Elderly health education

The essence of health education for the elderly is not to “transmit correct medical knowledge” at all, but to base it on the physiological characteristics, living habits and even social circles of the elderly, and provide them with content that they can “understand, trust and use” - this is more effective than hiring many experts, holding many activities, and printing promotional materials.

There are actually two voices in the industry that have been arguing for a long time. One is the "strict school", which believes that there is no room for vagueness in health knowledge and that medical guidelines must be strictly followed. For example, the WHO recommends that the daily salt intake should not exceed 5 grams. It must be accurate to the gram. To say too much is to mislead the elderly.； The other school is the "practical school". They think that most elderly people don't have food scales in their homes. If you say 5 grams, they have no idea at all. It is better to just say "the amount of a beer bottle cap smoothed". Even if the error is 1 or 2 grams, it is much better than the previous meal of pickles. There is no need to worry about accuracy.

Don’t tell me, I have personally seen the results of these two viewpoints. In the first half of last year, our community invited the deputy director of the nutrition department of a provincial tertiary hospital to give a lecture. He was very well prepared. The PPT was full of the latest research data, nutritional composition tables of various foods, and even the fat loss of different cooking methods. He was also very rigorous when talking, and every point of view was marked with references. As a result, after the 40-minute lecture, there were more than 30 elderly people in the lecture. Seven of them left with their vegetable baskets in the middle of the lecture. The remaining half were napping. At the end of the question-and-answer session, not a single person raised their hand. Two months later, we transferred to Nurse Zhang, who had worked in a community hospital for almost 20 years. She didn’t bring any PPTs with her, so she went up with a cloth bag she usually used to buy vegetables. She took out pork belly, pickled radish, corn, and eggs and set up a table. She said, "I know the uncles and aunts here usually don’t like to listen to those docile words. Today I will tell you something real. What are the things you usually eat when cooking, which ones are not good for eating in excess, and how can you change them to be healthier." When talking about salt control, she took out a beer bottle cap and said, "That's it. It's enough for one day. If you have an elderly person with high blood pressure in your family, just add one third less. You don't need to buy a scale. It's almost the right amount." When talking about sugar control, she gave the example of Uncle Li who often comes to the community to play cards: "Uncle Li, the bowl of sugar-sweetened rice-treasure porridge that you drink every morning raises your blood sugar faster than if you eat two bowls of white rice. Your fasting blood sugar was 7.2 last time. Don't drink it every day." After the lecture, the old man gathered around her and asked her questions for almost an hour. The next day, several aunts came over to tell me that they had dumped half a jar of pickled radishes when they got home.

Who do you think is right and who is wrong among these two views? In fact, it all makes sense. If you are dealing with an elderly person who has been diagnosed with diabetes and needs insulin injections, then you must be rigorous. When you say "inject half an hour before meals", you cannot say "inject before and after meals." You cannot be vague when you say "12 units at a time." At this time, accuracy is directly related to the life safety of the elderly, and you cannot be wrong in the slightest. But if you are giving universal education to the elderly who have no serious health problems but have poor eating habits, there is really no need to be so strict with your words. Otherwise, the elderly will give up as soon as they hear "I can't be so precise at all", which will be of no use at all.

Another very interesting point is that many people think that health education for the elderly must be delivered by professionals in white coats to be effective, but this is not necessarily true. There used to be an Uncle Wang in our community who had been diabetic for 5 years. He was deceived by a health product seller and spent more than 20,000 yuan on capsules that were said to "can cure diabetes." We tried to persuade him three times to no avail, saying that we "didn't want him to get better, but just wanted him to keep taking medicine and spending money." Later, we talked to Uncle Li, who plays chess with him every day. He is also a diabetic himself. He has been taking insulin for 6 years, and now he can still climb mountains in the suburbs every day. He said to Uncle Wang, "I have bought capsules exactly like yours before. After taking it for half a month, my blood sugar spiked to 18, and I almost ended up in the ICU. If you don't want to suffer like me, stop it immediately." As a result, Uncle Wang threw away all the remaining health products the next day. Now he is taking medicine according to the doctor's instructions at the community hospital, and his blood sugar is very stable. You see, the "health experience" in a circle of acquaintances is sometimes more effective than ten words from professionals. Now when we do missionary work, we will first cultivate a few "health leaders" who are in good health and have high prestige among the elderly. We first explain the knowledge to them thoroughly, and then let them tell their old friends around them. The effect is multiplied several times.

We used to make promotional materials. At first, we printed brochures on coated paper with small words and complicated pictures. Later, we found that they were either taken home by the elderly to put on the table, or simply thrown away. The elderly with poor eyesight could not see the words on them clearly, and the elderly who could not read were even more useless after taking them. Later, we changed it and made cards with large fonts. Each card talked about a knowledge point, such as "Don't stop taking antihypertensive drugs at will" and "Don't drink alcohol while taking cephalosporins." The characters were larger than size 1, and the elderly could carry them in their pockets. Some elderly people don’t know how to use smartphones, so we record the knowledge points into about 1 minute of audio and save them in a small speaker that costs 10 yuan each. You can get it for free at the community door. Now before square dancing every evening, everyone turns on the speakers to listen to 3 small knowledge points. After listening to them more, they will naturally remember them.

In fact, after working in this industry for so long, my biggest feeling is, don’t regard the elderly as “students who need to be corrected”, treat them as your parents, and tell them how you tell your parents to buy less health care products, smoke less, and use less salt in cooking. You don’t need to use fancy forms or use jargon that they don’t understand. They can listen to what you say, believe it, and follow it. This is the best health education for the elderly.