Daily care essentials for the elderly

The core principle of daily care for the elderly has never been to apply a unified standardized template, but to take the individual wishes and physical condition of the elderly as the core and balance the relationship between physiological care, risk prevention and control, and psychological support. "Appropriate" always has a higher priority than "correct".

I have worked as a front-line caregiver in a community nursing home for 6 years. I have seen too many family members follow the "care list" found online, which in the end made the elderly uncomfortable. Let’s talk about the most common dietary care. Now there are two voices in the industry: one insists on strictly controlling the intake of oil, salt and sugar, especially the elderly with high blood pressure and diabetes. They cannot touch even half a mouthful of pickles and half a piece of sugar. ； The other group believes that if the elderly is over 80 years old and does not have serious metabolic emergencies, there is no need to completely deprive him of the pleasure of eating for the sake of numerical values ​​- Grandma Zhang, who we served before, has loved to drink porridge with pickled radish all her life. Her children forced her to quit completely. She secretly hid a jar under the bed and was reluctant to throw it away when it got moldy. Later, we discussed cutting half a piece of pickled radish for her to serve with porridge every morning. She ate happily and her blood pressure did not fluctuate. To be honest, it is much more cost-effective to relax the dietary restrictions a little and change a good mood than to let the elderly get upset over rice with clear soup and water every day. Oh, by the way, I would also like to mention that elderly people with dysphagia should not casually try the "thick liquid recipes" mentioned on the Internet. They must first undergo a swallowing function assessment, otherwise they will easily be at risk of aspiration. There is no room for negotiation on this point.

When it comes to risk prevention and control, many people's first reaction is to install handrails, lay out non-slip mats, and regularly turn bedridden elderly people over. Yes, but few people consider the feelings of the elderly. Uncle Li in the community fell down once before. When his son came home, he installed a row of bright silver handrails in the toilet, living room, and entrance. As a result, Uncle Li lost his temper every day, saying that his nice home was like an inpatient hospital, and he refused to support him. Later, we suggested that he replace it with wood grain-colored invisible armrests. The armrests in the entrance hall were directly integrated with the shoe-changing stool. It looked like ordinary furniture. Uncle Li accepted it within two days. There is also great controversy in pressure ulcer care. Traditional care requires turning over every two hours. Now new clinical research has long mentioned that if the elderly are using a qualified high-density pressure-reducing mattress, their ability to move independently is acceptable, and their skin condition is stable, they can adjust the turning frequency to every 3-4 hours. There is no need to set the alarm clock in the middle of the night to turn over the elderly, which will affect sleep and increase blood pressure. There used to be a 92-year-old bedridden man. At first, his children strictly followed the 2-hour standard, which made the whole family collapse. The old man couldn't sleep well and groaned all night. Later, we adjusted the plan after doing a pressure ulcer risk assessment. The whole family was relieved, and the old man had no skin problems. The same goes for medication. There is no need for a cognitively conscious elderly person to have his or her family watch over the medication. Buying him a pill box with an alarm clock allows him to control the time of taking medication. This can actually improve compliance and give the elderly a sense of control that "they can take care of themselves."

Oh, yes, there is another point that many family members completely ignore: psychological support is really not as simple as going home more often. We caregivers often say "provide invisible support and don't take over completely." Many family members feel that hiring a 24-hour live-in nanny for the elderly and not letting him do any work is filial piety. In the end, the elderly feel that they are a useless burden. There used to be a grandma Wang. Her son was afraid that something would happen to her and hired a live-in nanny. As a result, she hid in her room every day and never came out. Later I found out that she felt that the nanny didn't even have a space to talk to herself at home, and she always felt like she was being watched. Later, it was changed to the nanny doing housework during the day and leaving at night. Her son video chatted for 10 minutes every day. Grandma Wang could go downstairs and dance a square dance with her old sisters when she was fine, and her condition suddenly improved. I have also seen many elderly people who are particularly willing to help the family pick vegetables or pay the electricity bill at the gate of the community. If you don't let them do it, they will feel that you think they are useless. It is appropriate to find some "small tasks within their capabilities" for the elderly, which will be more effective than buying many supplements.

After all, nursing is never a test paper, and there are no standard answers. It's like making shoes for people. No matter how expensive the brand is or how standard the size is, only the person who wears the shoes knows whether it wears out their feet. It doesn't matter if there are occasional "flaws". As long as the elderly can live comfortably and smoothly, it is the best care.