Opaleshoni ya Kuopsa Kwakukulu Oleza Mtima Okalamba
Lingaliro la kuchitidwa opaleshoni lingakhale loopseza, koma kwa okalamba omwe akhala akuuzidwa mobwerezabwereza kuti "ali pangozi yaikulu" ya opaleshoni, lingaliro lingakhale lowopsya. Ngakhale zili choncho kuti munthu wachikulire ali ndi chiopsezo chachikulu pa nthawi ya opaleshoni, pambuyo pa opaleshoni, izi sizikutanthauza kuti munthu ayenera kuyembekezera choipa kwambiri pakapita nthawi kapena posachedwa opaleshoni chifukwa chakuti sali aunyamata.
Ngati inu kapena munthu amene mumamukonda ali wokalamba komanso akufunikira opaleshoni, pali uthenga wabwino: Thandizo laumoyo makamaka likugwira ntchito yabwino kwambiri yosamalira okalamba, ndipo izi zikutanthauza zotsatira zabwino pambuyo pa opaleshoni. Izi zati, ndikofunikira kudziwa zomwe zingakumane ndi odwala okalamba opaleshoni komanso zomwe zingachitike kuti ateteze mavuto m'zaka zino.
Kodi Amaganiziridwa Kuti Ndi Okalamba?
Kutanthauzira kovuta kwa okalamba ndi munthu amene ali ndi zaka 65 kapena kuposerapo. Tsatanetsataneyi ndiyiyi, ndipo ikadali yolondola, lero ndi zaka zambiri ali ndi zaka 65 zomwe zikuyenda marathons, kugwira ntchito nthawi zonse, ndi kusangalala ndi moyo mokwanira. N'chimodzimodzinso ndi anthu omwe ali ndi zaka za m'ma 70 ndi makumi asanu ndi awiri, ndipo kuposa kale lonse, anthu omwe ali ndi zaka makumi asanu ndi atatu (90) amakhala ndi moyo wokhazikika komanso akusangalala. Izi zimayembekezeredwa kupitilira pamene anthu akupitiriza kukhala ndi moyo wautali.
Maganizo athu okalamba asintha pamene moyo umakula komanso pamene anthu ali okhutira komanso ogwira ntchito m'miyoyo yawo yonse.
Kwa ena, munthu wachikulire ndi wokalamba wamkulu, ena amangoyang'ana tsitsi loyera, koma pankhani ya opaleshoni pali zowonjezereka ku lingaliro lakuti ndinu okalamba momwe mumamvera.
Zovuta: Zochita Zonse za Opaleshoni?
Geriatrics ndipadera yosamalira akuluakulu 65 kapena kuposerapo. Pamene anthu akukalamba, chodziwikiratu ndi chakuti madokotala ochita opaleshoni omwe amachiza anthu akuluakulu, mosasamala kanthu zapadera, amatha kusamalira okalamba.
Izi siziri chifukwa chakuti akuphunzira maphunziro owonjezereka m'maganizo; iwo akukhala akatswiri okhwima mwachisawawa posakhalitsa pamene opitirira theka la opaleshoni yonse yochitidwa ku United States akuchitidwa pa anthu akuluakulu oposa 65.
Ndithudi ena apadera amachita opaleshoni yowonjezera kuposa ena. Mwachitsanzo, dokotala wa opaleshoni wamaphunziro omwe amadziwika kuti amalowa m'malo mwake amatha kuona odwala okalamba kwambiri kuposa ochipatala opanga pulasitiki omwe amadziwika bwino kwambiri, koma ambiri, opaleshoni ambiri okalamba amakhala okalamba kuposa ayi.
Ichi ndi kusintha kwa odwala opaleshoni omwe athandiza kupita patsogolo kwakukulu kwa chisamaliro cha akuluakulu. Kwenikweni, wochuluka amachitapo kanthu, wabwino amapeza pa chinthucho, ndipo izi zimaphatikizapo zipatala kusamalira wodwalayo okalamba.
Zochitika Zakale Zakale vs. Zochitika Zakale
Ngati muli okalamba, osati kuchita zaka zanu mukhoza kukhala chinthu chodabwitsa. Tikamayankhula za msinkhu, malingaliro ndi thupi nthawi zambiri sizolumikizana. Ndithudi mumadziwa kuti mnyamata yemwe "amachita zinthu zakale" kapena munthu wachikulire yemwe akuwoneka kuti ali ndi mphamvu zambiri kuposa anthu zaka makumi ang'ono.
Zolemba zakale ndi mfundo yosavuta. Ndili ndi zaka __. Matenda a thupi ndi thupi lanu lakale lomwe limakhalapo chifukwa cha kuvuta, ndipo izi ndi zovuta kuziwerengera.
Magalimoto ndi chitsanzo chabwino kwambiri cha zaka zofanana ndi zaka zam'thupi. Galimoto yanu ili ndi zaka ziwiri-izo nzabwino? Koma zaka za "physiologic" za galimoto yanu? Izi zimadalira ngati uli ndi mailosi zikwi khumi kapena 200,000, ndipo ndi ngozi zingati zomwe zakhalapo, komanso ngati galimoto yanu imamva ngati galu wanu, kaya simusintha mafuta molingana ndi malingaliro a wopanga, komanso momwe mukuyendera matayala anu amawoneka.
Monga munthu amene akuganiza za opaleshoni, wamng'ono ndi wam'thupi ndi nthawi yake, amakhala bwino. Izi ndichifukwa chakuti, zinthu zonse zatsala zofanana, ndizotheka opaleshoni pamene muli 50 kusiyana ndi pamene muli ndi zaka 90.
Wachinyamata amakhala wathanzi kusiyana ndi wina wazaka zapakati.
Kuti tifotokoze kusiyana pakati pa zaka zam'badwo ndi zaka zakuthupi , taganizirani za alongo omwe ali ndi zaka 85:
- Wina sanasute fodya, amachita masewera olimbitsa thupi kwa ola limodzi pa tsiku, amadya chakudya chochepa cha mafuta cholemera pa saladi ndi zipatso, ndipo amapezeka ndi mkulu wa cholesterol komanso kuthamanga kwa magazi m'zaka za m'ma 50 koma adatsatira malangizo a dokotala ndikusintha zakudya zake kaya chikhalidwe.
- Mchemwali wake ndi wotsutsana: Amasuta paketi ya fodya tsiku lililonse, amapewa kuchita masewera olimbitsa thupi, amakonda kudya chakudya, nyama, tchizi, ndi zakudya zokazinga ndipo nthawi zambiri amadya zipatso ndi ndiwo zamasamba. Amatenga mankhwala a kuthamanga kwa magazi, cholesterol chokwanira, akudwala matenda a mtima, ndipo auzidwa kuti angafunikire kumwa mankhwala a shuga posachedwapa.
Pankhani ya nthawi zakale alongowa ndi mphindi zochepa zokha. Mwachibadwa, mlongo # 2 ndi wamkulu kwambiri, thupi lake lakhala likudwala kwambiri ndi matenda ndi kuvulaza kuposa thupi la mlongo # 1. Ngati onse awiri amafunika kukhala ndi chiuno, kodi mukuganiza kuti ndi ndani omwe angakhale ndi mavuto ochepa panthawi ya opaleshoni ndi zovuta pambuyo pochitika?
Kulosera Kuopsa kwa Opaleshoni Okalamba
Mu chitsanzo chathu pamwambapa, mlongo # 2 ali ndi chiopsezo chachikulu kwambiri cha mavuto pamene akuchira kuchokera ku opaleshoni . Sitikusowa digiri ya zamankhwala kuti timvetse kusiyana kwakukulu pakati pa alongo awiri ndi moyo wawo ndi mbiri ya umoyo. Zaka zaposachedwapa, madokotala ochita opaleshoni anaganiza kuti akufunikira njira yabwino yodziwiritsira ngozi zomwe okalamba akukumana nazo pakuchita opaleshoni, chifukwa kuyang'ana pa msinkhu wawo sikunali kokwanira. Iwo ankafuna njira yodziwira yemwe kwenikweni, anali mlongo # 1 ndi yemwe anali mlongo # 2, ndipo anapanga Kuyeza Kwambiri kwa Geriatric kuti agwiritsidwe ntchito musanachitike opaleshoni.
Iwo anayang'ana pa gulu lalikulu la odwala okalamba opaleshoni ndi opaleshoni yawo pambuyo pa opaleshoni ndipo anafufuza maonekedwe awo kuti awone ngati n'zotheka kudziwiratu yemwe adzachita bwino ndi amene adzavutike nthawi ziwiri-mwezi woyamba wochira mwamsanga opaleshoni ndi miyezi 11 yotsatira.
Pamene ankayang'ana odwala opaleshoni omwe anali ndi zaka 65 kapena kuposerapo, adatha kudziwa zinthu zingapo zomwe zinathandiza kuti adziŵe chiopsezo cha imfa panthawi ya opaleshoni .
Zinthu zomwe zinapangitsa kuti anthu azifa mosavuta mwezi umenewo atatha opaleshoni:
- Zaka 75 kapena kuposa
- Mkazi: izi ndizoona makamaka pa chipatala chapadera chotseguka
- Angina woopsa (kupweteka pachifuwa) asanachite opaleshoni
Zochitika zomwe katatu kapena katatu pangozi ya imfa:
- Mtima arrhythmias (chizolowezi chosagwirizana ndi mtima)
- Kuwonongeka kwa impso
- Mtima wamapapo umayenda mopitirira mphindi 97 pa opaleshoni
Zinthu zomwe zinali zofala kwambiri pakati pa anthu amene anamwalira:
- Khansa
- Mawerengero otsika a albumin: izi ndi mapuloteni m'magazi, mawere otsika angakhale chizindikiro cha kusowa kwa zakudya
- Kudzidalira pa zochitika za tsiku ndi tsiku : Wodwala amene angasamalire zosowa zawo asanachite opaleshoni ali ndi mphamvu zowonjezera zosamalira zosowa zawo pambuyo pa opaleshoni, ndipo kaŵirikaŵiri amapatsidwa ndalama kuti azikhala ndi ufulu.
- Dementia : Kusokonezeka kumachepetsa mphamvu ya wodwala yopanga chisankho chabwino, kutenga nawo mbali pa kukonzanso ndikukhala wokondweretsa kwambiri pa nthawi yomwe amachira.
- Delirium : Ngakhalenso nthawi zochepa zosokoneza zingalepheretse kuchira
- Kachifupi pakati pa mkono wonyamulira: Ichi ndi chizindikiro cha kufooka, ndipo chifupi chaching'ono chikhoza kukhala chizindikiro cha minofu yaing'ono, yabwino (makamaka amayi) kapena kusowa kwa zakudya.
- Kusadya zakudya m'thupi
Kupewa Opaleshoni
N'zosavuta kunena kuti achikulire ayenera kupeŵa opaleshoni, kapena atenge nthawi yawo kukonzekera njira yochepetsera zoopsa zawo, koma opaleshoni zambiri sizinakonzedwe ndi zofunikira, ndipo sizingachedwe kosatha. Kupewa opaleshoni ngati n'zotheka kukhala ndi chithandizo chochepa kwambiri ndi malangizo abwino kwa wodwala, mosasamala za msinkhu. Izi zikhoza kutanthawuza kumwa mankhwala, mankhwala opatsirana, ndi njira zochepetsera zochepa musanasankhe opaleshoni.
Mlandu uliwonse ndi wapadera: Chifukwa chakuti kupeŵa opaleshoni ndizobwino sizitanthauza kuti nthawizonse n'zotheka, kapena kuti ndi nzeru kwambiri. Kulankhulana momveka bwino ndi dokotalayo akuvomereza kuti ndondomekoyi ingathandize kuwunikira ngati opaleshoni ndi yofunika kwambiri kapena ngati mankhwala ena alipo.
Kuchitira Okalamba Mwachilungamo
Wodwala wamkulu akuyeneranso kusamalidwa komweko komanso kupeza komweko kuti mudziwe zambiri zomwe zimafunika kuti asankhe odwala ngati odwala. Izi zikutanthauza, choyamba, osasankha kupanga opaleshoni pogwiritsa ntchito chinthu chimodzi: zaka zowerengera.
John, 85, ali ndi appendicitis. Kuwonjezera apo ndizosowa okalamba, koma zimachitika. Amalephera kulandira mankhwala ndi ma antibiotic a IV, yomwe ndi njira yoyamba yopaleshoni m'malo mwa opaleshoni kuchipatala china. Chizindikiro chake chikuwonjezereka, ali ndi ululu wambiri, koma dokotalayo akuti sakuyenera kuchitidwa opaleshoni chifukwa ali pangozi yaikulu ya mavuto oopsa. Chochitika ichi ndichabechabe, koma ndi chitsanzo chabwino kwambiri cha ukalamba umene okalamba angakumane nawo mu dongosolo lachipatala.
John amafunika opaleshoni, mosasamala kanthu za msinkhu wake, ndipo opaleshoniyo ndi njira yopulumutsa moyo. M'badwo wa Yohane suli wofunikira pa nthawi ino, chifukwa moyo wake umadalira njirayi. Moyo wa John udzawonjezeredwa pokhala ndi ndondomekoyi, ndi kufupikitsa mopanda pake. Chofunikira chomwecho cha opaleshoni kaŵirikaŵiri chimapezeka kwa iwo amene amafunikira opaleshoni ya mtima, opaleshoni ya mitsempha yomwe ingathandize kuleza mtima kuti apitirize kuyenda, ndi njira zina zazikulu ndi zofunika.
Nthaŵi zakale ndi gawo limodzi la phunzilo, monga momwe wodwalayo aliri pangozi yaikulu ya matenda kapena imfa pambuyo pa opaleshoni, ubwino wokhala ndi ndondomeko, ndipo wodwalayo amatha kuchira bwinobwino pambuyo potsatira njirayi.
Kukonzekera Kuchita Opaleshoni Ngati N'zotheka
Wakulirapo wamkulu, oposa zaka zina zonse, amapindula kwambiri podziwa nthawi yake kuti azikhala "wathanzi" thanzi lawo lisanayambe opaleshoni. Izi zikutanthauzira thanzi la wodwalayo m'njira zing'onozing'ono ndi zazikulu asanachitike opaleshoni.
Momwe wodwala wathanzi amayendera bwino amasiyana pakati pa anthu. Zikhoza kutanthawuza kusintha kwa magulu a shuga m'magazi wodwala matenda a shuga , kusuta fodya kwa fodya, komanso kuwonjezera chithandizo chachitsulo m'thupi la odwala matendawa. Khama loti likhale ndi thanzi labwino, ngakhale m'njira zing'onozing'ono, limapereka ndalama zambiri kwa okalamba chifukwa amalekerera mavuto pambuyo pa opaleshoni molakwika. Kupewa mavuto amatanthauza kuchepa kwa thupi panthawi ndi opaleshoni.
Kukonzekera Kubwezeretsa Pambuyo Opaleshoni
Odwala okalamba amakhala osowa kwambiri, kuphatikizapo kuchipatala , kapena kukhala kuchipatala, kusiyana ndi opaleshoni ya odwala ambiri. Iwo ali pachiopsezo chokwanira chakumagona chifukwa cha mankhwala, ululu ndi kusintha kwa chilengedwe, zomwe zikhoza kuchititsa kuti awonongeke, mtundu wa chisokonezo pambuyo pa opaleshoni.
Mwachidziwikire, wodwala wamkuluyo adzakhala ndi nthawi yowonongeka kwambiri kuposa wodwala wamng'ono, ndipo akuyembekeza kukhala ndi mavuto ambiri. Mwachidule, odwala okalamba adzafuna thandizo loposa laling'ono, kuchokera kwa othandizira ogwira ntchito zaumoyo komanso anthu ena m'banja lawo. Kulemba thandizo la anzanu ndi abambo musanachite opaleshoni kumathandiza kutsimikiza kuti zosowa za wodwalayo zimakwaniritsidwa pambuyo pa njirayi.
Pakukonzekera opaleshoni, wodwala wamkuluyo angafunenso kuganizira momwe angakwaniritsire opaleshoniyo. Mwachitsanzo, ngati dokotalayo akuwonetsa kuti azikhala pamalo osungirako zofunikira, wodwala angasankhe malo omwe amamufuna asanachite opaleshoni, komanso ngakhale atasankha.
Akatswiri Amavomereza Kuti Apewe Opaleshoni Yoperekera Geriatric
Mabungwe ambiri a zamankhwala, omwe ali magulu a madokotala omwe amachititsa zofanana zomwezo ndi kuyesetsa kuti apange khalidwe labwino kwambiri muzochita zamtengo wapatali, alangizidwe kuti asachite opaleshoni kwa wodwala wachikulire ali ndi matenda apamwamba a Alzheimer kapena matenda a dementia. Magulu ambiri amatha kukhala ndi umoyo wambiri pazomwe amachitira moyo, ndipo amatsutsa njira zopweteka komanso zowawa kwa anthu omwe sakudziwa okha. Izi zikuphatikizapo kupulumutsa moyo ndi njira zowonjezera moyo, koma zimasiyana kuchokera pagulu kupita ku gulu.
Nkhani imodzi yomwe amavomerezana ndi ndondomeko yotsutsa njira zomwe zimapereka moyo wothandizira odwala omwe sali oyembekezera kapena otsogolera chifukwa cha chifuwa chachikulu chaumtima. Maguluwa akunena kuti zopewera ngati tizilombo toyambitsa matenda sizili zoyenera pankhaniyi. Kafukufuku amasonyeza kuti kudyetsa ma tubes sikungowonjezera moyo wa wodwalayo, koma kumawonjezera kwambiri chiopsezo chawo chopanga zilonda zotchedwa decubitus zilonda (bedsores).
Alzheimer's Association ikuvomereza kuti, "ndizovomerezeka kuti zisavomereze kuti zakudya zowonongeka komanso zopatsa mphamvu zimagwiritsidwe ntchito ndi mitsempha kapena chapamimba pathupi pamene munthu amene ali ndi matenda a Alzheimer's or dementia ali kumapeto a matendawa ndipo sangathe kulandira chakudya kapena madzi mkamwa. "
Odwala ambiri amene amadzimva kuti sagwiritsidwa ntchito pa mpweya wabwino kapena amakhala ndi tizilombo toyambitsa matenda amapanga malangizo apamwamba a zachipatala , chikalata chovomerezeka momveka bwino chokhudzana ndi zofuna za wodwalayo, asanakayambe opaleshoni.
Mawu Ochepa
N'zoona kuti okalamba amakhala ndi thanzi labwino kuposa odwala, ndipo angakhale ndi kusowa kwakukulu kwa opaleshoni, komabe amakumana ndi zofuna zawo zakale akamayesedwa chifukwa cha zofuna zawo zachipatala ndi zopaleshoni. Zaka ndi mbali imodzi yokha ya kuwonetsa chiopsezo cha wodwalayo kuti achite, ndipo sayenera kukhala chokhacho chomwe chimatsimikizira ngati opaleshoni ikuchitika kapena ayi. Inde, zaka ndi zofunika, koma thanzi labwino, mlingo wa ntchito, kuopsa kwa matenda omwe alipo ndi zina zambiri ziyenera kuganiziridwa.
> Zotsatira:
> Kudyetsa mkamwa komanso kugwiritsira ntchito chubu. Alzheimer's Association. http://www.alz.org/documents_custom/statements/assisted_oral_tube_feeding.pdf .
> Naughton C, Ro Feneck, Roxburgh J, Kuyambilira koyambirira ndi kumapeto kwa imfa pambuyo pa kupomberana kwa mapopu kumapiritsira opaleshoni ya okalamba poyerekeza ndi achinyamata. http://ejcts.oxfordjournals.org/content/36/4/621.long. 2009.
> Filardo, G, et al, Kuwonjezera pa kufa kwa kanthaŵi kochepa kwa amayi atatha kuperewera kwapadera pochita upaleshoni. Tsegulani Mtima . https://www.ncbi.nlm.nih.gov/pubmed/27042323. March 2016
> Kim, SW, Zowonjezera Zambiri za Frailty Pulojekiti ya Kupha Mankhwala Opatsirana Pambuyo. Kuchita opaleshoni ya JAMA . 2014.