Features of care for geriatric patients
The care for him is of great importance for improving the quality of life of an elderly person.
General care for elderly patients is always complicated and requires a lot of attention and time. The most important in the care of elderly patients is respect for the patient's personality, understanding and acceptance of his physical and mental handicaps. To properly organize care for patients, you need to know the age features of their behavior. Often, age-related psychological changes in elderly patients are pathological, perverse. Older people become more sensitive, vulnerable, react to fears, depressions, often inadequate reactions to arising difficulties or changes in their lives. Elderly patients also suffer a change in the direction of decreasing their physical and mental functions. As a result, older people are more likely to develop depression, hypochondria, various phobias. Deprived of work, which was assigned a big role in life, elderly patients go to their senses, to take care of their health. Often they have hypertrophied anxiety for their health. The elderly are more and more irritable, crying, aggressive, talkative, their mood can change very quickly and quickly. Discomforting sensations in the body of an elderly person distract him from the surrounding life, which leads to depression, fears. Such features of the behavior of the geriatric patient need to be understood also because they are closely intertwined with the symptoms of disease. Even a small physical and emotional stress can lead to the development and progression of various mental and internal diseases.
When caring for geriatric patients, one should remember about the patient's memory loss, so it is necessary to remind the patient delicately and tactfully about the time of taking medications and undergoing procedures. Good care is very important, as it can significantly improve the patient's condition. Even with good treatment, the best medicines, without good care, the patient's chances of recovery and improvement of his quality of life are almost halved. Older patients need to communicate for the preservation of mental health, they need to receive information, exchange it, just as physical exercises need charging.
Often in elderly patients there is a violation of sleep - insomnia. The causes of this condition can be age changes, sleep during the day, poorly ventilated room, noise, anxiety. Insomnia badly affects the mood and condition of the patient, it becomes irritable, drowsy, attention is disturbed, which can lead to injuries. For the prevention of insomnia, it is necessary to ventilate the room, to provide the patient with a calm environment. Often used light sleeping pills and sedatives.
In elderly patients, due to age-related changes in the urinary system, frequent urination, nocturia, and urinary incontinence can occur. Due to frequent nighttime urination with adenoma, cardiovascular diseases, the patient may be disturbed by sleep, so such patients can be placed next to the bed with a ship or recommend wearing diapers for adults at night. You can also recommend that the patient limit fluid intake at night. However, one should not forget about the importance of taking diuresis in patients with cardiovascular pathology. Daily diuresis should be at least 1 liter. If the patient has incontinence, it is also recommended to wear diapers. In these cases, it is necessary to carefully observe the rules of personal hygiene, since if it is not observed, infectious diseases of the genitourinary sphere are possible.
In elderly and old age patients develop chronic cerebral ischemia, which is associated with the presence of cerebral arteriosclerosis. Such patients may have dizziness, impaired orientation in space, as a result, the possibility of falling and trauma increases. Increased possibility of injuries also occurs due to reduced vision, hearing, weakness in the limbs. With age, osteoporosis also appears, which leads to easily developing fractures. Therefore, such patients should walk with a walking stick( or accompany them).It is also recommended to inform the elderly about the rearrangement of furniture, because when walking around the room they are more accustomed to the habit than to seeing. This will help to avoid injury.
Dizziness can also occur when the patient moves from a horizontal position to a vertical position - an orthostatic collapse. Especially often this condition occurs in patients taking antihypertensive drugs, in which, due to lowering blood pressure, there may appear phenomena of transient disturbance of cerebral and coronary circulation. In such a case, the patient should be advised to get out of bed slowly: first turning over on his side, then taking a sitting position and then getting up.
Cases of injuries in bathrooms are frequent( in a slippery bath or on a wet floor).In order to avoid this, floor mats are needed, additional handles for the support of the elderly.
In the elderly, thermal lesions are also common: burns and frostbites. Getting burns is possible if the faucet is mistakenly opened only with hot water, so you need to adjust the water temperature and then take a shower. In addition, it is better to take a shower in the presence of one of the helpers, the water temperature should be 36-37 ° C.Do not direct a jet of hot water to the head and heart area in order to avoid acute disturbance of cerebral circulation, myocardial infarction. Also, the patient can get burned with dizziness, loss of consciousness at the time of taking hot food, cooking. Therefore it is necessary at this moment the presence of one of the members of the family.
Also elderly patients due to memory disorders often leave home, are lost and in cold weather, when they are long on the street, they can get frostbites. To avoid this, such patients need to put a note in the pocket of their clothes or engrave the patient's name, patient's name, home address, telephone number on the bracelet.
For an old person, it's important to make a bed. It should be at least 60 cm, have handrails to help the elderly person when going to a sitting position. It is necessary to have a bedside table for convenience of food intake, medicines.
For bedridden patients, the bed should be functional with an orthopedic mattress. For the prevention of pressure sores, you need to monitor the cleanliness of bed linen, on the bed there should be no wrinkles, stitches. The patient should be regularly hygienic treatment of the body( 2-3 times a day).In bed, the patient should regularly change positions. It is necessary to examine the skin every day, rub your skin regularly, do a massage, taking into account the age-related skin thinning. If redness occurs, they are treated with camphor alcohol or 2% hydrogen peroxide solution, special rubber cups are placed under such places and places of special compression( the back of the head, shoulder blades, elbows, and heels).
Older patients due to reduced microcirculation are very sensitive to cold. A comfortable temperature in the room for them is 20-23 ° C.
Make sure that there are no drafts in the room. If the air in the room is too dry, you can put a container of water to the radiators. The room should be well lit for various treatment procedures.
Age-related changes in the skin in elderly and old age lead to its thinning, sweat and sebaceous glands also undergo involutive changes. This causes a change in skin reaction to temperature, chemical, mechanical stimuli. Therefore, frequent water procedures lead to increased dryness of the skin, itching, hair loss. Such patients only need one bathing per week using soap with a high fat content. After water procedures it is recommended to lubricate dry areas of skin with a fat cream, it is possible for children.
Special attention should be paid to foot care. In the elderly due to circulatory disorders in the lower limbs, the presence of diabetes mellitus with inappropriate care, it is possible the formation of long-healing wounds, ulcers, which can subsequently lead to gangrene and limb loss. It is recommended to wash your feet regularly with warm water and soap, gently treat the nails, and cut them only after the legs are ripped.
It is necessary to encourage elderly patients to self-service. If the elderly person independently monitors his appearance, regularly cuts, combs, shaves, changes clothes, it always raises his mood, helps improve the overall condition.
Proper nutrition is important for elderly and senile patients.
In elderly patients, the intensity of metabolic processes in the body is reduced, so you should reduce the calorie content of food by reducing the fat and carbohydrates. In the diet should include foods with a content of coarse fiber to prevent constipation, which is typical for elderly patients, especially those who observe bed rest. The tendency to constipation in the elderly and old age is explained by intestinal atony, decreased mobility, reduced consumption of fluid, and the intake of medications( soothing, hypnotics, anesthetics).To prevent constipation, it is also worthwhile to include in the diet of juices, fruit compotes, apples, beets and other vegetables and fruits that stimulate intestinal peristalsis. If necessary, such patients are recommended to take lung laxatives( preparations of buckthorn, senna), weakly alkaline mineral waters, cleanse
enemas, use folk remedies to empty the bowels( taking cold water on an empty stomach, 1 tablespoon of sunflower oil on an empty stomach).It is necessary to reduce the consumption of table salt to 5-8 g per day. It is recommended to consume not less than 1-1.5 liters of liquid per day if, of course, there is no need to reduce its consumption( with heart failure, anasarka).
In the presence of an elderly hemorrhoid patient, it is recommended that after every act of defecation do not use toilet paper, which traumatizes hemorrhoids and causes bleeding from them, and wash the area of the anus with cool water or decoction of herbs. When the disease worsens, special rectal suppositories are used.
Fecal incontinence is common in elderly and senile patients. The causes of this condition can be a prolapse of the rectum, the intake of laxatives. This disease is manifested by the constant separation of the semifinished feces. As a result, the patient has constant irritation, and in neglected cases, inflammation of the anal area. Such patients are advised to use a calico, hygiene for such patients is of particular importance. However, the solution to this problem should be shared with health workers, relatives and the patients themselves.
Patients who are forced to comply with bed rest, for the prevention of hypodynamia, which can lead to the development of hypostatic pneumonia, it is necessary to conduct classes in physiotherapy. For the prevention of congestive pneumonia, it is recommended to deal with patients with respiratory gymnastics, inflate balloons.
Any disease occurs with the appearance of various symptoms( such as fever, eating, sleeping, urinating disorder, stools, nausea, vomiting).In patients with geriatric age, this leads to a limitation of mobility, self-care. Therefore, in combination with good adequate treatment, there should be the same good care, including physical exercises, diet, sleep and wakefulness, various medical procedures, help with administration, prevention of pressure sores, constipation, hypodynamia, etc. Only good care can facilitate and help in improving the condition of the patient.