Currently, respiratory diseases have entered a high incidence period. Although children are more likely to be infected, the elderly are susceptible to respiratory infections and have a higher chance of developing severe symptoms after infection, so they also need to strengthen prevention.

01

Why is it easy for the elderly to

Got a respiratory infection?

　　Whether a respiratory infection will occur after pathogens enter the human body and its severity is determined by the body’s resistance and the confrontation between the pathogens, one good and one evil. The elderly have a decline in lung function, reduced local and systemic immunity in the respiratory tract, and aging of cellular immunity, humoral immunity, innate immunity, and acquired immunity due to aging, which can all make them more susceptible to respiratory infections. In addition, the elderly often have multiple underlying diseases or the use of immunosuppressive drugs due to disease can also weaken the patient’s immune function.

02

Current respiratory infections

Which pathogen is the main one?

　　At present, the most common respiratory infectious diseases are influenza, mainly subtype A H3N2, and other pathogens include rhinovirus, Mycoplasma pneumoniae, respiratory syncytial virus, adenovirus, etc. The infection of Mycoplasma pneumoniae is gradually declining. Influenza virus, human metapneumovirus and common coronavirus are the main infectious diseases in the elderly, and some patients are mixedly infected with multiple pathogens.

03

Respiratory tract infection in the elderly

What are the clinical manifestations?

　　Typical symptoms of respiratory tract infection include upper respiratory tract symptoms, fever, cough, body aches, fatigue, etc. Patients with concurrent lung infection may have symptoms such as expectoration and chest pain. It is important to be aware that some elderly people often have atypical symptoms after respiratory tract infection, including the lack of typical respiratory tract infection symptoms, symptoms such as the pentad of geriatric diseases (falls, altered mental status, incontinence, autonomous activity, loss of appetite), and unexplained aggravation of the primary disease.

　　Therefore, when elderly people experience changes in mental state, a significant decrease in food intake, a significant decrease in independent activity, or even falls, they need to be alert to the possibility of respiratory infection and seek medical attention as soon as possible to avoid delaying the disease.

04

How can the elderly prevent

Respiratory tract infection?

　　Prevention of respiratory infections in the elderly includes two aspects: basic prevention and vaccination.

　　1. Basic prevention

　　It is still necessary to maintain the hygienic habits of wearing masks, ventilating more, and washing hands frequently. Take personal protection when you have respiratory symptoms, avoid close contact with other relatives at home, open windows for ventilation 2-3 times a day, each time for at least 30 minutes. When opening windows for ventilation, pay attention to keep warm and avoid “drafts”. Respiratory secretions should be sealed and discarded in time.

　　Nursing homes need to do a good job of disinfection and hygiene, reduce gatherings, and reduce unnecessary visits. Visitors need to wear masks for protection during visits.

　　2. Vaccination

　　Vaccination is a safe and effective preventive measure for the elderly. Flu vaccines need to be administered every year, usually before the flu season arrives in October, because it takes 2-4 weeks for the body to produce protective antibodies after the flu vaccine. Patients who are allergic to vaccine ingredients cannot be vaccinated. Elderly people who are in the acute stage of chronic diseases need to postpone vaccination and consider vaccination after their condition stabilizes.

05

Elderly people accidentally get sick

what to do?

　　If the elderly accidentally fall ill, don’t panic. First, they need to identify the recent illness of their relatives or friends with whom they have had close contact.

　　If you have been in contact with influenza patients and have related symptoms, you can go to a community health center or hospital for pathogen testing and receive targeted treatment, and take medication within 48 hours of the onset of influenza. If it is a viral infection such as rhinovirus or adenovirus, there is usually no targeted antiviral treatment, and only medication for respiratory symptoms is needed to relieve discomfort.

　　Elderly people with underlying diseases need to seek medical treatment in a timely manner. Patients who do not seek medical treatment in time need to be closely monitored for changes in their condition, including changes in body temperature, respiration, pulse, blood pressure, etc. If conditions permit, a finger-clip pulse oximeter can be used at home to monitor pulse oxygen saturation. If the patient has a high fever, or the temperature does not subside for 3 days, shortness of breath, faster or slower heart rate, irregular rhythm, significantly increased or decreased blood pressure, pulse oxygen saturation ≤93%, mental depression or even mental disorder, and poor food intake, they need to be sent to the doctor in a timely manner.

06

After rehabilitation of the elderly

How to recover?

　　Elderly people recover more slowly from respiratory tract infections than young people. After symptoms improve, they still need to eat easily digestible and nutritious food according to their own spleen and stomach function, pay attention to balanced nutrition, meat and vegetable combination, and avoid spicy and stimulating food. Elderly people’s renal function declines with age, so do not blindly supplement albumin. Elderly people may have problems such as decreased mobility after respiratory tract infection, and need to exercise step by step. They can use walkers to move around at home. They must prevent secondary injuries caused by falls, and do not rush to go out for strenuous physical exercise. They need to keep warm when going out. For bedridden elderly people, pay attention to turning over and patting their backs, strengthen respiratory care, and pay attention to whether the patient has swallowed the food completely when eating to prevent aspiration.

　　What is a pacemaker?

　　A pacemaker is an electronic therapeutic device that is implanted in the body through a minimally invasive method. It emits electrical pulses powered by batteries through a pulse generator. In short, it is a device that can make the heart beat.

What problems may occur with the permanent pacemaker pocket?

　　Pacemaker pocket complications include pocket bleeding, pocket hematoma, pocket infection and pocket rupture, which are progressive and gradually worsening processes. If not handled in time or measures are not in place, pocket rupture may be induced, leading to systemic infection and the removal of the entire pacing system, increasing the difficulty of clinical treatment and the economic burden on patients.

　　Pocket bleeding can be rapid or slow. If it is rapid bleeding, there will be pain, soreness and discomfort, and the pacemaker pocket will bulge rapidly, which is easy to detect.

　　However, if the sac oozes blood slowly, the symptoms of distension and pain are not obvious, and the sac gradually bulges, it is easy to be ignored and often not discovered until the sac is infected. Therefore, after permanent pacemaker implantation, it is crucial to observe the skin at the sac and identify bleeding and infection at an early stage.

3. What are the risk factors for permanent pacemaker pocket infection in elderly patients?

　　1. Elderly and frail, with other chronic diseases. This is related to the elderly patients’ thin body, poor nutritional status, relatively low immune function, and reduced wound repair ability.

　　2. Pocket hematoma. Pocket hematoma is one of the main causes of pocket infection. Elderly patients often have cardiovascular and cerebrovascular diseases, take anticoagulants for a long time, have thin subcutaneous tissue and loose skin, and are prone to “dead space” in the pocket, which increases the chance of pocket hematoma. Pocket hematoma is confined to the pocket and is therefore difficult to absorb.

　　3. It is related to improper size and location of the pouch and pacemaker replacement at the same location.

4. What are the precautions for home care of the pouch after permanent pacemaker implantation in elderly patients?

　　1. Pay attention to the skin condition of the pouch area. If the pouch area has bleeding, hematoma, local redness, swelling, heat and pain, fluctuation when touched, and secretions seeping out, it indicates pouch bleeding and infection, and you should go to the hospital for treatment in time.

　　2. Avoid strong friction. For elderly patients, especially those who are weak and thin, they should pay attention to protecting the skin of the sac area during daily activities and bathing, and avoid strong friction, such as rubbing the skin of the sac area vigorously when scrubbing the bath, so as to avoid bleeding and infection.

　　3. Diet and lifestyle care. Strengthen nutritional support and appropriately supplement high-quality protein and high-fiber foods, such as soy products, fish, beef and fresh vegetables. Diabetic patients should monitor blood sugar regularly, control blood sugar levels, and eat small meals frequently. Develop good living habits, maintain a regular work and rest schedule, avoid staying up late, overeating and other bad habits, etc., so as to improve the patient’s overall condition and enhance the patient’s immunity.

　　4. Psychological care. After permanent pacemaker implantation in elderly patients, caregivers should provide adequate social and psychological support to enable patients to maintain a positive and optimistic attitude and cooperate with treatment and care.

 

 

 

 

 

 

At work, we often hear people like this: “My elderly family member has been bedridden for many years, and what I fear most is bedsores!” The “bedsores” that everyone talks about have a professional name – pressure injury, which refers to local damage to the skin and/or subcutaneous tissue caused by pressure or pressure combined with shear force. It often occurs at bony protrusions, but may also be related to medical devices or other objects.

Once a pressure sore occurs, it will not only increase the patient’s pain and burden on the family, but may even threaten life. So, how can we prevent the occurrence of pressure sores in bedridden elderly people? Please follow my instructions:

01Change body position in time

Changing body positions is the most common way to avoid continuous pressure in the same position. Caregivers need to design a daily body position change plan for the elderly based on their activity level, limb flexibility, ability to change body positions independently, skin and tissue tolerance, and overall health status, and increase attention to changing body positions.

02Protect bony prominences

Avoid prolonged pressure on bony protrusions. For example, the heel is one of the most common sites of pressure injuries. For daily care, you can use a pillow or foam pad to elevate the heel to disperse the pressure along the calf and achieve complete decompression of the heel. You can also use medical foam dressings to protect bony protrusions.

03 Keep the bed flat.

    Clean, dry and free of debris

Wet bedding can soak the skin and cause prolonged irritation, increasing the risk of pressure sores.

04Keep your skin clean and properly moisturized

Clean the skin immediately after defecation and avoid using alkaline soaps and detergents. Use isolation products to protect the skin from moisture and avoid rubbing the skin vigorously. It is recommended to use highly absorbent urinary incontinence products, textiles with a low coefficient of friction, and silicone foam dressings to protect the skin.

05 Care should be gentle

When turning the patient over, avoid dragging, pulling, or tugging. If necessary, multiple people can operate or use tools to change the position, such as using a turning pad, sponge pad, soft pillow, etc. Tip: When turning over, a 30° side-lying position is better than a 90° side-lying position, and keep the patient’s bed head as flat as possible. Encourage patients who can change their position independently to sleep in a 20-30° side-lying position. When the head of the bed must be raised (such as to prevent ventilator-associated pneumonia), keep it at 30° or lower.

06Suitable temperature and humidity

The living environment should have appropriate temperature and humidity to avoid excessive dryness or humidity of the skin, which may cause eczema and other skin problems.

07Improve body nutrition

It is recommended to conduct a comprehensive nutritional assessment and develop a personalized nutritional plan for the elderly who are at risk of or have already suffered pressure injuries. Maintain a certain amount of subcutaneous fat to increase skin elasticity and prevent pressure sores.

08  Check the decompression tools in time

When using decompression tools for a long time, such as air mattresses and turning mats, the performance and effectiveness of the equipment should be checked regularly. We can check the airtightness of the air mattress pipeline connection every morning and adjust the pressure at any time according to the patient’s condition to maintain the patient’s comfort.

09 Raise awareness

When bedridden elderly people develop fever, weight loss, edema, or abnormal skin color in local pressure areas, be alert to the possibility of pressure ulcers and pay more attention to local tissue changes.

 

 

 

 

 

　　Preface

　　Recently, the department successfully treated an elderly patient who suffered from dyspnea and hypoxemia due to accidental inhalation of garlic cloves. The patient was in a critical condition. After emergency treatment, the doctor successfully removed the garlic cloves under bronchoscope and the patient was out of danger. In fact, such cases are very common among the elderly. Common foreign bodies include inhaled teeth and jujube pits. Why does this happen?

　　Elderly people may suffer from respiratory failure, cerebrovascular accident, weakness, sedative medication, etc., which may cause a decrease in cough reflex and incomplete glottal closure, leading to accidental inhalation of food, oropharyngeal secretions, or gastroesophageal reflux into the airway, causing lung infection or suffocation, and even endangering life. So how can we avoid aspiration during our daily eating?

　01 Eating status assessment

　　Pay attention to changes in the elderly’s eating habits. When the elderly choke when eating, take a long time to eat, chew weakly/slowly, have difficulty swallowing, or have food residue or food boluses left in the mouth after eating, caregivers should be alert and investigate the reasons for the changes in the elderly’s eating habits. If necessary, go to the hospital for further examination.

　02 Requirements for eating posture

　　Generally speaking, the patient should sit upright with the trunk straight and the head slightly tilted forward. For bedridden elderly people, caregivers can help raise the head of the bed 30 degrees or use soft pillows or cushions to maintain a sitting position. If the patient is unable to complete the above actions, the patient can choose to lie on the healthy side or tilt the head to one side.

　03 Eating environment

　　The elderly should concentrate on eating and should not be distracted by talking or watching TV or playing with mobile phones while eating. Try to avoid noise or sudden movement of people while the elderly are eating.

04 Eating tools

　　It is recommended that elderly people with swallowing disorders use small, shallow spoons to facilitate the delivery of food to the mouth and avoid eating too large a bolus at one time. If the elderly have difficulty opening their mouths, they can also choose a bottle or nasogastric syringe to deliver liquid food such as fruit puree and rice paste into the mouth.

05 Food Choice

　　Dynamically adjust the elderly’s dietary structure. When it is known that a certain food may cause choking or swallowing difficulties in the elderly, we should pay great attention to it, avoid choosing food in similar forms, and change the cooking method of the ingredients.

　　For example, some elderly people like to eat beef very much, but the fibers of beef chunks are coarse and it is not easy for the elderly to chew and swallow. We can make beef balls, meat puree, etc. for easy eating; if the elderly choke when drinking water, we can use a special thickener to change the viscosity of the liquid to make it easier for the elderly to drink safely.

06 Eating process

　　01

　　Avoid eating too fast and putting too much food in your mouth at one time.

　　Be sure to chew slowly and thoroughly, swallow one bite at a time before eating the next, and do not rush the elderly to eat.

　　02

　　Break up large chunks of meat into smaller, chewable pieces.

　　03

　　Before eating, cut long pieces of food that are difficult to bite off into pieces, or cut them into small pieces that are easy to swallow when cooking. Avoid eating vegetables and long leafy vegetables that contain crude fiber.

　　04

　　When eating fruits with pits, chewing bones or eating fish, check carefully to avoid fruit pits, small bones, fish bones, etc. from accidentally entering the airway.

　　05

　　If choking or coughing occurs while eating, you should stop eating immediately and resume eating after the coughing stops completely.

　　06

　　Check your mouth for any food residue after eating and rinse your mouth after each meal.

　　07 Identification of aspiration

　　According to the manifestation of aspiration, it can be divided into overt aspiration and covert aspiration. Overt aspiration is accompanied by sudden respiratory symptoms such as coughing and voice changes after swallowing, and dyspnea is the first and most prominent manifestation.

　　Hidden aspiration is often not detected until the elderly develop aspiration pneumonia, which is often manifested as mental depression, apathy, slow reaction, fever, etc. Further examination and tracing of the cause reveal that it is caused by aspiration.

　　Therefore, if you find severe choking during/after eating, or if the elderly still have coughing, wheezing, hoarseness, difficulty breathing, cyanosis, fever, etc. after a brief relief from choking, you should go to the hospital for treatment as soon as possible.

Conclusion

　　Once again, we remind the family members and caregivers of the elderly to pay attention to the safety of the elderly’s eating. In case of aspiration, the Heimlich maneuver can be used for emergency treatment, and if necessary, go to the hospital for comprehensive examination and treatment.

 

 

 

 

There are many kinds of vegetables, and they are one of the important nutritious foods in people’s lives. They are brightly colored, delicious, and rich in vitamins, minerals, dietary fiber, and natural antioxidants necessary for the human body. They play a special role in human health.

Fresh vegetables are an important source of vitamin C, carotene and B vitamins in the diet. Vegetables are rich in minerals, such as calcium, phosphorus, potassium, magnesium, iron, copper, sodium, etc. They are alkaline foods and play an important role in maintaining the acid-base balance in the body.

It is good for the health of the elderly to eat more vegetables, but in real life, many elderly people often do not eat enough vegetables due to dental or other reasons, and the variety of vegetables they eat is also very limited. The “Dietary Guidelines for Chinese Residents (2022)” recommends that the elderly consume 300-500 grams of vegetables per day, preferably half of which should be dark vegetables, and ensure that there are 1-2 kinds of vegetables at each meal, and pay attention to the combination of types and colors.

Scientists have found that the nutritional value of vegetables is closely related to their color. According to the depth of color, vegetables can be divided into dark vegetables and light vegetables.

Dark vegetables usually refer to dark green, red, orange-red and purple-red vegetables. The darker the color of the vegetables, the more nutritional advantages they have.

green vegetables

Green vegetables are the most common in daily life, mainly spinach, rapeseed, lettuce, romaine lettuce, broccoli, etc. Green vegetables give people a bright and fresh feeling, have a certain sedative effect on people with high blood pressure and insomnia, and are also good for the liver. Green vegetables contain tartaric acid, which can prevent sugar from turning into fat. Overweight and obese people can eat more green vegetables. In addition, green vegetables are also rich in nutrients such as folic acid, calcium, and selenium.

Yellow vegetables

The greatest nutritional value of yellow vegetables is carotene, vitamin C, and vitamin A. For people with poor appetite, it can increase appetite and moisturize the skin. Representative vegetables of yellow include carrots, yellow peppers, pumpkins, and golden gourds.

Red vegetables

Red vegetables mainly include tomatoes, red peppers, red sweet potatoes, etc. They give people a striking and exciting feeling, can increase people’s appetite and stimulate the excitability of the nervous system. Red vegetables are also rich in carotene, vitamin C and vitamin A.

Purple vegetables

The biggest feature of purple vegetables is that they contain the legendary antioxidant artifact – anthocyanin, which can prevent cardiovascular and cerebrovascular diseases. The representative vegetable is purple cabbage, and there are also purple eggplant, perilla, cowpea, purple bean, etc.

White vegetables

Vegetables mainly in white color include wild rice stem, lotus root, bamboo shoots, winter melon, oyster mushroom, cauliflower and white radish. They give people a feeling of cleanliness, coolness and freshness. They play a certain role in regulating visual balance and calming emotions. They are also beneficial in preventing and treating hypertension and myocardial diseases.

Black vegetables

Vegetables that are mainly black include hair algae, kelp, black fungus, black sesame, etc. They give people a rustic, strong taste and a strong feeling. Black vegetables can stimulate the endocrine system, promote saliva secretion, benefit gastrointestinal digestion and enhance hematopoietic function. Studies have shown that the active substances in black fungus can inhibit tumor cells and reduce the incidence of cancer.

Different vegetables contain different nutrients, so in daily life we ​​need to eat a wide range of vegetables and eat vegetables of different colors at the same time to make up for their shortcomings, balance nutrition and stay healthy.

In addition, colorful vegetables not only satisfy the taste buds, but also satisfy the eyes, which helps to increase appetite, add fun and prolong life.

 

 

 

Home oxygen therapy refers to the method of providing oxygen therapy in a home environment to relieve hypoxia symptoms and promote health. Studies have shown that long-term home oxygen therapy can correct hypoxemia, reduce the damage of hypoxia to important organs such as the heart, brain, kidneys, and lungs, and improve the quality of life.

 Who is suitable for home oxygen therapy?

Not everyone needs long-term home oxygen therapy. Generally speaking, for the elderly, COPD patients, or elderly people with cardiovascular and cerebrovascular diseases, if oxygen inhalation can improve the hypoxia state, the doctor will recommend a home oxygen therapy plan such as appropriate oxygen therapy concentration, oxygen therapy time, and oxygen delivery method by evaluating the condition, airflow obstruction, lifestyle, and treatment compliance.

 What equipment is needed for home oxygen therapy?

Oxygen breathing device

①Double-lumen nasal cannula :

The advantages are that it is convenient and does not affect eating. It is suitable for patients with mild to moderate reduction in oxygen partial pressure or oxygen saturation.

Instructions:

Connect it to the air supply end of the device, adjust the oxygen flow, check that the pipeline is unobstructed before wearing it. When using it, be careful not to tie it too tight to avoid compressing the skin around the ears and cheeks.

②Oxygen mask:

It is suitable for patients who breathe through their mouths, have nasal diseases that affect oxygen inhalation, and have high requirements for oxygen concentration.

Instructions:

Cover the mouth, nose and chin with the mask, fix the flexible metal strip on the bridge of the nose, and adjust the elastic band to ensure the patient’s comfort.

2 Oxygen supply device

① Compressed oxygen cylinder:

There are many ways to buy home oxygen cylinders. You can buy products that meet production and use standards through pharmacies, medical equipment stores or e-commerce platforms. However, oxygen cylinders are large in size and heavy in weight, and require regular refilling or replacement of oxygen. It is recommended that before purchasing, you should consult the merchant about “oxygen cylinder filling and other after-sales services” to ensure the continuity of subsequent home oxygen therapy.

②Oxygen concentrator (commonly known as oxygen concentrator):

Home oxygen concentrators are easy to operate, portable, and can produce oxygen continuously. You only need to regularly test the oxygen flow and concentration. When purchasing, you should consider the reliability, safety, economy, and portability of the equipment. You can refer to the “Home Oxygen Concentrator” industry standard (QB/T 5368?2019) approved and issued by the Ministry of Industry and Information Technology, and be sure to choose a regular manufacturer with complete qualifications.

 Oximeter 

Home oxygen therapy can be equipped with a finger-clip oximeter to monitor blood oxygen saturation and heart rate. It is recommended to purchase one that meets national safety standards and quality requirements, and pay attention to the measurement range, accuracy and stability of the equipment.

Home oxygen therapy precautions 

1. Follow the doctor’s advice and carry out home oxygen therapy regularly

When using oxygen at home, you need to adjust the oxygen flow and oxygen therapy time according to the doctor’s advice.

2. Ensure humidification effectiveness

To avoid dry oxygen irritating the nasal cavity and respiratory tract, it is very important to increase humidification. When breathing oxygen at home, you can buy pure water and pour it into the humidification cup to achieve the humidification effect.

3. Pay attention to observation

During oxygen inhalation, pay attention to pulse, blood pressure, mental state, skin color, humidity and breathing pattern. If you feel that the symptoms of hypoxia cannot be relieved, please seek medical attention in time.

4. Prevent infection

Oxygen inhalation devices and humidification bottles must be strictly cleaned and disinfected, replaced regularly, and used by designated personnel to avoid the growth of mold and bacteria, and to prevent cross infection and secondary infection.

5. Improve oxygen safety

Oxygen can help combustion, so when performing oxygen therapy, be careful to keep the oxygen concentrator away from fireworks and flammable materials. Families using oxygen cylinders should avoid tipping and bumping when moving them to prevent explosions.

 

 

Hypertension is a common and frequently occurring disease worldwide, which can cause target organ damage in multiple organs and seriously threaten human health. For this reason, on April 7, 1978, the World Health Organization and the International Federation of Societies of Cardiology decided to designate May 17 of each year as “World Hypertension Day” to draw people’s attention to hypertension.

May 17th this year is the 10th World Hypertension Day. The theme of this year’s event is “Healthy Blood Pressure, Healthy Heartbeat”.

What is the connection between blood pressure and heart rate? Experts explain in detail:

Understanding Blood Pressure and Heart Rate

Blood pressure is the lateral pressure exerted on the blood vessel wall when blood circulates in the blood vessels. The regulation of blood pressure is a complex process, which mainly depends on the amount of blood discharged by the heart and the resistance of blood vessels. When the heart contracts, the blood in the heart is discharged into the blood vessels, and when the heart relaxes, the blood in the blood vessels returns to the heart, and the cycle repeats.

One heartbeat is when the heart completes one contraction and one relaxation. The amount of blood pumped by the heart is related to blood volume, myocardial contractility, and heart rate. If our vascular resistance increases and blood pressure rises, the heart needs a stronger heartbeat and a faster heartbeat to ensure blood circulation throughout our body.

Blood pressure and heart rate are closely linked

When the patient experiences symptoms such as palpitations, intermittent heartbeats, palpitations after activity, and intolerance to activity; when the electrocardiogram shows a rapid heartbeat, irregular heart rate, premature beats, etc., the doctor will consider whether the patient may have high blood pressure.

Sometimes the patient’s heart rate is not fast, but there is a strong sense of panic, increased myocardial contractility, too strong heartbeat and other symptoms, it is also necessary to consider whether there is hypertension. For example, some patients hear their heartbeats very strongly when they sleep (which they could not hear before), or feel the blood vessels in their heads pulsating when they lie down.

Although some patients who feel anxious during activities do not have high blood pressure in daily measurements, their blood pressure rises rapidly during exercise. At this time, they should pay attention to preventing exercise-induced hypertension. Exercise-induced hypertension often indicates the emergence of new hypertension.

High blood pressure, fast heartbeat

What are the hazards to the heart

Hypertension can cause symptoms such as tachycardia, strong heartbeat, irregular heartbeat and premature beats. In addition to causing discomfort, long-term tachycardia may lead to decreased heart function and heart failure. Strong heartbeat is caused by excessive myocardial contraction. Long-term excessive myocardial contraction can lead to myocardial hypertrophy, which in turn leads to myocardial diastolic dysfunction and even hypertrophic cardiomyopathy.

When blood pressure rises, the heart will increase the pressure in the heart chambers to ensure effective blood circulation throughout the body. The heart is divided into atria and ventricles. The muscles of the atria are relatively thin, so the pressure increase in the atria is more significant, and arrhythmias such as atrial premature beats and atrial tachycardia may occur. If blood pressure is not controlled for a long time, the atria will be under high pressure for a long time, leading to atrial flutter and atrial fibrillation; long-term high atrial pressure may also lead to atrial enlargement, increasing the risk of heart failure and thromboembolism.

How to Maintain Healthy Blood Pressure

In order to stay healthy, adults should adopt a reasonable diet and good living habits, and monitor their blood pressure at least 1-2 times a year. If diagnosed with hypertension, we also need to fully evaluate whether there are other cardiovascular and cerebrovascular risk factors related to hypertension, and evaluate whether there is target organ damage caused by hypertension. Based on individual conditions, choose antihypertensive drugs that are suitable for you to control your blood pressure at an ideal level and keep your heart rate at an ideal level. Let us work together to maintain a healthy blood pressure and heartbeat.

 

Medical

1. Although there is no cure for Alzheimer’s disease, early detection and appropriate intervention can significantly improve the quality of life of the elderly with the disease, and patients can still enjoy life within their capabilities for a long time. According to the evaluation results of the doctor or nurse on the patient at discharge, the patient’s ability to live may be mildly dependent, moderately dependent or severely dependent, requiring a small amount of care, a large part of care or complete care respectively. You can choose home care or enter a suitable nursing home based on your family’s manpower and financial situation.

2. After discharge, family members or other caregivers should pay attention to changes in the patient’s intelligence, behavior, and mood. If the symptoms are relatively stable, the elderly can be taken for a follow-up visit every three months as instructed by the doctor; if there are obvious changes in the condition, such as suddenly becoming more “confused”, dangerous behaviors such as attacking or self-harming family members or themselves, abnormal excitement or depression, bulimia or refusal to eat that cannot be corrected, falls, fever, frequent urination, weight loss, and other physical discomforts, the patient should be sent to the hospital in time for re-evaluation by the doctor, and the treatment plan may be adjusted.

3. If there are cholinesterase inhibitors (donepezil hydrochloride, rivastigmine bitartrate, galantamine) in the medication taken out of the hospital, the patient’s pulse needs to be counted frequently. If it is less than 60 beats/minute, the medication needs to be stopped and timely medical treatment is required; if antipsychotic drugs (risperidone, olanzapine, quetiapine fumarate, etc.) are taken out of the hospital to control mental symptoms, in addition to the need to return to the doctor every 1-2 months to evaluate mental symptoms, adjust the drug dosage or stop the drug in time, you should also observe whether the patient has side effects such as unsteady walking, body stiffness or crookedness, choking when swallowing, excessive sleepiness, etc.; if there are hypnotic drugs (such as estazolam, zopiclone, zolpidem tartrate, midazolam maleate, etc.) in the medication taken out of the hospital to improve sleep, the elderly need to be closely watched at night to prevent falls. In principle, these drugs should not be taken for a long time and need to be returned monthly for adjustment according to the doctor’s advice. At each follow-up visit, the doctor should be informed of the full list of drugs and the conditions observed.

4. In addition to taking medication according to the medical instructions in the discharge instructions and the instructions of doctors and nurses, after discharge, whether at home or in a specialized nursing institution, a barrier-free environment must be created for the patient, that is, an environment that makes the patient feel comfortable and safe, where they can move freely, not easily get lost, and not easily bumped into anything. In addition to the usual care from their relatives, they must also be more patient and communicate more with the patients. The principle of conversation should be to make the patients emotionally stable and happy. There is no need to emphasize right or wrong. Those who are no longer able to communicate verbally can provide companionship or touch to improve the patient’s mood. Maintain a regular schedule and encourage participation in family and social activities and hobbies within a safe range. Mild to moderate patients can consciously play educational games, such as playing cards, building blocks, doing handicrafts, singing, etc.

5. The best department to visit is a cognitive specialist or memory clinic . You can also choose a neurologist , psychiatrist or geriatrician who specializes in cognitive impairment. In order to ensure the continuity of treatment and save medical resources, it is not recommended to frequently change hospitals and doctors. It is best to go to a regular hospital close to home and convenient for treatment, and find a cognitive specialist you are relatively familiar with and trust for medical treatment and follow-up. If a referral is required due to changes in the condition, the doctor will usually recommend or discuss the next treatment location with you.

Nursing

1. Daily care

Family members should create a clean, quiet and comfortable living environment for patients. Supervise and assist patients to maintain good personal hygiene habits, pay attention to the care of urination and defecation, and reduce the chance of infection. Patients in the middle and late stages often lose the ability to take care of themselves and need careful care from their family members, including cutting nails (toenails), cutting hair, and drying bedding. And add or remove clothes in time according to climate changes. Those who have been bedridden for a long time should be turned over and their backs should be tapped regularly to prevent pressure sores and pneumonia. Supervise patients to go to bed on time, including taking a nap at noon, to ensure that they have enough sleep time every day, and try to create a quiet, comfortable and good sleeping environment for patients, but patients should be encouraged to move appropriately during the day, especially outdoor activities.

2. Safety care

Elderly people who are at risk of getting lost should be accompanied when they go out. Communication devices such as mobile phones and GPS locators can be used to keep track of the elderly’s location at any time; cards with home addresses and guardians’ contact information can be sewn on the elderly’s clothes. If an elderly person accidentally gets lost, call the police as soon as possible. Keep the floor flat and non-slip to avoid falls. The bed should be low, and bed guards can be added if necessary. Use a sitting toilet and non-slip floor in the bathroom. Be careful not to get burned when taking a bath. Toxic and harmful items should be placed in a locked cabinet to avoid ingestion. Sharp objects and sharp tools should be placed in a hidden place to avoid hurting others or yourself.

3. Nursing for cognitive impairment

Prepare memos for elderly people with memory loss. Encourage patients to watch TV and newspapers at appropriate times, and explain texts, pictures, and objects. Encourage patients to recall past life experiences frequently. Gently and considerately induce patients to express themselves in words. Activities can be arranged according to hobbies and remaining abilities. Physical activities: walking, practicing big pole, swinging upper limbs, doing health exercises, etc. Household activities: picking vegetables, washing vegetables, preparing chopsticks, washing dishes, wiping tables, etc. Nostalgic activities: watching and talking about old photos, listening to old songs, watching old movies, talking about the past, etc. Handicraft activities: origami, weaving, stringing beads, coloring, painting, etc. Educational activities: board games, jigsaw puzzles, building blocks, filling in lyrics, classifying items, etc. Gardening activities: planting, watering, touching flowers, smelling flowers, making decorations with plants, etc. Guidance and encouragement should be given during the activities, and the difficulty should be adjusted in time, and more encouragement should be given to give patients confidence.

4. Drug care

Take the medicine on time and in the prescribed amount strictly according to the doctor’s instructions. Some patients refuse to take medicine under the influence of delusions, hide medicine, and spit it out. Caregivers should strictly check and carefully examine the patient’s mouth, cup, and hands. Closely observe the adverse reactions of the medicine, such as orthostatic hypotension, dysphagia, coughing when eating, choking, constipation, urinary retention, etc. Caregivers should communicate with the doctor in time when they find it, so that it can be properly treated in time.

Rehabilitation

Based on the comprehensive assessment of the elderly, personalized and targeted physical rehabilitation methods are selected according to the patient’s physical and cognitive functions.

1. For patients with mild to moderate Alzheimer’s disease, appropriate exercise 3-5 times a week can help improve the patient’s physical fitness, cognitive function and ability to maintain daily life. Recommended exercise methods:

(1) Table tennis: Elderly people who have a hobby and foundation for table tennis and whose physical condition allows can play table tennis for 30 minutes every day.

(2) Power bicycle exercise: 40 minutes each time, which is beneficial to improve patients’ cognitive ability.

(3) Brisk walking: The pace should be no less than 3 km per hour, and this can be completed in several sessions of one hour per day.

(4) Tai Chi: At least 30 minutes a day can improve reaction ability, daily living ability, improve cognition, improve balance and prevent falls.

(5) Perform rhythmic exercise with music: improve falling conditions and increase strength and endurance.

(6) Practice bouncing a ball while walking: This can improve balance.

(7) Playing tennis: For the elderly who have a hobby and foundation in table tennis and whose current physical condition allows, playing tennis twice a week can prevent osteoporosis, enhance strength and reaction ability, and improve cognitive function.

2. For patients with severe Alzheimer’s disease, who have severe disability at this stage and are bedridden or have difficulty swallowing:

(1) Provide the patient with food and fluids of the nature requested by the therapist.

(2) Generally, patients need to sit up when eating unless the therapist has special requirements.

(3) Encourage patients to eat in small bites.

(4) Allow patients adequate time to eat;

(5) When feeding more food, make sure the patient has swallowed the previous mouthful of food completely.

(6) If the patient chokes, stop feeding immediately. If the choking does not subside within a short period of time, send the patient to the hospital for emergency treatment if necessary.

(7) Generally, the patient is allowed to sit and rest for 20 to 30 minutes after a meal.

(8) Passive and active limb movements, encouraging maximum range of motion while ensuring safety to avoid muscle contracture or other complications.

Nutrition

1. Ensure a diverse and balanced diet. Eat the right amount of calories to maintain a healthy weight. Pay attention to protein intake and ensure that half of your food is high-quality protein. Eat an egg a day and eat animal food in moderation. Among animal foods, fish has a low fat content and is easy to digest, making it very suitable for the elderly. Drink milk or dairy products every day to increase calcium intake. Eat a small amount of soy products every day. Avoid consuming too much fat and cholesterol. A certain amount of coarse grains can be included in the staple food every day, and eat more fresh vegetables and fruits. Eat small meals frequently, and the food should be soft and easy to digest. The diet should be light and low in salt, and steaming, boiling, stewing and other cooking methods should be used more often.

2. The food should be non-irritating, boneless, easy to digest, less greasy and easy to chew.

3. As the disease progresses, patients will have some eating problems, such as eating more, eating less, or refusing to eat.

(1) Hyperphagia is manifested as hyperphagia. The patient forgets to eat right after eating. Excessive eating leads to weight gain. The treatment method is to limit the patient’s food intake skillfully. Distracting the patient’s attention is a good way. If the patient wants to eat again right after eating, the caregiver can take the elderly to do other activities. Because the elderly eat a lot, they should eat more light foods in their diet to prevent excessive calorie intake. The patient can be allowed to eat appropriate high-fiber, low-calorie vegetables to make the patient feel full. In addition, the elderly eat more food gluttonously, so they should increase their activity level appropriately to increase consumption and maintain a balance between eating and moving.

(2) Eating less or refusing to eat means that the patient gradually loses the need to eat, refuses to eat or eats too little, leading to malnutrition. For such elderly people, it is necessary to arrange a personalized diet and improve the patient’s eating environment. Caregivers are required to pay more attention to the patient’s diet and increase the elderly’s dietary intake as much as possible by adjusting the variety, color, and taste of the meal.

(3) Some patients with severe dementia may have difficulty swallowing. In terms of diet, attention should be paid to adjusting the properties of food, and some special products for dysphagia can also be taken orally. If the above efforts still cannot ensure the nutrition of the elderly, it is necessary to provide the patient with necessary nutritional support under the guidance of a professional nutritionist. The most commonly used method is to ensure the patient’s dietary intake through enteral nutrition such as nasogastric feeding or gastrostomy.

4. The eating environment should be quiet and clean. Patients should sit down and the head of the bed should be raised 30-45 degrees. The food should be at a moderate temperature. The patient should not eat too fast. One teaspoon at a time. The patient should be fed the next mouthful after swallowing. For patients with severe dementia, family caregivers should assist the patient in eating to avoid obstruction and suffocation.

Take care of your eyes, start from now!

With the increase of age, the degeneration of eyeball structure and the influence of bad eye habits, the eye health problems of the elderly are becoming more and more obvious. How should the elderly take care of their eyes? With the arrival of National Eye Care Day, let’s learn about it together!

Avoid prolonged use of the eyes

Some elderly people do not like to go out or have limited mobility, so they can only move around indoors or in bed, which results in watching TV and playing with mobile phones becoming their main pastime every day. Here is a reminder for everyone: do not use your eyes for a long time!

In order to see nearby objects clearly, our eyes will contract the ciliary muscles. If the ciliary muscles do not get a rest for too long, the burden on the eyes will be increased, thus causing eye diseases. So please remember: after using your eyes for 40 minutes to 1 hour, you should relax for 5 to 10 minutes by looking into the distance, closing your eyes, or doing eye exercises.

Pay attention to the lighting environment when using your eyes

Some elderly people have a strong sense of thrift and are often reluctant to turn on the lights when watching TV or using their mobile phones at night. In fact, in a dark environment, the light emitted by electronic screens can cause a relatively large stimulation to the eyes. On the contrary, if you read books or newspapers in a bright outdoor place, it will also damage your visual function, causing dry eyes, sore eyes, and even tears. Therefore, when using your eyes for a long time, you must pay attention to the impact of ambient light on your eyes.

Avoid using handkerchiefs

Or rub your eyes with your hands

Rubbing your eyes can easily cause bacterial infection in the eyes. If your eyes are uncomfortable, you can wash your hands first, then close your eyes and press gently. When problems such as dry eyes and increased secretions occur, you should seek medical attention in time, buy regular eye drops, take correct eye drops, and use symptomatic medication.

Get regular eye exams

Elderly people often suffer from eye problems due to chronic diseases, such as diabetic retinopathy; people with high blood pressure and thrombosis often suffer from retinal vein occlusion; emotional excitement, mental stress, and excessive fatigue may induce glaucoma, etc. Therefore, the elderly should pay more attention to eye examinations, and achieve early monitoring, early detection, early warning, and early intervention.

Wear glasses correctly

When you need to wear glasses or sunglasses, you should buy them from a regular optician after testing and evaluation. At the same time, you should promptly provide feedback to your doctor about your experience after wearing them and have regular checkups.

Nutritional supplements to prevent eye diseases

Eat a balanced diet and eat more foods rich in lutein, such as corn, broccoli, carrots, tomatoes, etc.

Take rest

With acupressure

Closing your eyes and resting your mind can not only give your eyes a full rest, but also relieve the pressure of using your brain. You can also gently massage the acupuncture points around your eyes, such as pressing the Jingming acupoint: every morning and evening, press the thumb and index fingertips in the depression above the inner corner of the eye, first press down, then squeeze upwards, for 10 minutes each time, once a day in the morning and evening.

Falls in older adults are a common but serious problem that can lead to fractures, decreased physical function, and psychological distress. Understanding the causes and prevention of falls is critical to the safety of older adults.

Causes of falls in the elderly

A fall is a sudden, involuntary, unintentional change in body position, falling to the ground or a lower plane. According to the International Classification of Diseases (ICD-10), falls are classified into the following two categories: ① Falls from one plane to another (lower) plane; ② Falls on the same plane. Falling out of bed, falling to the ground when standing up from a wheelchair, etc. are all considered falls.

Risk factors for falls include physical factors, mental factors, drug factors, disease factors and environmental factors.

(1) Physical factors:

The decline in gait coordination, balance stability and muscle strength in the elderly, as well as the decline in vision, hearing, vestibular function, proprioception, and the decline in urinary and bowel control ability are all risk factors for falls.

(2) Mental factors:

Psychiatric problems such as dementia, delirium, abnormal behavior, and confusion can precipitate falls.

(3) Drug factors:

Drugs are another important cause of falls in the elderly. Taking sedatives, antipsychotics, antihypertensives, vasodilators, hypoglycemic drugs, etc. can easily lead to changes in consciousness, spirit, and blood pressure, thereby affecting the balance function and causing falls. The coexistence of multiple diseases in the elderly and multiple medications are also risk factors for falls in the elderly.

(4) Disease factors:

Elderly people often have multiple diseases. Acute and chronic diseases such as nervous system diseases, cerebrovascular diseases, cardiovascular diseases, bone and joint diseases, diabetes, etc. can cause dizziness, unstable gait, imbalance, weakness, visual or consciousness disorders, thus inducing falls. Many elderly people have psychological disorders such as depression, anxiety, fear, etc., which are manifested as inattention, unwillingness to accept old age, and unwillingness to trouble others. They also try to do things that are beyond their ability by themselves, which significantly increases the risk of falls.

(5) Environmental factors:

Environmental factors that cause falls include the floor, lighting, furniture, clothing, facilities, etc. Wet and uneven floors, loose carpets, overly slippery floors, small indoor spaces, improper placement of items, too dark or too strong light, inappropriate step heights, seats and beds that are too high, too low or too light, toilet chairs without safety handrails and non-slip mats, inappropriate clothing, pants that are too long or too loose, shoes that are not the right size, shoes that are not non-slip, and walking in slippers are all factors that can easily cause falls.

What are the serious consequences of falls in the elderly?

(1) Physical aspects:

22% to 60% of the elderly have been injured due to falls. The mildest injuries include hemarthrosis, dislocation, sprain and hematoma; the severest injuries include fractures, including fractures of the hip, surgical neck of humerus and distal radius, and compression fractures of the spine. The most serious ones are craniocerebral injuries, which can directly lead to death.

(2) Functional aspects:

Elderly people who fall and get injured usually need to stay in bed or have their limbs immobilized for a long time, which can lead to muscle atrophy, osteoporosis, and even joint contractures, seriously affecting limb function.

(3) Psychological aspects:

50% of people who fall develop a fear of falling again. The fear of falling can lead to a vicious cycle of falling → loss of confidence → fear of moving → weakness → more prone to falling, and even becoming bedridden.

Elderly people with reduced mobility

How to prevent falls?

01

Help the elderly understand their own mobility and act within their capabilities.

02

When moving, body position should be changed slowly, and if necessary, assistive devices (such as various types of crutches, walkers, wheelchairs) or help from family members should be used.

03

Wear appropriate corrective devices (glasses, hearing aids, etc.) and adjust them regularly.

04

Adjust your lifestyle, drink less water before going to bed, develop a habit of going to the toilet on time, and practice urination control training.

05

For elderly people with mobility impairment, a toilet should be prepared at the bedside, and nursing pads, external drainage devices or diapers should be used when necessary. Elderly people with cognitive impairment need caregivers to assist in training and improve their nighttime toileting methods, and choose to use bedside commode chairs, bed toilets, etc., to reduce the frequency of leaving bed and reduce the risk of falling.

06

Balance training: The elderly can be helped to do Tai Chi, standing on one leg with a chair, and other exercise training according to their degree of cooperation.

Mentally unstable elderly people

How to prevent falls?

01

When the elderly are emotionally unstable, they should be comforted in time, have someone accompany them, reduce their activities and prevent falls.

02

Urge the elderly to take medicine on time and pay attention to adverse reactions after taking medicine.

03

Keep the furniture as simple as possible and avoid sharp corners. Leave enough space for walking in the activity area and avoid stacking too much clutter or small objects that could easily trip the elderly.

04

Place items in a fixed position to keep dangerous items away from the elderly. Use anti-slip materials or anti-slip treatment on the ground. If there is water on the ground, wipe it off in time. Give elderly people with cognitive impairment non-slip and well-fitting shoes to prevent them from falling.

05

When the elderly lie in bed, they should draw the bed rails, have armrests and backrests on the seats, and use seat belts for protective restraint when necessary.

How to prevent falls caused by medications?

01

Antihypertensive drugs can easily cause dizziness. It is recommended that the elderly monitor their blood pressure regularly and move slowly and within their ability when changing body positions.

02

Blood sugar lowering drugs can cause hypoglycemia, which manifests as dizziness, fatigue, and palpitations, leading to falls. It is recommended that the elderly monitor their blood sugar regularly, and caregivers should remind the elderly with cognitive impairment to eat on time and help them eat in time when hypoglycemia is found. It is not advisable to exercise on an empty stomach.

03

Sedatives, hypnotics, antipsychotics, etc. can easily cause drowsiness, dizziness, fatigue, unstable gait, etc., which may lead to falls. It is recommended to assist the elderly in washing, going to the toilet, etc., and take the medicine after the elderly go to bed. Try to avoid leaving the bed after taking the medicine, and use the toilet next to the bed or on the bed at night.

Preventing Falls

How should the home environment be arranged?

(1) Ground:

The floor material should be non-slip and non-reflective; tile carpets should not be used; activities should be suspended after wet cleaning the floor, and safety warning signs should be placed; the passages should be wide and unobstructed.

(2) Lighting:

The light from the lamps is sufficient, soft and not dazzling; turn on the night light at night.

(3) Furniture:

The items in the room are placed in a fixed position, and the height of the bed should be such that the feet of the elderly can reach the ground when sitting on the edge of the bed; provide a chair with good stability and armrests.

(4) Facilities:

Bathrooms and toilets should be equipped with handrails, non-slip floors, outward-opening doors, and toilets should be 42 to 45 cm high. Bathrooms should be equipped with bath chairs. Toilets should be at an appropriate height; table corners and window sills should be rounded or covered with protective stickers.

Preventing falls among the elderly is a topic we have always been concerned about. Let us work together to care for the health of the elderly and pass on the relay of love!