Disability and semi-disability in the elderly
Written by Song Danyang
Edited by Health Care Jun
As older people age,
In home care
How to prevent disability and semi-disability
occurs and slows down its progress,
Significant.
To this question,
The elderly and their families should have a correct understanding,
Older people need to make the most of it
Own initiative.
1. What is disability and semi-disability?
According to international standards, among the six daily life activities of eating, dressing, getting in and out of bed, going to the toilet, walking indoors, and bathing, 1~2 items cannot be mildly disabled, 3~4 items cannot be moderately disabled, and 5~6 items cannot be severely disabled.
Mild and moderate disability is also called "semi-disabling", and severe disability is also called "disability".
2. Causes of disability and semi-disability
The main cause of disability and semi-disability in the elderly is the result of the vicious circle of aging and geriatric diseases.
These geriatric diseases include stroke, Alzheimer's disease, fractures caused by falls, bone and joint diseases, Parkinson's disease, etc., the most common of which is stroke.
Studies have reported that among the causes of disability or semi-disability in the elderly aged 65~74 years, stroke accounts for 47%, bone and joint diseases account for 11%, Parkinson's disease accounts for 10%, fractures caused by falls account for 7%, and Alzheimer's disease accounts for 4%. Among the causes of disability and semi-disability in people over 75 years of age, stroke accounts for 20%, fractures due to falls account for 14%, Alzheimer's disease accounts for 13%, bone and joint diseases account for 11%, and Parkinson's disease accounts for 5%.
Therefore, if we can properly delay the aging of the body, and at the same time carry out effective rehabilitation medical training for the elderly with stroke, fracture, Alzheimer's disease, Parkinson's disease and other geriatric diseases, we can greatly reduce or delay the occurrence of disability and semi-disability.
3. What should be paid attention to when taking care of the disabled and semi-disabled elderly
When it comes to caring for the disabled and semi-disabled elderly, we also need to be targeted, and here are a few tips for you.
01. Anti-decubitus sores
Bedsores refer to the long-term compression of some skin or tissues, resulting in continuous ischemia, hypoxia and other problems, resulting in ulceration and necrosis of skin tissues.
To prevent bedsores, attention should be paid to helping the elderly turn over, and rubbing the hands and feet of the elderly more, and the elderly can also be moved to a wheelchair with a lift machine to push out more activities.
02. Sanitation and cleaning
Plan the number of times you need to lift the toilet every day, and use the lift machine to move the disabled or semi-disabled elderly to the toilet on time.
The clothes of the elderly should be changed frequently, and the close-fitting clothes should be kept neat and tidy.
03. Dietary problems and nutritional intervention
Since the physical function of the elderly is not as good as before, in terms of diet, it should be arranged according to their specific situation, and the required nutrients should be supplemented according to the doctor's advice to correct bad eating habits.
04. Rehabilitation training and exercise
Appropriate exercise can help improve the symptoms of disabled or semi-disabled elderly, improve physical motor function, promote the improvement of balance and muscle strength in the elderly, and reduce chronic pain.
05. Management of comorbidities and polypharmacy
Disabled or semi-disabled elderly people often suffer from multiple diseases such as depression, heart failure, kidney failure, cognitive impairment, diabetes, vision and hearing problems. Therefore, the drug treatment of the elderly may involve a variety of drugs, and the principle of individualized treatment should be paid attention to to avoid excessive medical treatment.
06. Intervention for psychological problems
Elderly disabled patients are prone to mood swings due to the long course of the disease and the recurrence of the disease. Psychological care and good doctor-patient communication can make patients emotionally stable, willing to cooperate with treatment, and promote the stability and recovery of the disease.
Outdoor activities for the elderly can be planned to relieve their depressed mood.
07. The combination of home care and communication
● Reduce the patient's fear of death.
● Control the impact of various diseases on mood.
● Listening, empathy, and attention to relieve psychological burden.
● When communicating with patients, family members should pay attention to gentle words and family affection.
Fourth, how to be a healthy and happy old man
01. Try to stay in bed as little as possible during the day
The long-term bed rest of the disabled or semi-disabled elderly will inevitably make their physical and mental functions and living ability worse and worse. Therefore, the elderly should be taken out of bed as much as possible during the day, and the time that the elderly can sit in a chair or wheelchair should be increased.
Medical studies have found that the longer an elderly person sits during the day, the greater his or her mental clarity is higher than when lying in bed, the desire of the elderly to take the initiative to act will also increase, and the possibility of bedsores and joint contractures will be greatly reduced.
02. Give full play to the "residual function" of the elderly
Support and help the elderly to change from passive to active in daily living activities as much as possible, and only help the elderly person to do so when they are unable to do so. Reduce the "substitute work" to a minimum, and make the elderly progress from disability to semi-disability as much as possible, or from semi-disability to take off the hat of "semi-disabled". In rehabilitation medicine, this kind of care is called "effective use of residual functions", and the purpose is to prevent the disabled and semi-disabled elderly from losing all of their remaining functions.
If all the life activities of the elderly are "carried out" by others, it will only further accelerate the deterioration of their physical and mental condition.
As for when family members and caregivers should "help", this needs to be observed and judged in the actual care care.
03. Exercise prescription for the elderly
It is recommended to develop a targeted exercise program according to the interests, abilities, health conditions, training conditions and purposes of the elderly, and the more personalized the program, the higher the compliance of the elderly in participating in exercise, and the greater the benefits of exercise.
The amount of exercise for the elderly needs to be gradual according to their health condition.
It is recommended for the elderly to do 150~300 minutes of moderate-intensity aerobic exercise, or 75~150 minutes of high-intensity aerobic exercise, or an equivalent combination of moderate-intensity and vigorous-intensity activities within 1 week.
Older adults can increase moderate-intensity aerobic activity to more than 300 minutes in 1 week, or more than 150 minutes of vigorous-intensity aerobic activity, or an equivalent combination of moderate- and vigorous-intensity activity throughout the week, as their body allows.
Aerobic exercises include Qigong, Baduanjin, Pilates, Tai Chi, Yoga, Walking, Dance, etc.
On the one hand, aerobic exercise can increase the cross-sectional area of muscles, on the other hand, it can improve the quality of cell mitochondria, enhance the activity of metabolic enzymes, and improve the function of skeletal muscle, so as to improve muscle strength, improve balance, flexibility and other physical functions.
Moderate- and high-intensity aerobic exercise is particularly effective in older adults.
Exercise intensity refers to the degree of exertion during exercise, and the intensity is directly proportional to the heart rate and perceived fatigue. On a 10-point scale, sitting is 0 points; Exerting all effort is 10 points; Moderate-intensity exercise is 5 or 6 points, with a marked increase in heart rate and breathing; High-intensity exercise is 7 or 8 points, and the heart rate and breathing increase substantially.
Older people with weak constitution and poor endurance can slowly increase the duration of exercise until they reach the recommended level of exercise.
It is an elderly disabled or semi-disabled patient
Formulate scientific, reasonable and effective
rehabilitation and care programs,
Improves in elderly patients
quality of life and healthy life expectancy,
It is a shared responsibility of society and family.
About the Author
Song Danyang
Chief therapist of the Department of Rehabilitation Medicine of Beijing Hospital. He is a certified occupational therapist of WFOT International Occupational Therapy Alliance, a member of the Youth Committee of the Beijing Association of Rehabilitation Medicine, and a member of the Rehabilitation Professional Committee of the China Association for the Rehabilitation of Disabled Persons.
He has been engaged in occupational therapy, intensive rehabilitation, neurological rehabilitation, orthopedic rehabilitation, and high-level health care for a long time. He has participated in 2 scientific research projects at the institute level, published 1 SCI article and 1 core journal article.
Read the magazine "Mediaging Healthcare" for more details
The above is the original work of the magazine "Health Care for the Elderly", if reprinted, it must be authorized by this journal!