Ugqirha weNgcipheko ePhakamileyo Umonde omdala
Ingcinga yokuba utyando unokuba yingozi, kodwa kubadala abadala baye baxelelwa ngokuphindaphindiweyo ukuba "bangengozini enkulu" yokuhlinzwa, ingcamango ingaba yinto eyoyikisayo. Nangona kuyi nyaniso ukuba umntu osekhulile unengozi ephezulu yeengxaki ngexesha kunye nangemva kokuhlinzwa, oko akuthethi ukuba umntu kufuneka alindele ixesha elibi kakhulu okanye emva kokuvavanywa nje ngenxa yokuba asemaselula.
Ukuba wena okanye umntu omthandayo uswelekile kwaye udinga ukuhlinzwa, kukho iindaba ezilungileyo: Unonophelo lwempilo ngokubanzi wenza umsebenzi ongcono ngakumbi wokunyamekela abadala, kwaye oko kuthetha iziphumo ezingcono emva kokuhlinzwa. Oku kuthetha, kubalulekile ukuqaphela iingxaki ezinokujamelana nezigulane ezisebekhulile kunye nento enokuyenza ukunceda ukukhusela iingxaki kwili qela leminyaka.
Ngubani Ocingwa Ngumdala?
Inkcazo eqinileyo yabalupheleyo ngumntu oneminyaka engama-65 ubudala okanye ngaphezulu. Le nkcazo ihleliwe, kwaye ngelixa lihlala lichanekile, kule mini kunye neminyaka baninzi abaneminyaka engama-65 ubudala abaqhuba i-marathons, basebenze ixesha elipheleleyo, banandipha ubomi ngokuzeleyo. Kuyafana nabantu ngabanye kuma-70s kunye nama-80, kunye nangaphezulu kunanini ngaphambili, abantu abaneminyaka engama-90 bahlala ngokuzimeleyo kwaye banandipha ubomi obusebenzayo. Olu hlobo lindeleke ukuba luqhubeke njengoko abantu beqhubeka bephila ixesha elide.
Ukujonga kwethu ixesha elikhulile litshintshile njengoko ubomi buye banda kwaye njengoko abantu bafanelekile kwaye baphumelele ubomi babo.
Kwabanye, umntu osekhulile ngumdala omdala okhulile, abanye bajonga nje iinwele ezimhlophe, kodwa xa kuziwa ekuvuthweni kunento efanelekileyo kwimbono yokuba uneminyaka endala njengoko uvakalelwa.
Geriatrics: Yonke i-Specialist's Specialty?
I-Geriatrics yinto ekhethekileyo yokunyamekela abadala abadala nabadala. Njengoko uluntu luguga, inyaniso elula kukuba abagqirha abaphatha abantu abadala, kungakhathaliseki ukuba zizodwa, zixhomekeke kwiinkathalo zabantu abadala.
Oku kungenxa yokuba bafuna ukuqeqeshwa okongeziweyo kwintsimi ye-geriatrics; ukuba ziba ngcaphephe zengcali ngokungagqibekanga njengoko ngaphezu kwesiqingatha sazo zonke iintlobo ezenziwa e-United States zenziwa ngabantu abadala abangaphezu kwama-65.
Ngokuqinisekileyo ezinye izabelo zenza utyando olunzulu kunabanye. Ngokomzekelo, ugqirha ogqithwe ngamathambo ogqithiseleyo ekutshintshelweni ngokubambisana uya kubona izigulane ezide kakhulu kunokuba ugqirha wegulana eplastiki ogqithiseleyo ekunyusweni kwebele, kodwa ngokubanzi, izigulane ezininzi zokuhlinzwa zikhulile kunokuba zingekho.
Yile nguqulelo kwimbali yesigulane esisigxina esiye savumela intuthuko ephawulekayo kumgangatho wonyango onikwe umntu omdala. Ngokumane nje, ngaphezulu kokwenza into ethile, umntu olungeleyo ufumana into ethile, kwaye iquka izibhedlele ezinikela ngononophelo okhulile.
Ixesha lexesha lexesha lePhysical Age
Ukuba ungumdala osemthethweni, ukungenzi ibanga lakho kungaba yinto enkulu. Xa sithetha ngobudala, ingqondo kunye nomzimba kaninzi akukho kwisivumelwano. Ngokuqinisekileyo uyazi ukuba umntu omdala "owenza umdala" okanye umntu omdala obonakala enamandla amaninzi kunabantu abangamashumi eminyaka.
Iminyaka yokulandelana yinto elula. Uneminyaka engama -__ ubudala. Iminyaka yobudala yindlela umzimba wakho uncike ngayo ekunxibeni nasekukrazeni, kwaye oku kunzima kakhulu ukubala.
Iimoto zinomzekelo omhle wexesha lokulandelana ngokubhekiselele kwiminyaka yobudala. Imoto yakho ineminyaka engama-2 ubudala-oko kulungile? Kodwa ubudala be-"physiologic" yakho yemoto? Oku kuxhomekeke ekubeni ingaba ngamamayela angama-10 000 kuyo okanye amawaka angama-200,000, kwaye zingaphi izingozi eziye zangena, kwaye ingaba imoto yakho iyabetha njengenja yakho, nokuba ingaba ungatshintshi ioli ngokuya kwinconywa yomenzi, kwaye indlela yokunyathela akho amathayi abukeka.
Njengomntu ocinga ngokuhlinzwa, omncinci wokuphila kunye nokulandelana kweminyaka, ngcono. Kungenxa yokuba, zonke izinto zihlala zilingana, kuphephe ukuhlinzwa xa uneminyaka engama-50 kunokuba uneminyaka engama-90.
Umntwana oseneminyaka engama-10 ubudala uhlala enempilo kunomntu ophakathi.
Ukubonisa umzekelo phakathi kwexesha lokulandelana kunye nobudala bexesha lezinto eziphilayo , cinga ngamadada ofana namawele angama-85 ubudala:
- Omnye akakaze atshise, asebenze ngeyure ngosuku, adla ukutya okunomsoco ophantsi kwi-salads neziqhamo, kwaye wafunyanwa ukuba ene-cholesterol ephakamileyo kunye nokunyuswa kwengcinezelo yegazi kwiminyaka yakhe engama-50 kodwa walandela isiluleko sikagqirha kwaye watshintsha ukutya kwakhe kwaye akaze afune unyango nokuba yintoni imeko.
- Udade wakhe ulwahlukileyo: Utshaya ipakethi ye-cigarettes ngosuku, ugwema ukusebenzisa umzimba kangako, uthanda ukutya ukutya okukhawuleza, inyama, ushizi kunye nokutya okuthosiweyo kwaye ngokungaqhelekanga udle izityalo nemifuno. Uthabatha imishanguzo yengcinezelo yegazi ephakamileyo, i-cholesterol ephezulu, uye wahlaselwa yintliziyo, kwaye uye watshelwa ukuba unokufuna ukuthatha iyeza zesifo sikashukela kusondele.
Xa kuziwa ngexesha lobudala aba dade banemizuzu embalwa kuphela. I-Physiologically, udade # 2 umdala kakhulu, umzimba wakhe ugcine ugula kakhulu kunye nezifo kunye nengozi kunomzimba woodade # 1. Ukuba bobabili badinga ukutshintshwa kwe-hip, ngubani ocinga ukuba uya kuba nengxaki ephantsi yengxaki ngexesha lotyando kunye neengxaki emva kwenkqubo?
Ukubikezela Ingozi Yokuhlinzwa Kwabadala
Kulo mzekelo ungentla, udade # 2 unomngcipheko ophezulu kakhulu weengxaki ngexesha lokubuyiswa kwakhe kwi-operesheni . Asiyidingi isidanga sezokwelapha ukuqonda ukungafani okwenene phakathi koodade bobabini kunye nendlela yabo yokuphila nembali yezempilo. Kwiminyaka yakutshanje, oogqirha banqume ukuba bafuna indlela engcono yokuqikelela ingozi yokuba izigulane ezisebekhulile zijamelana nokuhlinzwa, kuba ukujonga nje iminyaka yabo kwakungekho okufanelekileyo. Bayafuna indlela yokufumanisa ukuba ngubani, ngokuyinene, wayengudade # 1 kwaye ngubani owayengudade # 2, kwaye wadala uVavanyo oluPhezulu lweGeriatric olusetyenziswa phambi kokuhlinzwa.
Bakhangele iqela elikhulu labagulane basebekhulile kunye neziphumo zabo emva kokuhlinzwa kwaye bahlalutya iimpawu zabo ukuze babone ukuba kunokwenzeka yini ukuba ngubani oya kwenza kakuhle kwaye ngubani oza kulwa ngexesha lexesha elimbini-inyanga yokuqala yokuphucula ngokukhawuleza emva koko unyango kunye neenyanga ezili-11 ezalandela.
Xa bejonge izigulane zokuhlinzwa ezazingama-65 nangaphezulu, zazikwazi ukucacisa izinto ezininzi ezanceda ukuqikelela ingozi yokufa ngexesha lotyando .
Izinto eziphindwe kabini umngcipheko wokufa ngenyanga leyo emva kokuhlinzwa:
- Ubeminyaka 75 okanye ngaphezulu
- Ibhinqa: oku kunjalo ngokukodwa kwintsebenzo ethile yokuhlinzwa- intliziyo evulekile
- I-angina enobuhlungu (intlungu yesifuba) phambi kokuhlinzwa
Izinto eziphindwe kabini okanye eziphindwe kabini umngcipheko wokufa:
- I-arrhythmias yenhliziyo (intliziyo engavumelekanga)
- Ukukhubazeka kweengso
- Intliziyo yomphunga ikhuphuka ngaphezu kwemizuzu eyi-97 ngexesha lotyando
Izinto eziqhelekileyo phakathi kwabo bafa:
- Cancer
- Amanqanaba e-albin ephantsi: oku kwiprotheni egazini, amanqanaba aphantsi angabonakalisa ukungondleki
- Ukuxhomekeka kwimisebenzi yokuphila kwansuku zonke : Isigulane esinokunyamekela iimfuno zabo phambi kokuba utyando lunegunya elikhulu lokunyamekela iimfuno zabo emva kokuhlinzwa, kwaye ngokubanzi lutyalo-mali ukugcina ukuzimela.
- I-Dementia : Ukudideka kunciphisa amandla okgulisa ukwenza ukhetho oluhle, ukuthatha inxaxheba ekubuyiselweni kunye nokuba yiyona nto ihamba phambili ekuhlaleni.
- I-Delirium : Nangona iziqulana ezimfutshane zokudideka zingalimaza ukubuyiswa
- Umgca omfutshane weengalo eziphakathi: Lo luphawu lobuthathaka, kwaye i-short circumference ingabonakalisa ubunzima be-muscle ephantsi, ibhonasi encinci (ngokuqhelekileyo kubafazi) okanye ukungondleki.
- Ukungondleki
Ukuphepha Ukunyanga
Kulula ukuthetha ukuba abantu abadala kufuneka bagweme ukuhlinzwa, okanye bathathe ixesha labo balungiselela inkqubo yokunciphisa ingozi yabo, kodwa uninzi lwabasebenzi aluqulunqwa kwaye luyimfuneko, kwaye alukwazi ukulibaziseka ngonaphakade. Ukuphepha utyando xa kunokwenzeka ukuba unyango oluncinci luyiluleko elungileyo kwisigulane, kungakhathaliseki ubudala. Oku kunokuthetha ukuzama amayeza, unyango lomzimba, kunye neenkqubo ezincinci ngaphambi kokuba ukhethe ukuhlinzwa.
Icandelo ngalinye liyingqayizivele: Kungenxa yokuba ukuphepha ukuhlinzwa ngumbono olungileyo awuthethi ukuba uhlala unokwenzeka, okanye ukuba ukhetho olukhethekileyo. Ingxoxo ephosakeleyo kunye nodokotela ophandwayo ukucebisa inkqubo inokukunceda ukucacisa ukuba utyando luyimfuneko okanye ngaba ezinye iindlela zonyango ziyafumaneka.
Ukuphatha abantu abadala kakhulu
Isigulane esipheleleyo sifanele umgangatho ofanayo wokunakekelwa kunye nokufikelela okufanayo nolwazi olufunekayo ukwenza izigqibo zonyango njengezigulane ezincinci. Oko kuthetha ukuba, okokuqala, ingakumbi ukwenza izigqibo zokuhlinzwa ngokusekelwe kwinto enye: ixesha lokulandelana.
UJohn, oneminyaka engu-85, unomsebenzi wesicelo. I-appendicitis ayiyithandabuze kubantu abadala, kodwa kwenzeka. Uhluleka unyango kunye ne-IV antibiotics, eyona ndlela yokuqala unyango endaweni yokuhlinzwa kwezinye izibhedlele. I-appendicitis yakhe iya kuba nzima, inentlungu, kodwa ugqirha uthi akufanele abe notyando ngenxa yokuba unobungozi obukhulu beengxaki zokufa. Lo mzekelo ungenangqondo, kodwa umzekelo obalaseleyo wobudala obunokuthi abantu abadala bajongane nabo kwinkqubo yokunakekelwa kwezempilo.
UJohn ufuna ukuhlinzwa, kungakhathaliseki ubudala, kwaye utyando luyinkqubo yokugcina ubomi. Ubudala bukaJohane abuyikubaluleka kweli nqanaba, kuba ubomi bakhe buxhomekeke kwinkqubo. Ubomi bukaYohane buya kwandiswa ngokuba nenkqubo, kwaye lufutshane ngokukhawuleza ngaphandle kwayo. Imfuno efanayo yokuhlinzwa ihlala ikhona kulabo bafuna ukuhlinzwa kwentliziyo, ukuhlinzwa kwamathambo okuya kwenza ukuba isigulane siqhubeke sihamba, kunye nezinye iinkqubo ezinzulu neziyimfuneko.
Iminyaka yokulandelana yinto enye yepuzzles, njengokuba isigulane somntu ngamnye somngcipheko weengxaki ezinzulu okanye ukufa emva kokuhlinzwa, inzuzo yokuba nenkqubo, kunye nokukwazi isiguli ukuphucula ngokupheleleyo emva kwenkqubo.
Ukulungiselela Ukuhlinzwa Ngendlela Xa Kunokwenzeka
Umdala omdala, ngaphezu kweyiphi na ibini leminyaka, uzuza kakhulu ngokuthatha ixesha lokuba "uhlalutye" kwimpilo ngaphambi kokuhlinzwa. Oku kuthetha ukuphucula impilo yesigulane kwiindlela ezincinci kunye ezinkulu ngaphambi kokuhlinzwa.
Indlela impilo yesigulane isilungele ngayo phakathi kwabantu. Kungathetha ukuphucula ama-glucose egazi kwisigulana sesifo sikashukela , ukuyeka ukutshaya umbhebhe kunye nokuphucula amanqanaba esinyithi kwisigulane sesigulane. Le migudu yokuphucula impilo, kwindlela ezincinci, ihlawulela enkulu kubadala kuba zibekezelela iingxaki emva kokuhlinzwa ngokungafanelekanga. Ukuthintela iingxaki kuthetha ukuxinzezeleka kwengqondo emzimbeni ngexesha kunye nangemva kokuhlinzwa.
Ukulungiselela Ukubuyiswa Emva kokuPiliswa
Izigulane ezindala zifuna ukulungiswa nokuquka unyango , okanye nokuba uhlale kwindawo yokuvuselela, kunokuba ugqirha oqhelekileyo unyango. Basengozini ephezulu yokuphazamiseka kokulala ngenxa yemichiza, intlungu kunye nokutshintsha kwimeko yendalo, leyo leyo ingakwazi ukufaka isandla kwi-delirium, uhlobo lokudideka emva kokuhlinzwa.
Ngokuqhelekileyo, isiguli esipheleleyo siya kuba nexesha elide lokubuyisela ngaphezu kwesigulane esincinci, kwaye kulindeleke ukuba kube neengxaki ezininzi. Ngamafutshane, umgulane okhulileyo uya kufuna inkxaso ngakumbi kuncinci, kubanikezeli bobabini bezonyango kunye nabanye abantu kwintsapho yabo kunye neentlalo zentlalo. Ukubhalisa uncedo lwabahlobo kunye nosapho ngaphambi kokuba unyango luya kunceda ukuqinisekisa ukuba iimfuno zesigulane zidibene emva kwenkqubo.
Xa ulungiselela ukuhlinzwa, isiguli esipheleleyo sinokufuna ukuqwalasela amalungiselelo okuya kuyimfuneko emva kokuhlinzwa. Ngokomzekelo, ukuba ugqirha ubonisa ukuhlala kwindawo yokuvuselela kuya kuba yimfuneko, isigulane sinokukhetha indawo abayifunayo ngaphambi kokuhlinzwa, kwaye banokutyelela ukuba bayakukhetha.
Iingcali ziyavuma ukukhusela le ngonyango
Iibhodi ezininzi zezonyango, eziyiqela lamagqirha asebenza ngokukhethekileyo kunye nokusebenza ekubhekiselele kumgangatho ontle kakhulu kwizinto ezizodwa, ucebise ekusebenziseni utyando kwisigulane esikhulileyo ngesifo esiphezulu se-Alzheimer okanye ukugula komzimba. Uninzi lwamaqela lithatha umgangatho wobomi ngaphezu kobuninzi bokuphila, kunye nokuchasa iinkqubo ezingenangxaki kwaye zihlala zibuhlungu abantu abangabaziyo. Oku kubandakanya ukugcina ubomi kunye neenkqubo zokuphila, kodwa ziyahluka ukusuka kwiqela ukuya kwiqela.
Isihloko esisodwa abavumelana ngazo sisinconywa ngokuchasene nenkqubo eqhubekayo yokuxhasa ubomi kwizigulane ezingasayi kuqwalasela okanye zijoliswe kuko ngenxa yengqondo. La maqela achaza ukuba ukungenelela okufana ne- tube yokutya akufanelekanga kule meko yokuncipha kwengqondo. Uphando lubonisa ukuba izibilini zokutya azidluli ixesha lokuphila kwesigulane, kodwa ukwandisa kakhulu umngcipheko wokwenza izilonda ze-decubitus (i-bedsores).
Umbutho we-Alzheimer's Association uvumelana, uthi "uvumelekile ukuba unqande ukutya kunye ne-hydration ephathiswe ngokugqithiseleyo ngethambo okanye isisu segastric xa umntu one-Alzheimer's disease okanye u-dementia ekupheleni kwezi zifo kwaye akasakwazi ukufumana ukutya okanye amanzi ngomlomo. "
Izigulane ezininzi ezivakalelwa ngamandla malunga nokungabikho kwifenisi okanye ukufumana ityhulo yokutya zigqibelele umyalelo wokunakekelwa kwezempilo , umqulu osemthethweni ochaza ngokucacileyo izifiso zomguli, phambi kokuhlinzwa.
Ambalwa amagama avela
Kuyinyani ukuba abantu abadala basoloko beba neengxaki ezininzi zempilo kunezigulane ezincinci, kwaye banokuba banesidingo esikhulu sokuhlinzwa, kodwa bajongana neengxaki ezixhomekeke kwiminyaka xa bevavanywa kwiimfuno zabo zonyango kunye nezigulane. Ubudala yinto enye kuphela yokuvavanya umngcipheko wesigulane kwinkqubo, kwaye akufanele ibe yinto kuphela ebonisa ukuba utyando lwenziwa okanye cha. Ewe, iminyaka ibalulekile, kodwa impilo yonke, izinga lomsebenzi, ubunzima bezifo ezikhoyo kunye nezinye izinto ezininzi kufuneka ziqwalaselwe ngokunjalo.
> Imithombo:
> Ukuncedisa ukondla ngomlomo kunye nokuxhaswa kwebhubhu. I-Alzheimer's Association. http://www.alz.org/documents_custom/statements/assisted_oral_tube_feeding.pdf .
> Naughton C, uFeneck RO, uRoxburgh J, Ukuqala kwangaphambili kunye nokukhawuleza kwexesha lokufa ngokulandela i-pump-coronary artery ngokugqitywa ngokugqithiswa kwabasebenzi asebekhulile xa kuthelekiswa nabantu abancinci. http://ejcts.oxfordjournals.org/content/36/4/621.long. 2009.
> Filardo, G, et al, Ukunciphisa ixesha elifutshane lokufa kwabasetyhini emva kombhobho olwahlukeneyo we-coronary umthamo wobugcisa obunjenge-graft. Vula Intliziyo . https://www.ncbi.nlm.nih.gov/pubmed/27042323. Matshi 2016
> Kim, SW, i-Multidimensional Frailty Score yeNgqungquthela yokuLawulwa kweMpilo yengozi. JAMA Utyando . 2014.