Contents of daily care standards for the elderly

There is essentially no unified "universal formula" for the core specifications of daily care for the elderly. The core is centered around the three core principles of "ensuring safety, maintaining comfort, and retaining the ability to live independently to the greatest extent." It covers the three core modules of basic physiological care, chronic disease management, and psychological support. During the implementation process, it needs to be flexibly adjusted according to the physical condition and living habits of the elderly, and it is by no means a rigid copy of the standard process.

Speaking of basic care, I have been working in a community nursing home for three years, and the most common misunderstanding I have seen is that "care" is equated with "doing for you." Take eating as an example. There are actually two different operating ideas in the industry: one is "efficiency first", which believes that the elderly eat slowly and tend to spread all over the floor. It is not as good as family members or caregivers to feed them, which saves time and ensures intake. ； The other school is the "independence first" approach generally advocated by geriatricians. As long as the elderly do not have severe dysphagia and can hold tableware with their hands, even if it takes forty minutes for him to eat a meal and half the table is full of rice scraps, try to let him eat by himself. Aunt Zhang from the previous inn had just broken her leg and went home to recuperate. Her daughter was filial and didn't let her touch anything. She even brought her food to the bedside to feed her. However, after only three months, Aunt Zhang, who could walk slowly on crutches, was no longer strong enough to even hold a spoon. Later, we came to do rehabilitation training. It took almost two months to return to her previous state of autonomy. It was really a good intention but a bad thing.

Don’t think that the elderly don’t need to take oral care because they have no teeth. Once the food residue hidden in the gaps between the dentures gets stuck in the trachea, the probability of inducing aspiration pneumonia is alarmingly high. Uncle Li at the previous post station didn’t clean his dentures carefully for more than three months because he thought it was troublesome. In the end, he had a fever and coughed up yellow phlegm and was hospitalized for a week, which was a long time ago. There are no rules for small things like bathing and dressing, as long as the elderly feel comfortable - for example, some elderly people are used to washing in the morning, and some like to soak their feet before going to bed. There is no need to forcefully change their decades-old habits. The only thing to remind is that the water temperature should not exceed 40 degrees. The elderly's skin is less sensitive to temperature, and sometimes the water is red without even noticing. Installing a constant temperature shower can save a lot of worry.

In addition to daily trivial matters such as eating and dressing, safety care is the most important aspect for all family members and is also the most likely to go to extremes. Many people think that to prevent falls, they have to wrap up all the edges and corners of the house, install a ring of handrails, and simply not let the elderly go out alone. In fact, this is not the case. The grandfather Wang who lived in our area before was 82 years old and still strong, but he was a bit deaf. He fell once when he went out. His children were so frightened that they "trapped" him at home and even refused to let him go to the small garden downstairs. As a result, after only half a month, Grandpa Wang was throwing things at home every day and getting angry, and his originally stable high blood pressure jumped to 170. Later, we equipped him with a smart bracelet with positioning, and set up three resting spots with handrails along the road in the community. We agreed with him that he would go shopping for at least an hour a day. If he felt uncomfortable, he could sit at the resting spot and call his family. Now he goes downstairs to walk every morning and plays chess with his old friend, and his blood pressure is very stable. Security is never about "locking people up", it is about giving enough freedom within a controllable range. This is something I feel very strongly about.

There is no controversy about the safety of medication. There are only a few practical pitfalls to avoid: Do not unpack all the medicines and mix them in one medicine box, especially extended-release tablets and controlled-release tablets. Unpacking and breaking them into pieces can easily cause an instant overdose. In the past, a family member broke the nifedipine extended-release tablets and gave them to an elderly person. After that, he fainted due to low blood pressure and sent him to the emergency room. Also, don’t just add “tonics” to the elderly, such as protein powder and ginseng and deer antler, especially for the elderly with gout and chronic kidney disease. Over-supplementation will increase the metabolic burden. If you really want to take supplements, ask the doctor in charge first.

Many people think that nursing care only needs to take care of eating, drinking, and getting out of trouble. In fact, chronic disease management and emotional care are the key to determining the quality of life of the elderly in their later years. Take the elderly with diabetes as an example. They don’t just stare at the blood glucose meter value every day. Previously, a family member chased the elderly every day to ask how much his blood sugar was. If it was slightly higher, he would talk about it for a long time. As a result, the elderly secretly stopped eating staple food. The high and low blood sugar was even more dangerous than high blood sugar. There are also psychological matters. Don't always say "stop doing it and rest". This sounds like concern, but in fact, if the old man hears it too much, he will feel that he is a useless "baggage". Previously, our post station organized the elderly to make handmade canvas bags, and the money sold was donated to children in mountainous areas. Many old people who are usually wilted and don't even like to leave the house come to the post station to report early every day, and take the finished bags home to show off to their families. The energy they bring is more effective than any number of tonics they take.

When I usually do science popularization for family members, I always like to tell you a few tips that don’t cost money: when buying clothes, choose cardigans first, don’t buy pullovers, they are easy for the elderly to take off and put on.； It’s best to cut your nails after taking a shower, when your nails are soft and not easy to cut. ； Speak slowly to the old man. Don't blame him for his poor memory. Just tell him the same thing twice.

To put it bluntly, all standards are just references, and the core standard is always the old man's own feelings - after all, our original intention in providing care is never to make the old man "conform to the standards", but to make him live comfortably.