Elderly Health Care Textbook

The core of elderly health care has never been to copy the standardized care process to complete the "task", but to take the individual feelings and actual needs of the elderly as the core, and to balance the medical standards, living habits, and emotional appeals of the personalized care system. This is the core conclusion I came to after 7 years of hard work in community nursing homes, geriatric departments of tertiary hospitals, and home care scenes, and stepped on countless pitfalls.

A while ago, a family member came to us to make trouble, saying that the caregiver did not turn his father over at 3 a.m., which caused a red spot on his father's back. We adjusted the monitoring and found out that the old man didn't fall asleep until 2 o'clock the night before. The caregiver felt that his skin was in good condition and wanted him to sleep for half an hour longer. As a result, his family members came to check on him just after 2:30. After this incident, we held a special case discussion meeting, and the two groups argued fiercely: the nurse from the evidence-based nursing group said with a guide that turning over for 2 hours is the gold standard for pressure ulcer prevention. Even if you are asleep, you have to turn over. No one can afford it if something goes wrong. ； Sister Li, who has worked as a home care provider for 10 years, disagreed. She said that a 92-year-old man she cared for had very light sleep. Every time he woke up and turned over, he would be in trouble for half the night. He couldn't sleep well for a week and was hospitalized with pneumonia. Later, she changed to putting a thick pressure-reducing mat under the old man's body and helped him move when he woke up. When the old man walked away, there was no pressure sore on his body. In fact, there is nothing absolutely right or wrong? The objects of care are real people, not textbook cases. If you insist on waking up a sleeping old man, he will be in a bad mood and cannot eat, and his immunity will be reduced, which will make him more likely to have problems than lying down for half an hour longer.

Of course, this does not mean that medical standards are useless. When I first entered the industry, I memorized the "Guidelines for Elderly Care" so hard that the edges of the pages curled up. But in many cases, standards are the bottom line, not the upper limit. When it comes to medication care, many children come up and ask, "Is there any standard process for checking?" I always ask first, "Is your elderly person dazzled?" Are your hands shaking? Can you read or not? ”The most dangerous thing I have ever seen was a 78-year-old man who took half a bottle of antihypertensive medicine that his grandson left on the coffee table as vitamins, and sent him to the hospital to have his stomach washed. Later, we classified the medicines at the elderly’s home: prescription drugs have red dot stickers, topical medicines have yellow stickers, and health care products have blue stickers. For morning, noon and evening medicine boxes, we just buy three different colors: red, blue, and green. The elderly don’t need to read. They just need to pick up the box of the corresponding color when they arrive. It is much more reliable than teaching him to recognize the name of the medicine. Of course, some people say that this is not rigorous enough. What if you forget to change the label after changing the medicine? In fact, there is no right or wrong method, the one that is suitable for the elderly is the best - if you ask an illiterate old man to check the name and dosage of the medicine every time he takes medicine, it is inherently difficult.

Many people think that care is just about eating, drinking, and seeing a doctor. In fact, emotions have a much greater impact on the health of the elderly than you think. There was an uncle Li who had Alzheimer's disease before our inn. He always said that his son was working as a People's Liberation Army soldier on the border and he would go out to give his son cotton-padded clothes. The previous caregiver always corrected him and said, "Your son has already changed his career to work in Shenzhen." Every time after saying this, Uncle Li would cry for a long time and go without eating for two or three days. Later, we all followed his advice. He said he wanted to send cotton-padded clothes, so we helped him find thick clothes and put them in his bag. We walked around the yard with him twice and told him, "There are sentries on duty at the border now. Your son has received the clothes." He came back to eat happily and was in a very stable mood. He has not caught a cold in the past six months. Of course, some professionals say that this kind of "supportive therapy" is wrong and that the elderly should be guided to recognize reality. But if you insist on revealing the only thought of an old man who can't remember anything, is it for the good of the old man, or is it to comply with your so-called "professional process"?

Even for the most commonly discussed issue of exercise for the elderly, there is currently no unified standard in the industry. Not long ago, there was an 86-year-old Grandpa Wang. He listened to a health program and said that walking 10,000 steps a day can lead to longevity. He continued to walk for half a month, and his knees were swollen with fluid and he couldn't put on pants. When his children pushed him over, he insisted, "I'll get used to it if I walk a few more days." Later, we helped him sit in the yard for half an hour every day to bask in the sun. Occasionally he would get up and walk around twice, and rub his hands and pat his legs when nothing happened. After only half a month, he had eaten half a bowl more than before. There are also elderly people who are really strong and can climb two floors to go to the vegetable market every day without breathing. If you insist on letting him lie down and rest, he will suffer from all kinds of ailments.

After working in this industry for so long, the stack of official textbooks in my hand can be as tall as half a person. But when it comes to care, there are very few death procedures that can be used. You have to know that Aunt Zhang, who has diabetes, has been drinking millet porridge for 40 years. Even if she has to control her sugar, she can drink less than half a bowl a day, which is much more stable than her secretly drinking a big bowl. ； You have to know that Uncle Liu, who is paralyzed in bed, loves to listen to Peking Opera. If you play "Dingjun Mountain" for him and help him wipe his body, he will cooperate more than ever. ； You have to know that some old people don't like to talk. You can just sit next to them and watch anti-Japanese dramas with them. There is no need to find something to talk about.

To put it bluntly, the best nursing teaching materials are never printed in books. They are slowly realized by yourself when you squat down and look at the elderly.