Daily care tips for the elderly

The core trick of daily care for the elderly is never to buy the most expensive care products and do the most complicated rehabilitation training. Instead, it is to grasp the three core principles of "error tolerance first, needs priority, and body sensation first" and then correspondingly adjust the details of the four dimensions of diet, cleaning, activities, and chronic disease management. This can avoid more than 90% of care misunderstandings and greatly improve the comfort of the elderly.

I have been volunteering as a nurse in a community nursing home for 6 years. The most common misunderstanding I have seen is that family members create greater risks in order to "prevent risks." Aunt Zhang's family used to live in Building 3. Her son heard that the bathroom should be anti-slip and had to raise the water retaining strip, so she hired workers to install an 8cm high marble threshold. However, within half a month, Aunt Zhang got up and walked in the dark at night. She tripped over the threshold and fractured her femoral neck. She had to lie down for more than two months before she could get off the floor. Many home renovation guides on the Internet regard heightening water retaining strips as a must-have anti-slip option for bathrooms. This has actually been controversial in the nursing community - if the elderly have problems with unstable gait and vision deterioration, no matter how high the demand for water protection is, it is recommended to give priority to the combination of zero-height silicone water retaining strips + foot-feeling flushing floor drains to eliminate the risk of tripping from the source. After all, slippers can be changed when they get wet, but it is the elderly who suffer if they fall and fracture.

Last time, a family member came to me for help, saying that their 82-year-old father was throwing tantrums every day and refused to eat. After asking, I found out that the children had listened to the nutritionist's advice and arranged steamed fish, boiled shrimps, and sugar-free multigrain rice for the old man. They were not allowed to touch his favorite millet porridge with added sugar, saying that high blood sugar is bad for the body. I followed him to his house and took a look. The old man only had three teeth left that could chew. He couldn't pick out the small thorns in the steamed fish for a long time. The multi-grain rice was so hard that it hurt his teeth, so of course he didn't want to eat it. The nutritional community does recommend that elderly patients with diabetes strictly control their refined sugar intake, which is also the basis for many children to strictly control sugar. However, in actual clinical care, we have always emphasized that "the desire to eat takes precedence over dietary standards" - if the elderly significantly reduce their food intake because they cannot eat what they want to eat, the risk of reduced immunity and muscle loss caused by malnutrition is much more harmful than the blood sugar fluctuations caused by eating some sugar occasionally. Later, we discussed with my family and replaced the white sugar in the small bowl of millet porridge every morning with low-GI trehalose, the multi-grain rice with cooked multi-grain porridge, and the steamed fish with longli fish with less spines. In less than half a month, the old man gained two pounds in weight, and he happily went downstairs for a walk every day.

Speaking of which, many people have a misunderstanding. They think that the elderly need to bathe every day to be clean. This is the case with Grandma Wang of our inn. Her daughter used to help her bathe every day. As a result, in the winter, she was itchy all over the body. She scratched all night long, and there were several scratches on her legs. Later, we asked her to change to washing once every three days. After each wash, she immediately applied fragrance-free body lotion all over her body, and changed her underwear to brushed pure cotton. Within half a month, the itching disappeared. Of course, it doesn’t mean that everyone has to do it at this frequency. If the elderly in hot flash areas in the south feel sticky on their bodies, it’s okay to do it every day. Just don’t use shower gel every time, just wash away the sweat stains with warm water. The sebaceous glands of the elderly are degenerated, and excessive cleaning will destroy the skin barrier, which is why dryness, itching and eczema are caused.

There are also some small details. If you do it more, you will figure out the rules. For example, it is difficult for the elderly to swallow medicine. Don't just break the pills and soak them in water. It will be painful and easy to choke. Go to the drugstore and spend a few dollars to buy a special medicine jelly, wrap the medicine in it, and swallow it. The elderly will not resist it at all. Don't use ordinary nail scissors when cutting nails for the elderly. The nails of the elderly are thick and hard, and it takes a lot of effort to cut them and they are easy to split. Soak them in warm water at about 40 degrees for 5 minutes in advance. Use the big-mouth nail scissors specially designed for the elderly. Don't grind them too hard after cutting, otherwise it will easily lead to ingrown nails and paronychia. There is really no need to buy electric nail grinders that cost hundreds of dollars, which are expensive and difficult to use.

After doing nursing for so many years, my biggest feeling is that many people think about nursing too complicatedly. They always want to set standards and follow strategies, but forget that the most important thing to ask is the elderly's own feelings. A while ago I met Aunt Zhang, who had fallen down before. Her son later removed the marble threshold and bought her a walker with a small basket. She pushed it downstairs every day to buy freshly baked pork buns with sauce, and told everyone she met that her son was filial. You see, there are no profound tips. Thinking from the perspective of an old man is more effective than reading ten guides.