Assisting a family member
Assist the elderlyAssessment of the subject State of functions and assessment scales The elderly frail Patient with stroke Patient with dementia Patient with fracture of the femur Hydration Restraints Means day centers
- Evaluation of the subject
- Function status and evaluation scales
- The frail elder
- Stroke patient
- Patient with dementia
- Patient with femur fracture
- Means of restraint
- Day centers
Evaluation of the subject
Aging causes a slowed down activity of many organs; the inability to defend against diseases translates into an increase in the recovery period, just as the possible sequelae of pathologies determine a peculiar fragility that requires a different perspective in the management of these people. When it is necessary to assist an elderly person it is necessary to know his / her psychophysical state in the best possible way; all this is necessary to understand what its potential is, or rather, what the residual capacities on which to leverage in the treatment of any pathologies may be.
The parable of life foresees inevitable transformations, a child up to seven years of age thinks and thinks in a particular way, growing the thought becomes more concrete, and rational, but when we get older, the organization of ideas and the physical is no longer like that of an adult: the elderly person is not an aged adult person. These changes are clearly identifiable with specific tools called rating scales.
A correct estimate foresees that the data is objectively contemplated and subjectivity is reduced to a minimum, to avoid making a series of errors, which in some cases can be serious. The use of rating scales is an integral part of the multidimensional assessment, that is, of all those tools used to take a precise photograph of the general situation of the elderly. This approach leaves no room for subjective interpretations, or at least it should not, and allows you to drastically decrease errors. The investigation on the degree of autonomy is feasible thanks to a series of relatively simple and absolutely non-invasive analyzes; with these tools, designed to investigate the various areas (dimensions) of life, it is possible to evaluate:
- the status of the functions
- cognitive functions
- the clinical state
- behavior disorders
- the risk of pressure ulcers
- the risk of falls
- the risk of malnutrition
- the risk of incontinence
- the quality of life.
Although the rating scales are used, it is possible that the operator who submits the elderly person to the investigation may make some errors related to their subjectivity, in all cases inaccuracies are very rare if you have a minimum of experience. Regardless of the various surveys, the non-professional operator, that is, the relative or the volunteer who is managing an elderly person at home, must necessarily have some basic notions on aging. Sometimes we tend to forget that age creates a series of metamorphoses that require a different approach. The main changes found in the elderly are summarized in the list below:
- the older person is more fragile than an adult;
- the manifest manifestation of diseases does not occur in the same way as for a young person: a heart attack, for example, can go completely unrecognized or present itself with very nuanced signs, especially in diabetics: stomach pain, mild chest pain;
- the affective dimension is often altered, many times the elderly suffer from depression, the initial (prodromal) symptom of particular neurological diseases;
- all organs undergo changes in their functionality: the skin thins, renal filtration may worsen, the heart may exhibit rhythm or contraction disturbances;
- all stressful circumstances cause diminished resistance and an inability to cope;
- from sixty-five years onwards, the appearance of pathologies and the loss of autonomy increase considerably; there is also an increase in diseases of the heart (cardiovascular), tumors, bones (arthrosis), the nervous system (dementias);
- some chronic diseases can cause damage to different organs, moreover several pathologies are found together (diabetes, heart failure, kidney failure), in this case we speak of comorbidity;
- cognitive functions undergo alterations: difficulty remembering or memorizing;
- reduced mobility tends to cause joint limitations which over time decrease the ability to dress and walk;
- single life (widower) can lead to social isolation and lead to regression.
From all these data it is clear, without a shadow of a doubt, that assistance to the elderly person requires a completely different perspective compared to the care of a young patient and an attitude of availability and understanding.
As relatives or carers of elderly people, it is necessary to understand that one's task must be the promotion of the autonomy of the elderly person and not the replacement of his / her functions. Unfortunately, this goal is not always achievable, especially with people with dementia.
The adoption of the rating scales does not have the task of making the elderly an individual to be broken down into a thousand pieces, but the use of these tools can help to give credit to the uniqueness of the person who can no longer fully manifest himself because some functions are compromised. The evaluation scales, capturing the problems in the right light, offer the possibility to plan the interventions before implementing them and to evaluate them later. Even if the diseases determine a morbid condition with its technical name, the obstacles to be faced with the person are more connected to the management of the most basic physiological functions (evacuating, walking, eating), therefore we need to think about how to live the hours of the day and of the night. It is better to think more in terms of help than in disease per se.
Disorders, when they occur, can create more or less marked disabilities and require a new type of balance, but the caregiver's task remains always the person's support.
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