·For patients with Alzheimer's disease, when they are in a more comfortable and safe environment, when they are happy, the brain's perception of activity and accuracy will be higher. Creating such an atmosphere is helpful for the patient's condition to get better or to delay the deterioration of the condition.
·"I think the things that can be pursued in life are limited, but the pursuit of happiness is infinite. In life, on the one hand, we should be content with happiness, on the other hand we must work tirelessly. Work hard, give, if there is The reward is what you deserve; but if there is no reward, it doesn’t matter. It may just be that you still lack some conditions at present, so just continue to take your time. This kind of mentality will make us more open-minded and not demanding. Slow down, Keep it simple, it's like talking to an elderly Alzheimer's. Life is not anxious."
· Dealing with patients is actually a kind of medical humanities. We are not looking at diseases, but people.
·If each of us can treat patients from a humanistic perspective, as a doctor, we will have a greater sense of professional accomplishment; as a family member, we will also have a greater sense of achievement.
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Before being interviewed by reporters, Wang Huali had just received an Alzheimer's disease patient. This is an old professor who has retired and lives with his daughter. When she became ill, she didn’t know her daughter and kept arguing and wanted to "go home to find her mother." Her daughter explained to her that "your mother has passed away, this is your home", but she didn't understand it at all. Continue to make noise and smash things. After this emotion, she completely forgot what happened, and asked her daughter: "Did a robber come to our house, how did you make it like this?" The daughter told her that she had broken it by herself. She didn't believe it at all, "How am I? Is it possible to do such a thing?"
"When happiness increases, symptoms will decrease"
Similar scenes are repeated every day. The daughter wants to correct her mother's behavior, trying to tell her the facts and reason, but the elderly with Alzheimer's disease cannot understand these facts. Restricting her behavior and conflicts with her made her especially prone to lose her temper. So the daughter took her to see the doctor, hoping to prescribe some medicine for her so that she would not have to worry about it. In fact, the symptoms of this old man are very common in Alzheimer's patients, and it is also the appeal of most family members of Alzheimer's patients to change the patient's behavior through medication.
The mother and daughter came to the hospital for registration early in the morning, but they still queued relatively late and waited a long time before it was their turn to see the doctor. The old man was very excited when he first entered the clinic and complained about waiting too long. Wang Huali did not explain to her, but listened to her complaints calmly and patiently. After the emotions were vented, her speech speed also slowed down, and she took the initiative to say "you are also very busy". This sentence moved Wang Huali very much. She thought this was a "reasonable" old man. She chatted with the old man softly and asked her what kind of food she likes to eat with her mother. A happy smile appeared on the old man’s face, and he said: "My mother does everything delicious." In the happy atmosphere, the old man’s mind seemed to be clearer. She, who originally called her "sister", actually recognized her. Daughter, and take her home.
"For patients with Alzheimer's disease, when he is in a more comfortable and safe environment, when he feels happy, his brain perceives more activity and accuracy. In other words, to create such a The atmosphere is helpful for the patient's condition to get better or to delay the deterioration of the condition." Wang Huali said.
During the conversation, Wang Huali found that the old man’s emotional expression was richer, and Gao and his unhappy were all written on his face. Therefore, Wang Huali told the old man’s daughter that she could use this feature to try to change the way she communicated with her, “She wants to find her mother. It must be her mother who brought her a sense of happiness and security. If you can bring her With the same sense of security, she will believe you and follow you. If you can’t bring her a sense of security, she will want to find someone who makes her feel safer. Don’t be impatient with the elderly, try Slow down and speak simpler, so that she feels that you are someone who can give her a sense of security, and she will be willing to get along with you."
"The most important thing for an elderly person with Alzheimer's disease is to make him feel happy, not dissatisfied. So far, Alzheimer's disease has not been cured. But when the patient's happiness increases, the symptoms will Alleviation. Therefore, the goal of the diagnosis and treatment programs we provide to patients' families is to provide the elderly with more pleasant experiences." Wang Huali said.
"Slow down, life is not anxious"
Among the elderly people who come to Wang Huali to see a doctor, many are patients with severe Alzheimer’s disease. They not only have severe cognitive impairments and cannot recognize people around them, but they also cannot organize complete sentences to express their thoughts and cannot follow them. Others conduct a question-and-answer communication, even unable to control their own behavior. This is the case with the patient Lao Li (a pseudonym). According to his wife, he "beats people at every turn" at home.
Before Lao Li came to Wang Huali for treatment, he had been hospitalized for some time and his condition was basically stable. Before leaving the hospital and returning home, the doctor told his wife not to be impatient when dealing with Lao Li, "Speak more slowly, speak simpler, and don't always criticize him." At first, my wife could still do the same, but after a month of persistence, her wife gradually lost patience, and began to speak quickly by his own nature, and complaints against Lao Li increased. In three months, Lao Li returned to her original state and beat her at every turn. During one visit, his wife told Wang Huali in a grievance that Lao Li beat her again and showed Wang Huali the bruise on his arm. Wang Huali touched her arm lightly, and comforted her: "It must be very painful, and you must be particularly uncomfortable in your heart." His wife nodded, almost crying. At this time, Lao Li suddenly leaned over and asked with concern: "Who made you like this?" His wife was surprised at his reaction, and said coquettishly: "It's you." Then his tears flicked away. The ground fell. Old Li shook his head quickly with a pitiful expression, like a kid who did something wrong, and said: "It's not me, I won't hit you." He wiped her tears again.
Wang Huali took the opportunity to persuade her wife: "Look, although he may not understand what you are saying, he still cares about you, and he will still be anxious when he sees you being bullied."
My wife was very touched and said, "I really didn't expect him to care about me."
At this time, Wang Huali asked his wife why Lao Li beat her and what was the situation at that time.
It turned out that my wife wanted to watch TV, and thought that Old Li was arguing next to him, so he went into the back room and shut himself up and watched TV alone. Lao Li was anxious outside and slammed the door hard. His wife was beaten as soon as he opened the door.
Wang Huali told her that Lao Li's beating was actually an expression of anxiety. "Because I care about you, I can't see you feel anxious, so I will smash the door. If no one opens the door, his anxiety and anxiety will increase. When the door opens, he will hit someone. He is not targeting you. Anyone who comes out of the house will definitely be beaten. You watch TV and he is arguing next to you to get your attention. As long as you care about him appropriately, he won’t make trouble, and talk to him gently. He won’t hit people anymore. In a caring atmosphere, he will feel comfortable and attack people around him a lot less.”
After this persuasion, his wife really made up his mind to change the way he and Lao Li get along. An old man in his seventies or eighties completely got rid of her violent temper. She spoke simpler and spoke slowly. She was more patient than before. More importantly, she would read poems to Lao Li and read those things. He may still have poems from memory, at this time, Lao Li would also shook his head and read along with her.
In the process of getting along with these elderly patients with Alzheimer’s disease, Wang Huali was deeply moved. She found that from the emotions between elderly couples and seeing how they loved each other when they were young, they could feel their true concern for each other. . "They will bring me a lot of touch. I also learned a lot from them. Many interns have told me that every time they follow the outpatient clinic, they have new insights about life. Seeing the old couple feel like each other, just Can imagine the happiness of their youth."
The process of diagnosis and treatment of patients with Alzheimer's disease gave Wang Huali more thoughts about life. "I think the things that can be pursued in life are limited, but people's pursuit of happiness is infinite. In life, on the one hand, one should be content with happiness, and on the other hand, we should also work tirelessly. The reward is what you deserve; but if there is no reward, it doesn’t matter. It may just be that you still lack some conditions at present, so just continue to take your time. This kind of mentality will make us more open-minded and not demanding. Slow down, To keep it simple, it's like talking to an elderly Alzheimer's disease. Life is not anxious."
"My relationship with the patient is to support each other"
Wang Huali’s most impressive patient was an old lady she had treated for 13 years. The old lady had a history of Alzheimer's disease for 5 years before Wang Huali took over. When Wang Huali met her, her condition was already moderate to severe. She was in a wheelchair and was completely unable to live independently.
Her husband is a well-known veteran expert. In order to concentrate on taking care of his wife, the veteran expert retired from the post of re-employment and devoted himself to taking care of his wife. The care of patients with Alzheimer's disease is very difficult, requiring a high degree of care, patience and long-term perseverance. Many families of patients gave up their efforts after persisting for five or six years. According to textbooks, after suffering from Alzheimer's disease, the life span of patients generally does not exceed 10 years. This is because after patients lose the ability to manage themselves, their body functions will gradually degenerate, and accidents are particularly prone to occur. The old experts took care of his wife for 18 years, until his wife finally passed away. During this period, he insisted on using drugs to treat his wife, and he would do everything possible to buy even the most difficult drugs. He learned the methods and concepts of caring for patients with Alzheimer's disease, and hired two carers to help him take care of his wife. Every day he pushed his wife out in a wheelchair to enjoy the sun, talk to her, and help her clean up and massage. Until the end of her death, the old lady never had bedsores.
What moved Wang Huali was that in the 1990s, people still knew very little about Alzheimer’s disease. In order to cooperate with the media to do more publicity and reports on the disease, so that more people can benefit from it, old expert The couple bravely accepted the newspaper interview, participated in the TV program, and told their stories to the public without shy.
Under the careful care of the veteran experts, although his wife is not clear in her head, she smiles on her face from time to time. Until his death, he walked peacefully.
"When she left, the functions of the various organs in the body were not very strong, especially the brain function, which was already quite poor. For example, when she was choked on food, she would not cough up. When she was drinking water that day, suddenly After coughing twice, the nurse saw that she was fine and went to the kitchen. When she returned to the house, the old man had already left."
After the old lady left, the old expert came to the sixth hospital of Peking University to hang up. When he saw Wang Huali, he said: "I'm here, just want you to record in the medical record, and my wife is gone. I also want to tell you how she left, so that other patients' families can know that they will meet in the future. In similar situations, we must pay attention to avoid such problems again."
Wang Huali said that the old expert’s care and care for his wife and the emphasis on Alzheimer’s disease made her very touched and admired, not only that, “he also supported and helped our entire team very much because he and Only when we interact will we continue to obtain updated information and pursue better treatment."
After the old lady was gone, for a long time, the old gentleman still had a very strong emotional experience, so Wang Huali continued to provide him with psychological support, listen to his talk, and give him psychological counseling. "My wife is gone, he has no one to tell. Many people may not be able to experience this feeling. I have taken care of my wife for more than a decade, and the person is gone, but the strong emotional bond is still there. It suddenly broke and he could not accept it, so we Gave him a lot of support".
"Seeing people" instead of "seeing a doctor"
Because the number of Peking University Sixth Hospital is too difficult to call, many elderly people cannot come to the hospital for treatment, so Wang Huali now goes to the community outpatient clinic once a week. The community health center will help the sick elderly in the community make appointments, which can alleviate the inconvenience of running back and forth for the elderly.
There are a total of 4 communities where Wang Huali visits, all in Haidian District. She goes to different communities once a week, from 8 in the morning to one or two in the afternoon. For almost half a day, she not only treated the elderly, but also trained community doctors, instructing them on how to deal with a certain patient's situation and how to prescribe medicine. In addition, Wang Huali also helped the community to create a sorority for the families of patients with Alzheimer's disease, and cultivated social workers to the family sorority to provide care and counseling to the families of patients.
"Dealing with patients is actually a kind of medical humanities. We are not looking at diseases, but people. We will understand the patient through the details of life, understand his perception of society, and understand his perception of life. Dang When we look at patients from a medical humanistic perspective, our handling and coping methods will be more comprehensive, or closer to the needs of patients and their families."
You must cultivate yourself to be able to "see people" instead of "seeing a doctor." It takes a lot of training. After graduating from Peking University, Wang Huali has engaged in clinical work in general psychiatry, psychological counseling and geriatric psychiatry, and has been engaged in research on mental health, senile mental disorders, and early diagnosis and care of senile dementia. At the same time, she has been engaged in counseling for family care. In addition to the insights gained in clinical and practice, she also took special courses in "Medical Anthropology" during her advanced studies at Harvard University.
"Study in these disciplines allows me to understand patients more deeply, and to look at patients from a more humanistic perspective. Adding humanity to the professionalism of medicine is very helpful to my work. If each of us can use Treat patients from a humanistic perspective. As a doctor, you will have a greater sense of professional accomplishment, and as a family member, you will also have a greater sense of achievement. When we all learn to consider problems from the perspective of others, it will be easier to form effective communication, and Can deal with problems better." Wang Huali said.
(Wang Huali: Professor and doctoral supervisor. Director of the Clinical Research Office of Peking University Sixth Hospital, and Deputy Director of the Center for Diagnosis, Treatment and Research of Memory Disorders, Deputy Director of the Beijing Key Laboratory of Translational Medicine for the Diagnosis and Treatment of Dementia. Has been engaged in mental health and Clinical diagnosis and treatment, research and training of senile mental disorders, senile dementia and other diseases.)
China Youth Daily·China Youth Daily reporter Xia Jin Source: China Youth Daily