What is holistic health management for the elderly

To put it simply, it breaks away from the traditional elderly health service idea of "only focusing on disease indicators" and puts the elderly individual as the core, covering the four core dimensions of physical health, mental state, social function, and living environment. The personalized health support plan ultimately pursues not "disease-free", but to allow the elderly to maintain their ability to live independently as much as possible and have a higher quality of life.

I have worked as a health manager at a street elderly care service station for 5 years. When I first came into contact with this concept, I thought it was an empty slogan. It was not until I handled Grandpa Chen’s case last year that I really understood its actual value. 76-year-old Grandpa Chen has a history of COPD and diabetes. In the past, his family doctor would keep an eye on his blood sugar and blood oxygen levels during every follow-up visit. After adjusting the medicine for several rounds, the values ​​still fluctuated up and down. He himself would always sigh, saying that life was meaningless. Later, when we conducted a comprehensive health assessment on him, we found out the root cause: He used to go to the park to play croquet with his old friend every day, and he didn't dare to go out after falling once last year. His children all work out of town, and he doesn't even have anyone to talk to. He always makes do with what he eats, and eats soda crackers when he's hungry. How can his blood sugar be stable? We didn't rush to use the medication plan. We first contacted the community's aging-friendly renovation team to install handrails in front of his house and in the bathroom. We also asked our croquet teammates who lived in the same community to ask him to go for a walk in the park every week to bask in the sun.

But to be honest, not everyone agrees with this model now, and there is considerable controversy within the industry. Many colleagues in primary medical institutions feel that family doctors in the community now have to take care of thousands of elderly people. If they can complete chronic disease follow-up on time and control the basic indicators of key groups, they are already overloaded. They also need to understand each elderly person's family situation, psychological state, and social needs. They are simply too busy, and it is easy to neglect the most basic medical services. However, most of us who provide long-term elderly care services believe that the health problems of the elderly are never isolated. For example, high blood pressure in elderly people living alone is often linked to long-term loneliness. Elderly people with degenerative arthritis are not effective even if they take medicine on time because they dare not move because there are no handrails at home. The more muscles atrophy, the heavier the burden on the joints. Focusing only on indicators is essentially "treating the symptoms but not the root cause."

To use an analogy, the difference between the two is a bit like the decoration of an old house. In the past, health management was a patchwork repair of repairing missing parts and replacing broken ones. Whole-person management involves an overall inspection first, and the water, electricity, walls, lighting, and living activities are all adjusted to the most suitable state for the elderly. The core is not whether the house itself is "standard" enough, but whether the people who live there are comfortable enough. Now many places are also exploring compromise implementation methods, such as giving priority to whole-person management for key elderly people who are very old, living alone, and disabled, while ordinary healthy elderly people will first focus on basic chronic disease prevention and control, and then gradually expand it. This can be considered as finding the pace of advancement that is most suitable for our national conditions.