Geriatric disease prevention and precautions training content

There is no universal "standard answer" for the prevention of geriatric diseases. The core logic is "give priority to individualized risk management and control, supplement by fine-tuning of lifestyle habits, and ensure the psychological state." All health care measures and medication plans must first match the basic physical conditions, lifestyle habits and even personality preferences of the elderly. Blindly applying general plans may cause health damage.

Let’s take a real case that we just encountered last week: 68-year-old Aunt Zhang in our community watched a short video and saw “Walking 10,000 steps a day to live to ninety-nine.” She insisted on walking around the community for two hours every day, and was hospitalized in half a month due to effusion in her knees caused by degenerative osteoarthritis. Obviously, her previous physical examination had revealed that her joints were seriously worn and she could not walk with weight for a long time. She just believed in the common health advice and went wrong. We who are engaged in grassroots elderly health management often say that the health accounts of the elderly should not only be calculated by indicators, but also the quality of life. If you insist on "health standards" that do not meet your own habits, the gains will outweigh the losses.

Nowadays, many of the suggestions in health care content are inherently academically controversial, so there is no need to focus on a certain implementation. Take calcium supplementation as an example. The Western medicine system generally recommends that people over 65 years old should supplement 1000-1200mg elemental calcium + 800IU vitamin D3 every day to prevent osteoporosis and sarcopenia. However, many doctors in the traditional Chinese medicine school do not recommend blind calcium supplementation for all elderly people - many elderly people have spleen If the stomach has a weak transport and transformation function, the calcium supplement will not only be unable to be absorbed, but may also aggravate the accumulation of phlegm and dampness, causing gastrointestinal discomfort. It is recommended to regulate the spleen and stomach through yam, poria, etc., and then consume calcium through food supplements such as milk and soy products. There is no absolute right or wrong between the two options, and they are suitable for the elderly with different physical foundations.

Don't tell me, many people think that geriatric diseases are chronic diseases such as hypertension, diabetes, and COPD. In fact, among the reasons for hospitalization of people over 65 years old in our jurisdiction last year, illnesses caused by accidents such as falls and aspiration ranked third, accounting for a higher proportion than acute exacerbations of COPD. In many homes, anti-slip mats are only used in bathrooms, but are ignored in kitchens, balconies and other places that are often exposed to water. Elderly people wear thick fleece socks when walking around the house in winter. It is particularly easy to slip on the tiles. Some elderly people like to put commonly used medicines and water cups in high places. When they stand on tiptoe to hold them, they fall. If you don't pay attention to these small details, the harm will be much greater than if the indicator is higher.

There is another point that is easily overlooked: emotions have a much greater impact on geriatric diseases than we think. The 72-year-old Uncle Li who we managed before had his high blood pressure under stable control. Last year, when his grandson went to study abroad, he stayed at home all day long and didn't talk much. His blood pressure was around 180/100mmHg for half a month, and he couldn't lower it even after using several antihypertensive drugs. Later, we contacted the community to sign him up for calligraphy and painting classes twice a week, and met a few old friends who practiced calligraphy together. Within a month, his blood pressure dropped to 130/80mmHg without increasing the dosage of medicine. Many children stare at the old man's physical examination form to see the indicators, but fail to notice that the old man stays at home all day with no one to talk to him, his mood is bad, and no matter how much medicine he takes, it will be of no use.

When it comes to taking medicine, I really want to remind everyone not to "gang up to buy medicine" with your neighbors. Last month, an aunt came to the clinic and asked why she was taking the same amlodipine as her elder sister. Her feet were so swollen that she couldn't wear shoes after taking it for half a month, but her elder sister was fine after taking it. Everyone’s liver, kidney, and blood vessel conditions are different. The same antihypertensive drug that works for others may not be suitable for you. There are also elderly people who have bilateral renal artery stenosis. If they buy ACEI antihypertensive drugs indiscriminately, it may cause acute renal failure in severe cases. This is really not an alarmist. There are also many elderly people who like to save medicines. They have cold medicines and expired antihypertensive medicines from three or four years ago in their drawers and are reluctant to throw them away. They take them out when they feel uncomfortable. This habit really needs to be changed.

Let’s talk about the dietary issue that everyone is most concerned about. Many elderly people said, “I already eat very little.” However, when they came to follow up, they found half a can of pickled radish and dried salted fish on the table. They had to eat less than half a plate when eating porridge every day. The amount of salt had already exceeded the daily standard of 5g. Some elderly people are afraid of waste and are reluctant to throw away the leftovers after reheating them for three or four meals. Last month, an aunt ate three-day-old leftover stir-fried vegetables and went to the emergency room for nitrite poisoning. She has chronic kidney disease and almost needed dialysis. There is really no need to spend tens of thousands of dollars in medical expenses for a few yuan of leftovers. Of course, there is no need to completely deny the old man the food he likes. For example, just a bite of pickles and limiting the amount to one chopstick a day is much better than forcing him to not eat at all and feel bad all day long.

There has always been controversy about exercise for the elderly. Experts in the field of sports medicine generally recommend that elderly people under the age of 70 with no underlying diseases can do moderate-intensity exercises such as strength training and jogging to increase muscle mass and effectively prevent sarcopenia and the risk of falls. However, many geriatric clinicians are more cautious. Shou believes that for the elderly who have no foundation in exercise, it is safer to start with gentle exercises such as slow walking, Baduanjin, and Tai Chi. Sudden high-intensity exercise can easily cause cardiovascular and cerebrovascular accidents. Both views are supported by clinical data. Which one to choose depends on the elderly's own physical condition and exercise habits.

In fact, having been doing elderly health training for almost ten years, my biggest feeling is that there has never been a "perfect template for healthy elderly people". Some elderly people just like to eat sweets, and some elderly people don't like to move. As long as the risks are within the controllable range, there is no need to judge the elderly harshly according to standards. If you are not sure what plan is suitable for your elderly, first find a family doctor contracted in the community for a comprehensive evaluation, which is much more reliable than blindly browsing online health posts.