How to take good care of the elderly at home in autumn?

As the saying goes, "the more autumn rain falls, the cooler it gets." Even the young and strong can get sick, so what should the elderly do? In this autumn, how can we ensure that the elderly at home spend every day in good health?

This question may seem a bit complicated, but it actually consists of three aspects: based on general principles, making flexible adjustments based on circumstances, and for some special problems, you can try more targeted solutions.

General Principles

First, let's look at the threats facing the elderly. In November 2022, Peking University and The Lancet published a report titled "China's Path to Healthy Aging." The report divides the health problems of the elderly into five categories, among which chronic diseases are the most common.

Health threats facing older people

Based on the causes, chronic diseases can be divided into two categories: one is related to the overall diet and exercise, and the other is related to specific behaviors.

The first category is diseases related to the overall state of diet and exercise, such as high blood pressure, diabetes, and chronic kidney disease. You may not be familiar with chronic kidney disease, but some scholars predict that in a dozen years, it will become the fifth leading cause of death among Chinese people.

What's more troublesome is that these diseases are like criminal gangs and will help each other: bad eating habits may interfere with the action of insulin and cause diabetes; blood sugar metabolism disorders may lead to an increase in lipoproteins and cause hyperlipidemia; blood lipids accumulate on the inner walls of blood vessels and affect the elasticity of blood vessels, resulting in high blood pressure; the brain, heart, and kidneys cannot do without healthy blood vessels. Therefore, after the three highs, cardiovascular and cerebrovascular diseases and chronic kidney disease may occur.

The second category is related to specific behaviors, such as chronic obstructive pulmonary disease (COPD). COPD is the third leading cause of death among Chinese people, with a prevalence of about 20% among men and nearly 10% among women. In other words, about 30% of people are threatened by it. However, less than 3% of people know about this disease. This is partly because the early symptoms of COPD are very mild, generally manifested as a chronic cough or shortness of breath and chest tightness after exercise.

So, how should we deal with these diseases?

For the three highs and chronic kidney disease, adjusting diet and exercise are the key. Establish a healthy lifestyle and don't cause trouble to the body's metabolic system.

Principles of healthy eating

As for COPD, eating more vegetables, fruits, and beans can help prevent it to a certain extent. However, the most fundamental way is to quit smoking. If the elderly at home have the habit of smoking, they should be persuaded to quit smoking as soon as possible; if necessary, they can go to the smoking cessation clinic of a regular hospital and ask the doctors to prescribe some targeted drugs, such as nicotine patches.

Flexible Adjustment

Generally speaking, we refer to people over 60 as elderly. That is, these people have certain common characteristics. This is also true from a medical point of view.

For example, the fat metabolism function of the elderly is reduced, which makes fat accumulation more likely. In addition, the spine is under long-term pressure, which may make people shorter and shorter. Adding these two together, the body mass index (BMI) will increase slightly. This is normal and there is no need to worry too much. Although "money can't buy thinness in old age", it is not advisable to blindly pursue low weight. Experts from the Chinese Nutrition Society recommend that the BMI of the elderly should be maintained above 20kg/m2.

What should we do if the elderly are indeed fat?

Ideally, only fat should be reduced, not bones or muscles. Eat less rice, but make sure to keep up with protein. If you live north of the Yangtze River, you can buy some vitamin D. Some experts also recommend supplementing with β-methyl-β-hydroxybutyrate (HMB). HMB is a metabolite of protein that can promote skeletal muscle protein synthesis. Appropriate supplementation, supplemented with exercise, is very beneficial for maintaining skeletal muscle mass and strength. Among seasonal foods, broccoli, grapefruit, catfish, and avocado are all rich in this substance.

For example, the eating habits of the elderly may change. On the one hand, about 80% of the elderly have at least one cavity, and many people have not received proper treatment; on the other hand, as the body ages, the taste buds on the tongue gradually shrink, and they may not be so sensitive to tastes such as sour, sweet, bitter and salty. Therefore, the elderly may have a decreased appetite, always feel that the food is tasteless, and like pickles more and more. It’s okay to eat pickles once in a while, but they are high in salt and not rich in nutrition. If this situation is not changed, malnutrition may occur, which will increase the risk of infection and reduce the ability to live independently.

How to avoid malnutrition in the elderly?

The most important thing is to check the weight of the elderly regularly. If the weight is reduced by 5% within half a year, it may be malnutrition. It is best to go to the hospital as soon as possible to find out the cause. When eating, use more seasonings that do not contain oil, salt or sugar, such as balsamic vinegar, to stimulate the aroma of food as much as possible; in addition, you can cook less and cook more meals to help the elderly develop the habit of eating small and frequent meals; when encountering harder foods, such as walnuts, lotus roots, and chestnuts, try to make them soft so that they can eat them.

In addition, there are two elements that are often overlooked: water and dietary fiber. Although these two elements cannot provide energy, they can relieve constipation. Constipation, straining during bowel movements, or squatting in the toilet for too long are important causes of falls, fractures, and even strokes in the elderly. The elderly should drink 1.5 to 1.7 liters of water every day. In the dry autumn, you can increase the amount of water appropriately. As for dietary fiber, beans, whole grains (such as corn grits), potatoes (such as sweet potatoes), and leeks can all be supplemented in seasonal foods.

Another example is the decline in athletic ability, especially the decline in balance ability. The heart and lungs of the elderly gradually weaken, the bone composition changes, and the muscle strength is insufficient, which makes fractures more likely; and the vestibular organ responsible for maintaining balance will also gradually weaken with aging, thus affecting the body's balance.

Therefore, when it comes to exercise, you must accept reality and not compare yourself with others or your younger self. You can find time to test your balance ability by closing your eyes, spreading your arms, and standing on one leg to see how long you can last. If you can stand for more than half a minute, it means that your balance ability is fine; if you can stand for less than half a minute, you can go to the hospital for a checkup or do some balance training, such as practicing Tai Chi or trying to walk backwards.

Secondly, pay attention to the time and place of exercise. Blood pressure has two physiological peaks, one occurs between 7 and 9 in the morning, and the other occurs between 3 and 5 in the afternoon. As for the venue, try to choose one that you are familiar with to avoid unexpected risks.

Finally, during exercise, you can follow the principle of "increase soreness, reduce pain, and stop numbness". Muscle soreness after exercise is normal and will gradually ease. Pain or numbness indicates invisible inflammation, nerve compression, or a problem with the exercise method. You should reduce or even stop exercise and go to the hospital as soon as possible to find out the cause.

Special circumstances

In addition, older people may encounter some special problems.

For example, the time spent with family members decreases, and the "empty nest syndrome" gradually appears. The elderly may always feel lonely, full of nostalgia for the past, and feel anxious and helpless about the future. And their children are either studying or working, and it is impossible for them to be with them all the time. In this case, we must learn to identify the mental state of the elderly, such as whether there are any changes in diet and sleep, and whether the time spent talking to others has increased; when necessary, we must help them build social support and encourage them to participate in some group sports, such as square dancing.

Another special problem is dementia. Elderly people may develop vascular dementia and Alzheimer's disease, become increasingly confused, and even unable to take care of themselves. In fact, the principles mentioned above are helpful in preventing dementia. The Chinese Nutrition Society also provides some additional suggestions, such as eating more deep-sea fish, drinking tea and coffee appropriately, and supplementing zinc, flavonoids, folic acid, vitamin B6 and other elements when necessary.

Autumn Food and Nutritional Elements

Conclusion

At the end of the article, an extra reminder: caring for the elderly is very hard and can cause tremendous stress. Children, while getting along with the elderly, should also learn to recognize the signs of excessive stress in themselves, such as insomnia, irritability, susceptibility to infection, and decreased concentration and memory, and take necessary measures to calm down. Otherwise, if we fall, what will they do?

Balancing family and self

References:

[1] CHEN

[2] Ge Junbo, Xu Yongjian. Internal Medicine [M/OL]. 8th edition. People's Medical Publishing House, 2013 [2023-09-07]. https://book.douban.com/subject/25725669/.

[3] Chinese Nutrition Society. "Scientific Research Report on Dietary Guidelines for Chinese Residents (2021)" [J/OL]. Acta Nutrimenta Sinica, 2021, 43(2): 102. DOI:10.13325/j.cnki.acta.nutr.sin.2021.02.001.

[4] Chinese Nutrition Society. Dietary Guidelines for Chinese Residents [M/OL]. People's Medical Publishing House, 2022 [2023-07-20]. https://book.douban.com/subject/35885945/.

[5] Chinese Society of Gerontology and Geriatrics. Guidelines for the management of chronic obstructive pulmonary disease in the elderly[J]. Journal of Integrated Traditional Chinese and Western Medicine, 2023, 15(3): 154-164.

[6] CHINA NH and FPC of the PR of. Guideline on China clinical smoking cessation (2015)[J/OL]. Chinese Journal of Health Management, 2016, 10(2): 88-95. DOI:10.3760/cma.j.issn.1674-0815.2016.02.003.

[7] Ma Lina, Ji Tong, Li Hailong, et al. Chinese expert consensus on multidisciplinary decision-making model for malnutrition in the elderly (2023)[J]. Chinese Journal of Clinical Health Care, 2023, 26(4): 433-445.

[8] Nutrition and Metabolic Management Branch of China Medical Health International Exchange Promotion Association; Clinical Nutrition Branch of Chinese Nutrition Society; Diabetes Branch of Chinese Medical Association; Parenteral and Enteral Nutrition Branch of Chinese Medical Association; Nutrition Physician Professional Committee of Chinese Medical Doctor Association. Guidelines for Medical Nutrition Treatment of Overweight/Obesity in China (2021) [J/OL]. Journal of Chinese Medical Frontiers (Electronic Edition), 2021, 13(11): 1-55. DOI:10.12037/YXQY.2021.11-01.

[9] SZCZEŚNIAK KA, OSTASZEWSKI P, FULLER JR JC, et al. Dietary supplementation of β-hydroxy-β-methylbutyrate in animals – a review[J/OL]. Journal of Animal Physiology and Animal Nutrition, 2015, 99(3): 405-417. DOI:10.1111/jpn.12234.

[10] Zhou Zuoxin, Wang Chenglin (eds.). Moderate exercise for the elderly promotes health [M/OL]. Hubei Science and Technology Press, 2017 [2023-10-18]. http://book.ucdrs.superlib.net/views/specific/2929/bookDetail.jsp?dxNumber=000016675268&d=C2C833E4E8309872FE28D23B0DF18706&fenlei=1604060101.

[11] KOSSIONI AE, HAJTO‐BRYK J, MAGGI S, et al. An Expert Opinion from the European College of Gerodontology and the European Geriatric Medicine Society: European Policy Recommendations on Oral Health in Older Adults[J/OL]. Journal of the American Geriatrics Society, 2018, 66(3): 609-613. DOI:10.1111/jgs.15191.

[12] Wei Minqi, Zhou Rena. Health preservation for the elderly in four seasons [M/OL]. Fudan University Press, 2021 [2023-10-18]. http://book.ucdrs.superlib.net/views/specific/2929/bookDetail.jsp?dxNumber=000019330662&d=B823840C2FA4F177E54396084E8CE98E&fenlei=16050302.

[13] Jiang Yugang, Huang Chengyu, Huang Guowei, et al. Expert consensus on nutrition for maintaining cognitive function in the elderly [J/OL]. Acta Nutrimenta Sinica, 2022, 44(6): 523-529. DOI:10.13325/j.cnki.acta.nutr.sin.2022.06.015.

[14] Chinese Nutrition Society. Dietary Reference Intakes of Nutrients for Chinese Residents (2013 Edition) [M/OL]. Science Press, 2014 [2023-10-16]. https://book.douban.com/subject/26813060/.

[15] DK Publishing, UK. Stress Psychology [M/OL]. Publishing House of Electronics Industry, 2019 [2023-09-24]. https://book.douban.com/subject/34441929/.

Author: Zhao Yanchang, a popular science author

Editor: Guru