Daily care knowledge for the elderly

The core of daily care for the elderly is not to take care of everything, but to adhere to the three basic principles of "preserving autonomy, preventing risks, and smoothing emotions". Only by neither being absent nor offside can the quality of life of the elderly be truly improved.

Let me tell you a real story that I encountered at a community elderly care service station last year. Aunt Zhang, 72, who lives in Building 3, fell once while shopping for groceries. Her son was so frightened that she asked for leave and went home. She spent 10,000 yuan to install handrails in the whole house and even locked the kitchen stove and balcony door to prevent her from falling again. As a result, less than half a year later, Aunt Zhang went for another physical examination. She found that the muscle strength of her lower limbs had dropped by 20%, and she felt unsteady when walking. On the contrary, she fell more easily than before.

When it comes to falls, there has been quite a bit of controversy in the industry before: One group is the "absolute safety group", which advocates removing all risk sources at home and limiting the elderly's independent activities as much as possible to eliminate the possibility of falls from the source.； The other group is the "moderate exercise group", which believes that as long as the elderly are not cognitively impaired and are at high risk of falling, they should be encouraged to do activities within their capabilities to maintain muscle strength and balance, which can actually reduce the long-term risk of falling. Later, we helped Aunt Zhang adjust the plan and removed unnecessary guardrails, leaving only the handrails beside the toilet and the entrance. She was allowed to choose her own food and serve her meals every day. In the evening, she practiced Baduanjin Zhanzhuang for 20 minutes with the elderly group in the community. It has been almost a year, and she has never fallen again. Even the pain in her waist and legs that she often suffered before has improved a lot.

After talking about safety, let’s talk about food. There are more misunderstandings here. I have seen too many children talking about "lightness" and forcing the elderly to eat boiled vegetables and steamed pumpkin every day without even letting them put in soy sauce. Uncle Li from Building 6 was like this before. His son told him that he had to eat less salt because of his high blood pressure. He was not even allowed to touch his favorite sauce elbow for half a year. As a result, he lost 8 pounds in three months. He wobbled when he walked. When he went to the hospital, he was diagnosed with protein deficiency. Regarding the diet of the elderly, the academic community actually has different priorities: the nutrition community strictly requires the elderly to consume no more than 5g of salt and 25g of edible oil per day to avoid aggravating the burden of underlying diseases. ； However, most clinicians in the geriatric department are more flexible and believe that the elderly cannot eat due to their degraded sense of taste. The first priority is to ensure their food intake. As long as the total salt content does not exceed the standard, occasionally eating heavy and favorite foods is better than eating tasteless steamed vegetables all the time. Later, we came up with an idea for Uncle Li’s family to use natural ingredients such as mushrooms, dried shrimps, and tomatoes to enhance the freshness without adding extra salt. We allowed him to eat a small piece of sauced meat every day. Uncle Li’s food now tastes delicious and his weight has slowly gained back. Oh, by the way, there is another point that many people overlook. The elderly's thirst is degraded. Don't wait for him to say he is thirsty before giving him water. Pour a small cup of warm water each time. Just drink 1500ml a day. Don't drink too much at one time, which may increase the burden on the heart.

Speaking of taking medicine, it is also a headache. Grandpa Wang in our area had high blood pressure. His son was afraid that he would forget to take his medicine, so he bought a timed medicine box that would ring when the time was right. He also conducted video checks every day. As a result, the nanny later secretly told us that Grandpa Wang thought his son was treating him as a fool, so he always hid the medicine under his tongue, turned around and spit it out and threw it in the trash can. Regarding the medication care of the elderly, there are actually two ideas: one is to do it entirely for you, dividing the medicine into your hands to avoid taking the wrong or missed meals. ； The other is that as long as the elderly person's cognition is normal, let him take the medicine from the medicine list by himself, while his family members watch and remind him if he makes a mistake, which can actually improve medication compliance. Later, we persuaded Grandpa Wang’s son to put away the medicine box and let Grandpa Wang take the medicine by himself after meals every day. The child only needs to check the remaining amount of the medicine bottle every week. Now Grandpa Wang’s blood pressure is very stable and he has never secretly thrown away medicine again.

Another detail that is easily overlooked is skin care, especially in winter. In the past, many family members thought that the elderly must be hygienic and must bathe every day. As a result, many elderly people's skin secretes less oil, and the more they wash, the dryer it becomes. They are itchy and unable to sleep, and their blood pressure soars. In fact, there is no standard answer to this. If the elderly are used to washing every day, they should use water of about 37 degrees, do not use irritating soap, and apply moisturizer immediately after washing. ； If you have dry skin, it’s perfectly fine to wash it once or twice a week in winter, and you don’t have to bother the elderly just for the sake of “hygiene.”

I have been providing community care services for the elderly for almost 5 years, and I have seen too many family members who go out of their way to treat the elderly, but in the end they end up making a fuss. Last time I talked to the nursing supervisor in our station who has worked for 12 years, she said that the most taboo thing in elderly care is "I am doing it for your own good." What you think is the perfect nursing plan is not as important as the comfort of the elderly. To put it bluntly, when we provide care, we do not treat the elderly as "patients" who need to be taken care of, but help them maintain control of their lives as much as possible and live comfortably and with dignity, which is better than anything else.