Nursing knowledge of the disabled elderly
First, the nursing knowledge of the disabled elderly
1. Do a good job in oral care
The mouth of a normal person can resist the invasion of oral bacteria by means of its own resistance, the bactericidal effect of lysozyme in saliva, and the daily mechanical effects of brushing, drinking and eating. However, the disabled elderly have weak resistance and less saliva secretion, and need more external forces to ensure oral health. In daily care, the elderly should often be helped to clean their teeth to reduce the breeding of bacteria.
Methods of cleaning teeth:
Let the elderly lie on their sides, gently open the cheeks with a tongue depressor, take the mouthwash cotton ball with forceps, from the inside to the outside, along the teeth longitudinally wipe the inside and outside sides of the teeth, the occlusal surface, the tongue, the oral mucosa, the hard palate, etc., wash it, help the elderly gargle, dry the face. If there is an ulcer in the oral mucosa, it can be sprinkled with tin or green daisy... If there are dentures, you should help the elderly to remove them, brush them with cold water, and let the elderly gargle and put them on.
2. Take a regular bath
Bathing can promote blood circulation in the elderly, clean up bacteria on the body, and soothe the irritable emotions of the elderly.
The specific steps are:
2.1, loosen the neckline, wash the eyes, nose, face, ears, neck and other places of the elderly, pay attention to washing the back of the ears.
2.2, take off the shirt of the elderly (first wash the healthy side, then wash the affected side), scrub both arms. Take care to wash the armpits. Help the elderly to lie on their sides, facing the caregiver, put the washbasin on the large towel on the side of the bed, and wash the hands of the elderly.
2.3, untie the elderly trouser belt, scrub the chest and abdomen, pay attention to the lower breast and umbilicus, help the elderly turn over, scrub the back and buttocks.
2.4. Take off your trousers and scrub your legs, groin on both sides, and perineum. Move the basin under your feet, put a large towel on the bed, wash your feet, and put on your pants.
2.5, after bathing, you need to wash and change bed sheets and other items to keep the elderly in a clean environment.
3. Assist the elderly to turn over
Disabled elderly people can not move their limbs, a long time a posture will hinder the normal blood circulation of the body, is not conducive to the physical and mental health of the elderly. Regularly helping the elderly to turn over not only helps their blood circulation, but also allows some of the muscles of their body to be moved, thereby slowing down the aging of the muscles.
Methods of turning over:
3.1, when the supine elderly want to turn over to one side, first make the old man put both hands on the abdomen, bend the knees with both legs, the caregiver one forearm into the waist of the elderly, the other arm into its underside, with the strength of the arm, the elderly are quickly lifted, moved close to the edge of the bed, and turned to the opposite side at the same time.
3.2, lift the head and shoulders of the elderly, and turn to the opposite side, place a soft pillow on the back of the elderly to maintain the position, put a soft pillow on the chest, support the forearm, and make the elderly comfortable.
3.3, the elderly upper legs bent forward, the lower legs slightly flexed, between the knees, pad with a soft pillow, to prevent mutual pressure and friction between the legs.
4. Make beds for the elderly
Frequently making the bed, removing bacteria and dirt from the bed to keep the bed clean, is of great help to the physical health of the disabled elderly.
How to make a bed:
4.1, flatten the elderly, help the elderly lie on one side of the bed, turn their backs to the caregiver, and move the pillow to the opposite side with the elderly.
4.2, assist the elderly to turn over to the opposite side, loosen the near side of the sheet, use the bed brush from the head of the bed to the end of the bed to sweep the debris on the sheet, should pay attention to the pillow and the layers under the elderly body thoroughly clean, and then pull the sheet flat, to assist the elderly to turn over and lie on one of the cleaning sides. Turn to the opposite side and sweep layer by layer and flatten the sheets.
4.3, cover the quilt, flatten, so that the elderly comfortable lying flat.
4.4, one hand to hold the head and neck of the elderly, the other hand to quickly take out the pillow, replace the pillowcase, give the elderly a good pillow.
Second, the nursing points of the elderly with urinary incontinence
1. Try to pick up urine: for female patients, you can use a female urinal pot to close to the vulva to receive urine or use disposable diapers. For male patients, a urinal pot can be placed to receive urine, or a penis sleeve can be used to connect the drainage bag to receive urine.
2. Indwelling urinary catheter drainage: indwelling urinary catheters are given to patients with serious urinary incontinence or special treatment, and if a long time is required to indwell the urinary catheter, urinary catheter care should be carried out regularly.
3. Observe the urination reaction: Patients with overflow urinary incontinence may have bloating and uneasiness when the bladder is full, and nurses should be good at observation and strive to help patients try to urinate before the urine overflows. For chronic diseases or elderly patients, assist urination in advance every 2 to 3 hours, squeeze the bladder appropriately, and consciously control urination.
4. Psychological nursing: Urinary incontinence patients have great psychological pressure, often feel inferiority, do not interact with others, expect to be understood and helped, nurses should respect the patient's personality, give spiritual comfort.
5. Skin care: keep the skin clean and dry, the bed can be paved with an eraser or a disposable urine pad, and the perineum is washed regularly with warm water to prevent pressure sores.
6. Health care guidance: explain to the patient that drinking more water to promote urinary reflex, instruct him to consume 2000 to 3000ml of fluid per day, and limit drinking water before falling asleep to reduce the amount of urine at night. Bladder function is trained, allowing patients to urinate every 1 to 2 hours at the beginning. With the palm of the hand, the palm of the hand is continuously pressed downward from the top of the bladder, so that the urine in the bladder is passively discharged, and then gradually prolongs the urination time, and exercises the pelvic floor muscles to promote the recovery of urination function.
Third, the principle of care for the disabled elderly
1. Incivility should not be regarded as non-virtue
The daily life of the disabled elderly needs the assistance of others or complete dependence on others, which includes cleaning the perineum, changing diapers, manual defecation and other very private care, some elderly people are more reluctant to expose their private parts to outsiders, and even in order to refuse to clean the perineum and scold the nursing staff. At this time, we should not choose not to give the elderly care for these private parts in order to respect the so-called privacy of the elderly and comply with the so-called "incivility and do not look".
Method of care:
1.1, in the face of these special circumstances of the elderly, under the premise of conditions permitting, try to let the same sex for the elderly care, reduce the exclusion of the elderly.
1.2. When nursing private parts, you should carefully check the skin conditions of the vulva, perianal groin, etc., and check the skin conditions of the elderly regularly.
1.3. Pull the bed curtain for the elderly during nursing, and patiently persuade and comfort the elderly to protect the privacy of the elderly in front of others other than the nursing staff.
2, to be small, careful
The care of the disabled elderly is a matter of constraint