Ukwelashwa Kwengozi Ephakeme Emulondeni Omdala
Umcabango wokwelashwa ungaba ukwesabisa, kodwa kubantu asebekhulile abaye batshela kaningi ukuthi "bangengozini enkulu" yokuhlinzwa, umcabango ungaba owesabekayo. Nakuba kuyiqiniso ukuthi umuntu osekhulile unengozi enkulu yokubhekana nezinkinga ngesikhathi nangemva kokuhlinzwa, lokho akusho ukuthi umuntu kufanele alindele isikhathi esibi nakakhulu noma ngemuva kokuhlinzwa ngoba nje engasekho ebusheni bakhe.
Uma wena noma umuntu omthandayo usukhulile futhi udinga ukuhlinzwa, kunezindaba ezinhle: Ukunakekelwa kwezempilo ngokujwayelekile kwenza umsebenzi ongcono kakhulu wokunakekela asebekhulile, futhi lokho kusho imiphumela engcono emva kokuhlinzwa. Lokhu kusho, kubalulekile ukuqaphela izimpikiswano ezingase zibhekene neziguli ezikhulile kanye nokuthi yini engenziwa ukusiza ukuvimbela izinkinga kule nkathi yobudala.
Ubani Obhekwa Njengabantu Abadala?
Incazelo eqinile yabantu asebekhulile ingumuntu oneminyaka engama-65 ubudala noma ngaphezulu. Le ncazelo idatshiwe, kanti ngenkathi ihlala ilungile, ngalolu suku nangaminyaka kunezingane eziningi ezineminyaka engama-65 ezisebenza ngamarathoni, ukusebenza isikhathi esigcwele, nokujabulela ukuphila ngokugcwele. Kuyafana nabantu ngabanye abaneminyaka engama-70 no-80, futhi kunanini ngaphambili, abantu abaneminyaka engama-90 bahlala ngokuzimela futhi bajabulela ukuphila okusebenzayo. Lo mkhuba kulindeleke ukuthi uqhubeke njengoba abantu beqhubeka bephila isikhathi eside.
Ukuqonda kwethu leli gama asebekhulile lishintshile njengoba impilo ikhulile futhi njengoba abantu behamba kahle futhi bekhuthele kuzo zonke izimpilo zabo.
Kwabanye, umuntu osekhulile ungumdala omdala obuthakathaka, abanye bamane befuna izinwele ezimhlophe, kodwa uma kuziwa ekuhlinzekeni kunomqondo omuhle kumqondo wokuthi uneminyaka endala njengoba uzizwa.
Ama-geriatrics: Yonke i-Specialty of Doctor's?
I-geriatrics yikhethekile yokunakekela abadala abadala nangaphezulu. Njengoba abantu sebeguga, iqiniso elilula ukuthi abahlinzeki abahlinzayo abaphatha abantu abadala, kungakhathaliseki ukuthi bawuphi okukhethekile, bayazikhethela ukunakekela asebekhulile.
Lokhu akusho ukuthi bafuna ukuqeqeshwa okwengeziwe emkhakheni wezokwelapha; ziba ochwepheshe abakhulu ngokuzenzakalelayo njengoba ngaphezu kwengxenye yazo zonke ukuhlinzwa ezenziwa e-United States kwenziwa kubantu abadala abangaphezu kuka-65.
Ngokuqinisekile ezinye izinto ezikhethekile zenza ukuhlinza okungcono kunezinye. Isibonelo, udokotela ohlinzayo wama-orthopedic onguchwepheshe bokufaka esikhundleni esivumelanayo uzobona iziguli ezindala kakhulu kunomhlinzeki ohlinzayo we-plastic onguchwepheshe bokuncuthwa kwebele, kepha jikelele, iziguli eziningi zokuhlinzwa zikhulile kunalokho.
Lokhu kunguquko kuleziguli zesiguli sokuhlinzeka eziye zavumela inqubekela phambili ephawulekayo emgangathweni wokunakekelwa onikeziwe kumdala omdala. Ngokumane nje, uma umuntu enza okuthile, umuntu ongcono uthola lokho, futhi lokhu kufaka izibhedlela ezihlinzekela ukunakekelwa komguli osekhulile.
Isikhathi Sokulandelana Ngokweminyaka Ngokwemvelo
Uma usukhulile ngokweqile, ukungenzi iminyaka yakho kungase kube into enhle. Uma sikhuluma ngobudala, ingqondo nomzimba kaningi akuvumelanisi. Ngokuqinisekile uyazi ukuthi umuntu omusha "owenza ubudala" noma lowo muntu omdala obonakala enamandla amaningi kunabantu abangamashumi amashumi eminyaka.
Isikhathi sokulandelana yiqiniso elilula. Uneminyaka engu-__ ubudala. Iminyaka engokomzimba umzimba wakho uncike kangakanani ekuguleni nasekuphukeni, futhi lokhu kunzima kakhulu ukubala.
Izimoto ziyisibonelo esihle kakhulu sokulandelana kwesikhathi ngokuhambisana nobudala bokuphila. Imoto yakho ineminyaka engu-2 ubudala-lokho kulungile? Kodwa iminyaka "ye-physiologic" yemoto yakho? Lokhu kuncike ekutheni kunamakhilomitha angu-10 000 kuwo noma 200,000 miles, nokuthi zingaki izingozi eziye zaba khona, nokuthi ngabe imoto yakho iphunga njengenja yakho, kungakhathaliseki ukuthi ushintshile amafutha ngokusho kokunconywa komkhiqizi nokuthi indlela yokunyathela ngayo amathayi akho abukeka.
Njengomuntu ocabanga ngokuhlinzwa, omncane isikhathi sokuphila nokulandelana kwesikhathi, kungcono. Lokhu kungenxa yokuthi, zonke izinto zilingana, kuphephile ukuhlinzwa lapho uneminyaka engu-50 kunanini uma uneminyaka engama-90.
Intombazane inamathuba amaningi okuba nempilo kunomuntu oneminyaka ephakathi.
Ukufanekisa umehluko phakathi kwexesha lokulandelana kanye neminyaka yobudala , cabanga ngodadewabo abafana namabili abaneminyaka engama-85 ubudala:
- Omunye akakaze abhema, asebenze ihora elilodwa ngosuku, adle ukudla okunamafutha okuphansi okunomthwalo on salads nezithelo, futhi watholakala ukuthi une-cholesterol ephakeme nomfutho wegazi ophezulu ema-50s kodwa walandela iseluleko sikadokotela futhi washintsha ukudla kwakhe futhi akadingi imithi noma isimo.
- Udadewabo uphambene nalokho: Uphuza iphakethe lagwayi ngosuku, ugweme ukusebenzisa umzimba ngendlela ekhululekile, uthanda ukudla ukudla okusheshayo, inyama, ushizi, nokudla okuthosiwe futhi akadla neze izithelo nemifino. Uthatha imishanguzo yengcindezi ephakeme yegazi, i-cholesterol ephezulu, uye wahlaselwa yinhliziyo, futhi utshelwe ukuthi angadinga ukuthatha imithi yesifo sikashukela esikhathini esizayo esiseduze.
Uma kuziwa ngesikhathi sokulandelana kwezidade lezi zinsuku zihlukene kuphela. Ngokwemvelo, udade # 2 usekhulile kakhulu, umzimba wakhe ugcine ugula kakhulu nezifo nokulimala kunomzimba nodade # 1. Uma bobabili badinga ukufakwa esikhundleni se-hip, ucabanga ukuthi ingabe inengozi engaphansi kwezinkinga ngesikhathi sokuhlinzwa kanye nezinkinga emva kwenqubo?
Ukubikezela Ingozi Yokuhlinzwa Kwabadala
Esikhathini sethu esingenhla, udade # 2 unengozini enkulu kakhulu yezinkinga ngenkathi elulameka kusukela ekuhlinzekeni . Asidingi idijithali yezokwelapha ukuqonda umehluko omkhulu phakathi kwabadade ababili kanye nendlela yabo yokuphila nomlando wezempilo. Eminyakeni yamuva, odokotela bokuhlinza banqume ukuthi badinga indlela engcono yokubikezela ingozi ukuthi iziguli ezindala zibhekana nokuhlinzwa, ngoba ukubuka nje iminyaka yabo akulungile. Babedinga indlela yokunquma ukuthi ubani, ngokuyinhloko, wayengudadewabo # 1 futhi obengumdade # 2, futhi wadala ukuhlola okujwayelekile okumele kusetshenziswe ngaphambi kokuhlinzwa.
Babheka iqembu elikhulu labaguli basebekhulile kanye nemiphumela yabo emva kokuhlinzwa futhi bahlaziya izici zabo siqu ukuze babone ukuthi kungenzeka yini ukuthi ubani ozokwenza kahle futhi obani ababezobhekana nezikhathi zesikhathi ezimbili-inyanga yokuqala yokuphumula ngokushesha ukuhlinzwa nezinyanga ezingu-11 ezalandela.
Lapho bebheka iziguli zokuhlinzwa ezazingama-65 nangaphezulu, zakwazi ukunquma izici eziningi ezasiza ukubikezela ingozi yokufa ngesikhathi sokuhlinzwa .
Izinto eziphindwe kabili ingozi yokufa ngenyanga emva kokuhlinzwa:
- Uneminyaka engu-75 noma ngaphezulu
- Owesilisa: lokhu kuyiqiniso ikakhulukazi ekuhlinzekeni kwenhliziyo eyodwa evulekile
- I-angina enamandla (ubuhlungu besifuba) ngaphambi kokuhlinzwa
Izinto eziphindwe kabili noma eziphindwe kabili ingozi yokufa:
- I-arrhythmias yenhliziyo (ukushaya kwenhliziyo okungavamile)
- Ukukhubazeka kwezinso
- Inhliziyo yephunga yamaphaphu inkulu ngaphezu kwamaminithi angu-97 ngesikhathi sokuhlinzwa
Izinto ezijwayelekile kakhulu kulabo abafa:
- I-Cancer
- Amazinga e-albinini aphansi: lokhu amaprotheni egazini, amazinga aphansi angabonakalisa ukungondleki
- Ukuthembela emisebenzini yokuphila kwansuku zonke : Isiguli esingakwazi ukuzinakekela izidingo zabo ngaphambi kokuhlinzwa kunamandla amakhulu okunakekela izidingo zabo emva kokuhlinzwa, futhi ngokuvamile kutshalwa imali ekugcineni ukuzimela.
- I-Dementia : Ukudideka kunciphisa ikhono lomguli lokwenza izinqumo ezihle kakhulu, ukubamba iqhaza ekuvuselelweni futhi kube yi-cheerleader engcono kakhulu ngesikhathi senqubo yokutakula.
- Delirium : Ngisho neziqephu ezincane zokudideka zingalimaza ukululama
- Isimiso esincane esiphakathi kwengalo: Lokhu kuyisibonakaliso sobuthakathaka, futhi ukuzungeza ingalo emfushane kungase kubonise ukuthi ubuhlungu bomzimba obuphansi, obuncane obuningi (ikakhulukazi besifazane) noma ukungondleki.
- Ukungondleki
Gwema Ukuhlinzwa
Kulula ukusho ukuthi asebekhulile kufanele bagweme ukuhlinzwa, noma bathathe isikhathi sabo balungiselela inqubo yokunciphisa izinkinga zabo, kepha ukuhlinzwa okuningi akuhlelekile futhi kudingekile, futhi akukwazi ukubambezeleka kuze kube phakade. Ukugwema ukuhlinzeka lapho kunokwenzeka ukuthi uthole ukwelashwa okuncane okungenasisindo iseluleko esihle isiguli, kungakhathaliseki ubudala. Lokhu kungase kusho ukuzama imithi, ukwelashwa ngokomzimba, nezinqubo ezincane ezingenayo ngaphambi kokukhetha ukuhlinzwa.
Icala ngalinye lihlukile: Kungenxa yokuthi ukugwema ukuhlinzeka umqondo omuhle akusho ukuthi njalo kungenzeka, noma ukuthi kuyisinqumo esihlakaniphile kunazo zonke. Ingxoxo engagwegwesi nodokotela ohlinzayo encoma ukuthi inqubo ingasiza ukucacisa uma ukuhlinzeka kuyadingeka noma uma ezinye izinyathelo zitholakala.
Ukwelapha Abagugile Ngokufanele
Isiguli esidala sifanele izinga elifanayo lokunakekelwa kanye nokufinyelela okufanayo kolwazi oludingekayo ukwenza izinqumo zezempilo njengeziguli ezincane. Lokhu kusho, okokuqala, okubaluleke kakhulu, ukungenzi izinqumo zokuhlinzwa ngokusekelwe kuphela kwisici esisodwa: isikhathi sokulandelana.
UJohn, oneminyaka engu-85, une-appendicitis. I-Appendicitis ayivamile kubantu asebekhulile, kodwa kwenzeka. Uhluleka ukwelashwa nge-antibiotics e-IV, okuyinto yokuqala yokwelapha esikhundleni sokuhlinzwa kwezinye izibhedlela. I-appendicitis yakhe iba yimbi kakhulu, ubuhlungu obukhulu, kodwa udokotela ohlinzayo uthi akafanele ahlinzwe ngoba unengozi enkulu yokucindezeleka okubulalayo. Lesi simo singenangqondo, kodwa yisibonelo esihle kakhulu sobudala bokuthi abantu asebekhulile bangabhekana naso ohlelweni lwezempilo.
UJohn udinga ukuhlinzwa, kungakhathaliseki ukuthi uneminyaka yobudala, futhi ukuhlinza kuyinkambiso yokulondoloza impilo. Iminyaka kaJohane ayilutho ngalesi sikhathi, ngoba impilo yakhe incike enkambisweni. Ukuphila kukaJohane kuyodluliselwa ngokuba nenqubo, futhi kufinyelele ngokuphawulekayo ngaphandle kwayo. Isidingo esifanayo sokuhlinzwa sivame ukutholakala kulabo abadinga ukuhlinza inhliziyo, ukuhlinzeka ngamathambo okuzokwenza kube nesineke ukuqhubeka nokuhamba, nezinye izinqubo ezibalulekile futhi ezidingekayo.
Isikhathi sokulinganisa singumkhakha owodwa we-puzzle, njengezinga lomuntu ngamunye weengozi yokucindezeleka okunzima noma ukufa ngemva kokuhlinzwa, izinzuzo zokuba nenqubo, kanye nekhono lesiguli lokuphola ngokugcwele ngemva kwenqubo.
Ukulungiselela Ukuhlinzwa Uma Kunokwenzeka
Umuntu omdala omdala, ngaphezu kwanoma iyiphi enye inhlangano yobudala, uzuzisa kakhulu ngokuthatha isikhathi sokuthi "ahlabele" impilo yakhe ngaphambi kokuhlinzwa. Lokhu kusho ukuthuthukisa impilo yesiguli ngezindlela ezincane nezinkulu ngaphambi kokuhlinzwa.
Indlela impilo yesiguli ihlelwe kahle ngayohluka phakathi kwabantu. Kungase kusho ukuthuthukisa izinga lama-glucose egazini kwisiguli sesifo sikashukela , ukuyeka ukubhema kombhebhe wokubhema, nokuthuthukisa izinga le-iron kwisifo sofuba. Lo mzamo wokuthuthukisa impilo, ngisho nangezindlela ezincane, ukhokha kakhulu abantu asebekhulile ngoba babekezelela izinkinga ngemuva kokuhlinzwa ngokungalungile. Ukuvimbela izinkinga kusho ukucindezeleka okungokwenyama emzimbeni ngesikhathi nangemva kokuhlinzwa.
Ukulungiselela Ukubuyiswa Ngemva Kokuhlinzwa
Iziguli ezindala ziningi amathuba okudinga ukuvuselelwa kufaka phakathi ukwelapha ngokomzimba , noma ngisho nokuhlala endaweni yokuvuselela, kuneziguli ezijwayelekile zokuhlinzwa. Basengozini enkulu yokuphazamiseka kokulala ngenxa yemithi, ubuhlungu kanye nokushintsha kwemvelo, okungaholela ekutheni kube nomthelela ekudilizeni, uhlobo lokudideka ngemva kokuhlinzwa.
Ngokuvamile, isiguli esidala sizoba nesikhathi eside sokutakula kunesiguli esincane, futhi kulindeleke ukuthi sibe nezinkinga eziningi. Ngamafuphi, isiguli esisebekhulile siyodinga ukwesekwa okungaphezulu kunomncinyane, kusukela kokubili abahlinzeki bezempilo abaqeqeshiwe nabanye abantu emibuthanweni yabo emndenini nasemphakathini. Ukubhalisa usizo lwabangani nomndeni ngaphambi kokuhlinzwa kuyosiza ukuqinisekisa ukuthi izidingo zesiguli zihlangene ngemuva kwenqubo.
Lapho ulungiselela ukuhlinzeka, isiguli esidala singase sifune ukucabangela amalungiselelo okuzodingeka emva kokuhlinzwa. Isibonelo, uma udokotela ohlinzayo ebonisa ukuhlala endaweni yokuvuselela kuyodingeka, isiguli singakhetha indawo abayifunayo ngaphambi kokuhlinzwa, futhi ngisho nokuvakashela uma bekhetha.
Ochwepheshe bayavuma ukugwema lokhu kuhlinzekwa kwama-geriatric
Amabhodi amaningi wezokwelapha, okuyizinhlangano zamagqirha abenza okukhethekileko begodu abasebenzela ikhwalithi engcono kakhulu kulabo abakhethekileko, bacebise ngokuphikisana nokuhlinzwa okwenziwe ngesiguli esiphezuluko se-Alzheimer's disease noma ukuwohloka komqondo okukhulu. Amaqembu amaningi athatha ikhwalithi yokuphila ngaphezu kwenani lokuphila, futhi aphikisana nezinqubo ezingenangqondo futhi ezibuhlungu zabantu abangasazazi. Lokhu ngokuvamile kufaka phakathi izinqubo zokulondoloza impilo nezindlela zokuphila, kodwa zihluka kusukela eqenjini kuya eqenjini.
Isihloko esisodwa esivumelana ngazo yisincoma ngokumelene nezinqubo ezisekela ngokuphila impilo yeziguli ezingasaboni noma ziqondiswe ngenxa yesifo senhliziyo. Lezi zinhlangano zisho ukuthi ukungenelela okufana ne- tube yokudla akufanelekile kuleli cala lokunciphisa okunzima kwengqondo. Ukucwaninga kubonisa ukuthi amatholampilo okudla akudingi ukwandisa isikhathi sokuphila kwesiguli, kepha ukwandisa kakhulu ingozi yokudala izilonda ze-decubitus (bedsores).
I-Alzheimer's Association iyavuma ukuthi "ivumelekile ukuvimbela ukudla okunomsoco kanye ne-hydration ephatheka kahle nge-vein noma igastric tube lapho umuntu ophethwe yisifo so-Alzheimer noma ukuwohloka komqondo ekugcineni esho lesi sifo futhi akakwazi ukuthola ukudla noma amanzi umlomo. "
Iziguli eziningi ezizizwa ngokungazi ukuthi zifakwe ku-ventilator noma zibe nethubhu yokudla zigcwalisa umyalelo wokunakekelwa kwezempilo ophakeme , idokhumenti yomthetho echaza ngokucacile izifiso zesiguli, ngaphambi kokuhlinzwa.
Amazwi ambalwa avela
Kuyiqiniso ukuthi asebekhulile kaningi banezinkinga zempilo ezingaphezu kweziguli ezincane, futhi bangase babe nesidingo esikhulu sokuhlinzwa, kodwa futhi babhekana nokuhlaziya okuhambisana nobudala lapho behlolwe ngezidingo zabo zezokwelapha nezihlinzekwayo. Ubudala buyingxenye eyodwa kuphela yokuhlola ingozi yesiguli yenkambiso, futhi akufanele kube yinto eyodwa kuphela ebonisa ukuthi ukuhlinzwa kwenziwa noma cha. Yebo, iminyaka ibalulekile, kodwa impilo yonke, izinga lomsebenzi, ubunzima bezifo ezitholakalayo nezinye izici eziningi kumele kucatshangelwe kanjalo.
> Imithombo:
> Ukusizwa ngomlomo nokuxhaswa kwe-tube. I-Alzheimer's Association. http://www.alz.org/documents_custom/statements/assisted_oral_tube_feeding.pdf .
> Naughton C, Feneck RO, Roxburgh J, Ukubikezela kokuqala nokuphelelwa yisikhathi kokushona ngemuva kokusebenzisa i-pump-coronary artery ngokuphenya ngokuqanjwa kwabasebenzi asebekhulile uma kuqhathaniswa nenani elincane. http://ejcts.oxfordjournals.org/content/36/4/621.long. 2009.
> Filardo, G, et al, Ukufa okungekho isikhathi esifushane kwabesifazane emva komshini wokuphela komzimba owenziwa ngaphandle kokuhlinzwa. Vula Inhliziyo . https://www.ncbi.nlm.nih.gov/pubmed/27042323. NgoMashi 2016
> Kim, SW, ama-Frailty Score amaningi okubikezelwa kwe-Postoperative Mortality Risk. I-JAMA Ukuhlinzwa . 2014.