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    By who you are ยท 14 tips

    Older people at home

    Preventing falls and illness, protecting older relatives from scams, arranging things while they are still clear-headed, and the health of the person who provides long-term care.

    1 Preventing falls and illness

    Don't die early

    After 60, train balance and leg strength, and make the bathroom and stairs at home safer

    Training balance 2 to 3 times a week, tai chi for example, cuts the number of falls among older people by about 23% and the number of people who fall by 15%. Having someone come to assess and modify the home cuts the number of falls by about 20%. Falls are the leading cause of injury death for people over 65 in China, and more than half of them happen at home.

    • Moderate value
    • Evidence A
    • Buys life
    • For: Elderly relative at home, Age 60+
    Emergencies: what to do first

    If an older person falls or someone collapses, crouch down, call to them and call 120 (China's ambulance number); don't rush to pull them up. Walking away from a stranger is also legal in China, but if you stop, don't move them

    This approach is mainly for older people in your own family and people you know. First crouch down and call to them, and check whether they are breathing normally. If they don't respond and aren't breathing normally, start chest compressions as in ยง13.1 (press hard on the chest). If they are breathing normally, still don't pick them up: they may have fallen because of a stroke or a faint first, and forcing them up can make it worse. Ask whether they remember how they fell. If their back or lower back hurts or it looks like a fracture, never move them, and call 120 where they are.

    • High value
    • Evidence B
    • Buys life
    Emergencies: what to do first

    If an older person, two or three weeks to a few months after bumping their head, becomes unsteady on their feet, slow, sleepy or weak on one side, get a head CT

    After an older person bumps their head, blood usually collects only by the third week. The knock is often only a minor bump, and more than half of patients can't say they were ever injured. After surgery for this illness, the recurrence rate can reach 33% and the death rate can reach 32%. If you find an older person suddenly confused, floating when they walk, always wanting to sleep, or with one weak hand, first go back and ask whether they hit their head in the last two or three months, and then get a CT.

    • High value
    • Evidence B
    • Buys life
    • For: Elderly relative at home, Age 60+
    When there are elderly people at home

    If an older person's cataract already affects seeing the way, go to an eye doctor for an assessment and surgery; if both eyes have it, don't delay the second one too long

    For women aged 70 and over, having cataract surgery on the first eye promptly meant about 34% fewer falls in a year, and fewer broke a bone. But the number of people who fell at all did not drop. For the second eye, no clear difference in falls was seen. Among older people who had the surgery, hip fractures within a year were about 16% lower.

    • Moderate value
    • Evidence B
    • Buys life
    • Disputed
    • For: Elderly relative at home, Age 60+
    When there are elderly people at home

    If an older person walks a dog, hold the leash in the palm of the hand and don't wrap it around the hand, keep the leash short, and first train the dog not to lunge forward on the leash

    In the U.S., fractures among people aged 65 and over from falling while walking a dog on a leash were about 1,700 people in 2004 and about 4,400 in 2017, and about 80% were women. The hip was the most common fracture site, and nearly 30% were hospitalized. About three-quarters of hand injuries from dog leashes happened when the leash was wrapped around the hand and the dog yanked. So hold the leash in the palm, keep it short, and train the dog not to lunge.

    • Moderate value
    • Evidence B
    • Buys life
    • For: Elderly relative at home, Age 60+
    Don't die early

    Get the pneumococcal vaccine after 65

    In a trial of 84,500 (8.45ไธ‡) older adults, the 13-valent pneumococcal vaccine blocked about 46% of pneumonia caused by the types it covers, and 75% of the most dangerous invasive infections. But no effect was seen on pneumonia from all causes, so don't expect it to prevent all pneumonia.

    • Moderate value
    • Evidence A
    • Buys life
    • For: Elderly relative at home, Age 60+
    Don't get hurt by the medicine cabinet at home

    If you are 60 or older, have had stomach bleeding, or take blood thinners or steroids, ask a doctor before taking painkillers like ibuprofen

    Painkillers such as ibuprofen, naproxen and aspirin can damage the stomach. In trials at high doses, people taking ibuprofen had about 4 times the risk of stomach bleeding or perforation of those not taking it. People who are older, have had stomach bleeding, take blood thinners or steroids at the same time, or have 3 or more alcoholic drinks a day are at higher risk.

    • Top value
    • Evidence A
    • Buys life

    2 Scams and money

    When there are elderly people at home

    Keep an older person's money in a separate account, and set a rule that large payments need two people to confirm

    People who defraud the elderly often start with small gifts and warm concern to build up trust, and then take a large sum in one go. Scammers also often insist "don't tell anyone." Agree on a rule beforehand: any payment above a certain amount has to be mentioned to a particular person first. That way the family gets to know, and the payment is also delayed a little.

    • High value
    • Evidence B
    • Saves money
    • For: Elderly relative at home, Age 60+
    When there are elderly people at home

    Give an older person a ready line for turning things down: "I have to go home and talk it over with my family"

    Sales pitches and scams depend on pressure in the moment, to make you pay before you have time to think. When people get excited, they believe exaggerated ads more easily, and older people are more easily persuaded than younger ones. Agree on a line with the older person beforehand: "I have to go home and talk it over with my family." They can say it at any time, it gives them a way out on the spot, and they can decide after calming down at home.

    • High value
    • Evidence B
    • Saves money
    • For: Elderly relative at home, Age 60+
    When there are elderly people at home

    Stay away from any "invest for your retirement" scheme that asks an older person to pay first: cards, beds, retirement apartments, travel-retirement and senior products are all the same illegal fund-raising

    Eldercare schemes that ask the older person to pay first and promise a return are all the same fraud: cards, buying beds, buying retirement apartments, travel-retirement, and meetings selling senior products. Under the rules, money lost this way is yours to bear. In one case someone took 136,000,000 yuan (1.36ไบฟ) by supposedly reserving beds in a retirement apartment, and harmed more than 2,100 people.

    • High value
    • Evidence A
    • Saves money
    • For: Elderly relative at home, Age 60+

    3 Arranging ahead

    When there are elderly people at home

    While an older person is still clear-headed, name their future guardian in writing

    While the older person's mind is still clear, spend a few hundred yuan at a notary office to have a written document made that states who will be their guardian in the future. Without this document, once the older person can no longer make decisions, the order set by law applies: first the spouse, then parents and children, then other close relatives. If family members fight over it, the residents' committee (ๅฑ…ๅง”ไผš), the village committee (ๆ‘ๅง”ไผš), the civil affairs department (ๆฐ‘ๆ”ฟ้ƒจ้—จ) or a court appoints one.

    • High value
    • Evidence A
    • Saves money

    4 Long-term care

    When there are elderly people at home

    If someone at home is bedridden for a long time, treat pressure sores as the number one enemy: use a powered air mattress, turn them on a schedule, and check the bony spots every day

    For an older person who already had a pressure sore before hip-fracture surgery, the chance of dying within 30 days is about 20% higher. Switching to a powered air mattress cuts new pressure sores by about 60%. In ICUs, sensor reminders that got patients turned on schedule cut them by about 70%, while lying people face down gave far more pressure sores. Every day, look at the tailbone, heels, hips, shoulders and back, and if you see a red area that doesn't fade when pressed, contact a nurse or doctor the same day.

    • Moderate value
    • Evidence B
    • Buys life
    Living with a disability

    Someone who provides long-term care for a disabled person at home needs someone watching over their own health

    A caregiver breaking down is not being overdramatic. A study in the U.S. followed more than 800 older adults for four years. Among those who cared for a disabled spouse and also reported that they were mentally strained, the risk of death was about 60% higher than for people who did not give care. Caregivers who did not feel strained did not show this rise. So what to watch is not the caregiving itself but the long-term strain.

    • High value
    • Evidence A
    • Buys life
    • Disputed

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