Not all diseases need to be cured! Doctor reminds: the elderly must learn to coexist with the disease

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Geriatric syndrome is a syndrome unique to the elderly and caused by multiple factors; aging, disease and environmental factors May cause functional decline in the elderly. From disease prevention, acute disease management, chronic disease management, to functional maintenance, it is the work content of geriatric medicine.

For the diseases and health problems of the elderly, Liu Xiaohong, director of the Department of Geriatrics of Peking Union Medical College Hospital, suggested: “Our goal is not to cure a disease, but It is to maintain the functional status of the elderly, to support their home care, and to improve the quality of life of the elderly and their families.01

Q: Why do the elderly always choke?

A: associated with decreased muscle function

Choke is a manifestation of dysphagia, which is mostly related to aging, weakness, and poor coordination of oropharyngeal muscles. Disease factors such as stroke can also cause dysphagia.

Coughing and aspiration can cause aspiration pneumonia. Some elderly people have atypical symptoms.< span>If you often have a low-grade fever for unknown reasons, or if you have confusion, you need to seek medical attention in time.

Prevent sarcopenia and maintain pharyngeal muscle function is an effective preventive method. After the swallowing function declines, it is recommended to carry out rehabilitation exercises under the guidance of a rehabilitation doctor as soon as possible. You can use thickeners every day (such as adjusting the water to the texture of rice soup), do not choose a diet with uneven food texture (both liquid and solid in the bowl, such as glutinous rice dumplings), food with dregs (such as mung bean cake), broken or ground medicines, etc.

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Q: What should the elderly do to fall easily? A: Renovation of a suitable aging environmentIf the elderly have a walking distance Abnormal gait such as widening, swaying, lateral deviation, or inability to stand in series (one toe on the other heel), easy to lean back when lightly touched, and other balance abnormalities, or a fall within 1 year, all need to seek medical attention as soon as possible. Liu Xiaohong emphasized that in addition to internal factors, environmental factors are involved in about 70% of falls in the elderly. Aging-friendly modification is recommended for the home, such as preparing night lights, installing handrails in slippery environments, not using small carpets, removing stray wires on the floor, etc.. The elderly have a high risk of falling within one week of changing to a new environment, such as hospitalization, travel, etc., pay more attention.

Pets running, orthostatic hypotension, poor vision, taking sleeping pills and other factors are also likely to cause falls. It is recommended to do a comprehensive assessment of the elderly, regular drug reconstitution, and remove unnecessary or possibly falling drugs under the guidance of a doctor.

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/p>03Q: Is it normal to be constipated when I am old? A: Don’t be nervous if you don’t have a bowel movementConstipation and aging in the elderly, slowed gastrointestinal motility, insufficient dietary fiber, Insufficient drinking water, etc. Liu Xiaohong said that the elderly have decreased thirst and lack of water in hot and dry environments, which can cause the colon to absorb more water and have dry and hard stools. Older adults should avoid laxative abuse. Taking stimulant laxatives can disrupt the bacterial barrier in the gut, resulting in loose, incomplete bowel movements. After stopping the laxatives, there may be no bowel movement for 2 to 3 days, and the elderly are worried about taking the laxatives again, forming a vicious circle. “You don’t have to worry about not having a bowel movement for two days, you just need to stop the bowel movement.” Compared with the reduction in the number of bowel movements, the older people’s main complaint is that defecation is laborious and time-consuming, which is related to the decline of pelvic floor muscle function. , or the incoordination of rectal-anal function, you can adjust the way of defecation.For example, put a footrest on the toilet, so that the body is in a semi-squatting position, which is more conducive to defecation.

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Q: Which elderly can choose geriatric medicine? A: Those with advanced age, coexistence of multiple diseases, and decreased functional abilityCurrently, the specialties of the hospital are too subdivided, and there is no specificity for the elderly, the frail, and the Elderly patients with disease manifestations, and there is no suitable department for admission. The Department of Geriatrics takes into account multi-specialty disease treatment, geriatric syndrome diagnosis and treatment, and functional maintenance, greatly reducing repeated examinations and multiple medications. For the elderly with advanced age, coexistence of multiple diseases, frailty, and the decline of activities of daily living, multiple reversible problems can be identified and resolved through comprehensive geriatric assessment, which can help The elderly go home as soon as possible.

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Q: Is the longer the treatment time for the elderly, the better?

A: No long-term hospitalization necessary


The elderly should keep a variety of chronic diseases stable and avoid acute exacerbations.The key is to maintain inner ability (including physical and mental strength) , have the physical strength to go out of the community and do what you want, have good cognitive function, not be depressed, and have vision and hearing that can coordinate with daily activities.

Due to the frequent dietary restrictions in hospital examinations, poor sleep after changing the environment, and infusion tubes, urinary catheters and other pipelines restricting getting out of bed, etc., long-term hospitalization of the elderly will bring functional Falls, muscle loss, and even falls. Among elderly patients hospitalized with acute illness, about half of them cannot return to their pre-morbid state at discharge. It is recommended that elderly patients be discharged as soon as possible after their condition is stable, and follow up regularly after discharge.

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Q: How can the elderly prevent dementia?

A:It’s good to go to the supermarket< /strong>

Liu Xiaohong said that the incidence of dementia in the elderly over 65 years old in my country is 4% to 6%, and the incidence of dementia in the elderly over 90 years old is nearly 50%. “An older woman will be fine with 6 friends.”Older age, female sex, low education, and living alone are risk factors for dementia, it is recommended to make more friends to communicate, walk more, and do more educational activities. For example, going to the supermarket is a good choice, not only can you start, but also see a variety of colors, shapes, memorize prices, smell Multi-sensory stimuli, such as aroma and taste, increase brain activity areas. In addition, vascular dementia is related to diabetes, hypertension, hyperlipidemia, etc. These chronic diseases need to be managed well.

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Q: Does poor hearing and vision affect the elderly?

A: It is very important to maintain inner ability

Many elderly people have dazzled eyes, Hearing loss and feeling depressed, Liu Xiaohong emphasized that hearing and vision are very important for maintaining the inner ability of the elderly. The elderly with poor hearing can lead to social alienation, depression, and dementia due to lack of information stimulation; poor eyesight can affect independent living and outdoor activities. Presbyopia (presbyopia) can occur around the age of 50, and requires 2 to 3 years of optometry to protect vision; it is recommended to test vision every year, and if cataract occurs, ophthalmic surgery can be treated. About 75% of the elderly have hearing loss and often cannot hear clearly. High-frequency voice, it is recommended that the speaker keep his voice low when communicating, and the bytes are clear, so that the elderly can see the mouth shape. It is recommended that the elderly go to the ENT department for a hearing test and wear bilateral hearing aids.

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Q: The elderly should listen when they are sick Whose?

A: Choose a plan that meets the wishes of the elderly

For seniors with serious medical conditions, limited life expectancy, advanced age, frailty, or disability, medical care that meets their wishes is good medical care< /span>. “Liu Xiaohong said that there is a difference between the expectations of the patient and what the doctor can do. For example, the doctor will pay attention to the disease, the family members are worried that the elderly are hungry and require a nasogastric feeding tube, and the elderly hope that they can take a bath and go home without pain.In this regard, doctors need to objectively and in detail inform the condition, diagnosis and treatment plan, benefits and risks, burden, etc., and make joint decision-making between doctors and patients.In the stage where the cognitive function of the elderly with dementia is still good Make a medical plan in advance, explain the medical measures you want or don’t want, and appoint a medical agent to choose a plan that meets the wishes of the elderly.Families often express He is reluctant to tell the elderly about his condition and is worried that the elderly will not accept it. In fact, it is not difficult for the elderly to find abnormalities from some details. Instead, they are in a state of uncertainty due to the uncertainty of the condition and feel lonely and helpless because they cannot communicate with their family members. In fact, the elderly are stronger than expected. The truth is to make the right decision.

Source: Health Times >

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