quarrel now about whether to teach the elderly to use smartphones. Some people say that they must be taught, otherwise they will be out of touch with society. Others say that the elderly will feel frustrated if they cannot learn how to use smartphones. It is better not to use them. In fact, it still depends on the wishes of the elderly. If the elderly like to watch short videos or communicate with distant places If you have a grandson video, teach him slowly, with the words in a louder tone, and simplify the steps to "click this, click that." If the elderly are not interested in these, don't force them. Give them a phone with big buttons, set up several one-touch dials, and you can find people as long as you feel comfortable.

There is also the skin care that everyone often asks about. Some people say that the elderly should bathe frequently, otherwise they are prone to bed sores (which is also known as pressure injuries in professional terms). Others say that the elderly’s skin secretes less oil, and washing too frequently can easily make it dry, itchy and cracked, which is not good. This really depends on the region and personal habits. Southern Summer It's hot and sweaty, so it's okay to take a shower every day. Winters in the north are dry, so washing 1-2 times a week is enough. If you're an elderly person with limited mobility, you can also take a bath. Focus on the folds of your armpits, groin, and neck every time, and apply some body lotion afterward. There's no problem at all. If you are an elderly person who is bedridden for a long time, remember to turn over every 2 hours and place a soft pillow on the protruding bone area. An anti-bedsore mattress worth several thousand dollars is more effective.

To put it bluntly, in all my years of nursing, I have never seen any set of techniques that are universally applicable. The so-called nursing skills, in the final analysis, all revolve around the needs of the elderly. If you are willing to spend more time listening to what he has to say and observe his habits, it will be more useful than how many strategies you find. After all, the best care is always "what he feels comfortable with" rather than "what feels right to you".