Recently, during the 2024 World Health Expo, the 2024 Sino-French Professional Forum on the Whole-process Management of Cognitive Impairment and the Integration of Medical Care and Elderly Care hosted by the Hubei Chushang Federation and undertaken by the French Emmerzy Group was held at the Wuhan International Conference Center.
At the forum, Chen Zheng, vice president of the Chinese Geriatrics Society and former president of Beijing Geriatric Hospital, interpreted the "Standards for Care Services for the Elderly with Cognitive Impairment" (hereinafter referred to as the "Standards") and shared the nursing practices of Beijing Geriatric Hospital.
"When I went to the geriatric department abroad, the nurse made it very clear, 'We are not a substitute, but we are to guide and support (the patient)'." Referring to the care of the elderly with cognitive impairment, he said.
Chen Zheng interprets the "Norms". Photo/Jiupai News
[1] "Walking is the basic need of people", and the design environment is designed to prevent getting lost
Since the "Specification" has not been made public, on April 10, Jiupai News contacted the staff of the Chinese Geriatrics Society, and the other party provided the original documents.
Group standard "Specification for Care Services for the Elderly with Dementia". Photo/Courtesy of the Chinese Geriatrics Society
The Norms stipulate the basic requirements, service environment, facilities and equipment, service content and requirements, service evaluation and improvement of the care of the elderly with cognitive impairment, and are applicable to the service and management of the care of the elderly with cognitive impairment.
Jiupai News noticed that it was clear: the care environment should be quiet, ventilated, comfortable and well-lit. Each functional area should be distinguished by color, sound, light, theme decoration, etc., to strengthen the perception and spatio-temporal orientation. It is advisable to add the display content that the service users are familiar with and interested in in the living room or activity venue, avoid placing food with shapes and colors that are easy to eat by mistake, and should not place dangerous items such as irritants, sharp objects, and sharp utensils.
In terms of daily life care, it has detailed provisions on the dressing, cleaning, diet, excretion, activity, sleep, and medication care of the elderly with cognitive impairment, and in terms of safety risk prevention, it is subdivided into safety risk assessment and anti-wandering, anti-falling/falling prevention, anti-bump and bruising, anti-scalding, and anti-pressure ulcers.
"Walking is a basic human need, not only for normal people, but also for patients. As for the prevention of getting lost, Chen Zheng emphasized at the forum.
So, how do you design your environment to avoid accidents such as getting lost? He believes that "it is necessary to effectively assess [security risks], and assessment is more important than diagnosis." ”
He shared that when he was inspecting abroad, he found that the shielding design of local elevators and other elevators was very good, and (the elderly) would not get lost. The same is true of a circular corridor that it sees in France.
In this regard, the "Specification" points out that the risks that may occur to service users such as lost, falling, falling from bed, bumps, burns, and pressure ulcers should be regularly assessed. When it is found that the client has wandering or wandering behavior, the cause should be found and intervention should be given in a timely manner; it is advisable to reduce the change of living environment, and wear a contact card or positioning device for the client when going out for activities, and someone should accompany him.
[2] There are various non-pharmacological intervention therapies, and restraint can interfere with the normal functioning of the elderly
According to the definition of the above-mentioned "Norms", "cognitive impairment" is a type of acquired mental decline syndrome involving impairment of one or more cognitive functions such as memory, attention, executive function, language, perceptual motor and social cognition, or accompanied by abnormal mental behavior and personality changes, resulting in varying degrees of decline in daily life ability and social communication ability.
According to the Report on the Status and Development of Care Services for the Elderly with Dementia released by the China Association on Aging in May 2021, there are 10 million Alzheimer's disease patients aged 60 and above in mainland China.
At the forum, Chen Zheng also shared the example of the implementation of non-drug intervention for the elderly with cognitive impairment at the Beijing Geriatric Hospital, where he was the president. Specific measures include reward therapy (counting counterfeit money), recreational therapy (playing mahjong), daily functional training that simulates reality, time corridor (looking for long-term memories), dual-task training (watching movies while treadmilling), and language function training (calling out the name of the animal).
Chen Zheng shared the case of non-drug intervention in Beijing Geriatric Hospital. Photo/Jiupai News
In addition, Chen Zheng appealed, "I hope that our elderly care institutions, care institutions, and medical institutions, including geriatric hospitals, will have zero constraints." ”
Restraint refers to any method or device that restricts the elderly's freedom of movement or control of body parts that cannot be easily removed by the person. He found that there are many cases where the elderly with cognitive impairment are lying in bed and sitting in the car.
Citing a document prepared by SDIC Health and other units, he pointed out that restraint can interfere with the normal functions of the elderly, including walking, eating, infusion, changing positions, going to the toilet and social skills, and can also cause behavioral disorders, making people feel depressed, anxious, and even angry and fearful, and causing injuries, falls, urinary incontinence, malnutrition, dehydration and other consequences.
According to the above-mentioned document, alternative interventions are a comprehensive assessment of the elderly and the implementation of a personal care plan. Assistive devices fit well, increase daytime activity, protect wound care areas, and encourage family members to provide support or comfort.
Jiupai News intern reporter Hu Bingyue reporter Wu Feifei
Edited by Liu Meng
[Source: Jiupai News]
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