When you are old, you must "grow old healthily"
Author: reporter Zou Xiaojing
[Talk about health]
According to the relevant United Nations standards for aging, a region’s population over the age of 60 accounted for 10% of the total population, or 65-year-olds accounted for 7% of the total population, that is, the region is deemed to have entered an "aging society"; the population over 65 accounted for the total population If the proportion of the population exceeds 14%, it will enter the "aged society"; if the proportion reaches 20%, it will enter the "super-aged society".
Zheng Xiaoying, a Distinguished Professor of Peking University and an academician of the Academy of Sciences of the Developing Countries, believes that according to this standard, China has entered an aging society since 1999, and the rate of aging has gradually accelerated.
As the aging process of our country's population continues to accelerate, the trend of the elderly population and the problem of disability are becoming more and more serious, and the coverage of chronic diseases of the elderly is gradually expanding.
It is estimated that by 2050, the number of elderly people aged 60 and above in my country will increase to 490 million, accounting for 36.5% of the total population; the number of elderly people aged 85 and above will reach 53.15 million, accounting for 10.8% of the total elderly population; partly The disabled and completely disabled elderly will reach 97.5 million, accounting for 19.84% of the total elderly population.
In terms of chronic diseases and disability, by 2050, the number of chronic disease cases in the elderly population of 60 years and over in my country will also increase to about 300 million, and the number of disabled elderly will increase to 24.7 million.
At the same time, my country's population aging is also facing the problem of uneven development between regions and urban and rural areas.
Facing the increasingly large population of elderly people, especially the elderly, sick and disabled, how to effectively integrate health service resources, provide a healthy and friendly environment, actively promote their healthy aging, improve their quality of life, and become my country’s economy and society Major challenges in rapid development.
At a press conference held by the National Health Commission a few days ago, Wang Haidong, Director of the Department of Aging and Health of the National Health Commission, introduced that currently about 90% of the elderly in my country choose to stay at home for the elderly. The focus of integrated medical care services is the home and the community. The basic public health service program will provide free health management and health check-up services for the elderly over 65 years old every year.
Home care for the elderly is to support the elderly as a family unit to meet the material needs and spiritual needs of the elderly.
According to Zhang Ping, director and chief physician of the Gerontology Center of Beijing Jishuitan Hospital, many elderly people are more willing to take care of their lives at home due to traditional concepts and economic conditions. However, there are many issues that need attention in the elderly and their families. It is necessary to have a certain knowledge of disease prevention and body care in order to make the elderly healthy and aging.
1. To protect the health of the elderly, we must take precautions first
"Physical health is the basis for enjoying old age. The healthier the elderly, the fewer problems they may encounter in the elderly care at home." Liu Chan, the attending physician at the Department of Geriatrics, Xiangya Second Hospital of Central South University, believes that the elderly are immune With low power and weak resistance, it is a high-risk group of infectious diseases and many severe diseases.
"Healthy elderly people know how to prevent diseases. Don't go to the hospital until you get sick. Otherwise, they will easily fall into the vicious circle of'only cure but not prevent, the more you cure, the busier the cure'." This is Liu Chan's perception after working for many years.
Wang Huaqing, chief expert of the China Center for Disease Control and Prevention's Immunization Planning Center, also believes that to protect the health of the elderly must be prevention first, and vaccination is an effective disease prevention measure.
"In the past, we used vaccines, especially for immunization programs, mainly for children." Wang Huaqing explained that nowadays aging is increasing, and diseases of the elderly have an increasing impact on the quality of life and social development of individuals. With the development of science and technology, New vaccines continue to be developed successfully, and their effects should cover the entire life cycle, especially for the elderly.
Which vaccines are suitable for the elderly to vaccinate?
Liu Chan believes that the elderly and children differ in vaccine selection. The children are a blank sheet of paper, and the elderly have developed a variety of antibodies.
"I recommend that elderly people get flu vaccine, pneumococcal vaccine and recombinant shingles vaccine as soon as possible according to their own conditions to prevent the most common types of infectious diseases in middle-aged and elderly people." Liu Chan said that flu vaccination is not just to prevent the flu. It can effectively reduce or prevent related complications.
For example, influenza is easily combined with otitis media and other diseases and some chronic diseases. Influenza vaccination can effectively reduce the occurrence of these complications and reduce the mortality rate.
Talking about the necessity of vaccination for the elderly, Liu Chan explained by taking herpes zoster vaccine as an example: "The elderly are people at high risk of herpes zoster. For elderly patients with herpes zoster, the most troublesome thing is after the rash has healed. Many people suffer from sequelae neuralgia, which may last for one to three months, or even several years. This not only tortures the patient, but also brings a heavy mental burden to the patient’s family. Moreover, the current treatment effect of sequelae neuralgia is not good. So it’s best for the elderly to get vaccinated in advance and try not to get this disease."
Regular physical examinations are also a key part of disease prevention for the elderly.
Liu Chan suggested that the elderly should undergo a comprehensive physical examination every year. She also reminded: “Older women should undergo HPV and TCT examinations every year. If HPV is positive but TCT is negative, another colposcopy is required. She also suggested that the elderly should pay attention to the annual tumor screening, and it is best to have a gastrointestinal endoscopy every other year.
"A high-quality gastrointestinal endoscopy can prevent the occurrence of early colon cancer within five years."
In addition, some senile syndromes can also be prevented.
"Geriatric syndrome refers to some diseases that are unique to the elderly as they age. The prevention of senile diseases is mainly to prevent the disease as much as possible, or to delay the occurrence of the disease." Zhang Ping, for example, said, "Old age falls are a comprehensive combination of old age. One type of symptom is that many elderly people suffer from osteoporosis. They may fracture as soon as they fall, and they require surgical treatment. Inoperable conservative treatment is even worse. They require bed rest and high complications and mortality." In Zhang Ping's view, preventing falls is very important for all elderly people.
Special attention should be paid to the home environment. “Many elderly people with fractures in our ward tripped and broke fractures because of the rolled-up carpets and horizontal wires at home. The home environment of the elderly must be arranged.” Zhang Ping emphasized.
2. The elderly should go to the hospital for health assessment in time
"To do a good job in health management, it is not enough to rely on the elderly themselves." Zhang Ping suggested that the elderly should not stay in the stage of seeing whatever disease they have, but should go to the old age in time when the body has some uncomfortable symptoms. Department visits, let the doctor do a health assessment or timely examination for himself.
The importance of health assessment and timely examination of the elderly is determined by the characteristics of senile diseases.
"Different from the reaction of young people after illness, one of the characteristics of senile disease is that the onset is particularly insidious, atypical, and difficult to be recognized." Zhang Ping gave an example, "Young people with acute myocardial infarction will have precordial pain. And some elderly people may just not want to eat, their limbs are cold, etc., and the hospital examination found that it is myocardial infarction." Zhang Ping reminded that when the elderly do not know what they are suffering from and feel sick, family members should not ignore the chief complaint of the elderly. .
Many signs that you don’t care too much may be the signs of disease.
An elderly disabled patient just admitted by Fan Bin, the attending physician at the Geriatrics Center of Beijing Jishuitan Hospital, caused the elderly to "suffer a crime" because he failed to do a good health assessment after the occurrence of relevant signs.
"This patient actually has very poor swallowing function and eats very slowly, but the family and the elderly did not particularly care about it. As a result, after feeding yesterday, the elderly has been having a high fever. When we came to the hospital this morning, we learned from her A lot of eggs are sucked out of the lungs. It turns out that the food that the elderly ate yesterday swallowed into the trachea. This is what is often said: aspiration pneumonia." Fan Bin said that when the elderly have signs of slow swallowing, they can come to the hospital for an evaluation. The doctor believes that the patient has already suffered from swallowing dysfunction and should strengthen the training of swallowing function. If necessary, the patient is advised to add a gastric tube to prevent food from entering the trachea.
In addition, the elderly often have multiple diseases coexisting, and how to use medicine scientifically also needs to follow the doctor's guidance.
"The coexistence of multiple diseases will cause a problem, that is, the elderly take a lot of medicine, and each disease has a medicine, which is often referred to as the'multi-drug problem for the elderly.' There may be interactions between several medicines. "Zhang Ping said, "There are also elderly people who have high blood pressure and came to the hospital to prescribe drugs, but maybe a few days later, relatives and friends recommended a blood pressure medicine, so he also bought two kinds of blood pressure medicine. If the medicine is taken together, the blood pressure will be extremely low at once, and it is very likely to be dizzy and fall. This is an improper medication. Therefore, when the elderly suffer from more than three types of chronic diseases or take more than three types of drugs, they must seek medical treatment in the geriatrics department. Consult and evaluate whether the medication is reasonable."
"Geriatrics is mainly a science that studies the prevention and treatment of diseases of the elderly and improves the quality of life of the elderly. Our principle is to let the elderly be'old and not sick, sick but not disabled, disabled but not abolished'." Zhang Ping said, " The elderly should manage their own health, try not to get sick or get sick later, and avoid disability if they are sick. For example, prevent the elderly as much as possible to delay osteoporosis. Once the hip fractures and lie on the bed, life is very likely. There are not many days, because it is easy to cause thrombosis and other fatal diseases. Some people call it the last fracture in life." Now the Department of Geriatrics at Beijing Jishuitan Hospital will conduct perioperative evaluations for elderly patients with hip fractures to ensure stable geriatric disease. Come down, perform surgery as soon as possible to reduce disability.
“In the past, 80-year-olds who suffered fractures may not be able to undergo surgery. Now we will provide one-stop perioperative management for elderly patients to stabilize their condition, operate as soon as possible, and recover as soon as possible. It is also possible for 100-year-olds to undergo fractures. Operate in time, so that there is no disability after the fracture, and the quality of life is guaranteed. Of course, follow-up anti-osteoporosis treatment is also very important to reduce fractures again." Zhang Ping said.
3. A positive attitude is also a good medicine for recovery
"You must serve the elderly." This is Fan Bin's advice to the elderly.
"The elderly must be mentally aware that they have entered a state of aging. According to our experience and research, human aging is not a gentle process, but a cliff-like process. Some elderly people can climb five floors at the age of 80, but At the age of 81, a lot of physical functions may not work at once." Fan Bin said.
"Many elderly people are always afraid of causing trouble to their children. They dare not tell their children in time when they are sick." Zhang Ping analyzed a case. "An old man we were admitted to the toilet fell over in the middle of the night and couldn't stand after falling. I got up and called my wife, but my wife couldn’t hear her ears. When it was daybreak, my wife saw her and said to call the child. But she said that the child had just started work at nine o’clock and stopped calling, so she dragged her to noon. The child called and waited for the child to send her to the hospital. Her half of her body was crushed because of long periods of inactivity." Zhang Ping said that many elderly people are like this, they are always afraid of causing trouble to their children, and minor illnesses may lead to serious illnesses.
In fact, the elderly need more attention from their families.
Liu Chan believes that psychiatric treatment is very important for the cure of diseases of the elderly, because the elderly tend to become very sensitive after they get sick.
In addition to using some drugs to relieve the emotions of the elderly who are sick, she often tells the elderly that they can take care of themselves, "Don't always think that you are a patient. If you can eat by yourself, you can eat by yourself, and if you can dress by yourself, you can dress yourself. Respect yourself. Don’t lie in bed, go out and see the nature more. A positive attitude is also a good medicine for healing, and it can also make the elderly grow healthier.” The elderly who are still willing to take care of themselves mentally recover from illness. The possibility is even greater. This is Liu Chan's many years of experience.
(Reporter Zou Xiaojing)