Kuvhiya kweKukuru Kwengozi Yekare Murefu
Pfungwa yekuvhiyiwa inogona kunge iri kutyisidzira, asi kune vakwegura vagara vamboudzwa kuti "vari pangozi" yekuvhiyiwa, pfungwa inogona kunge isina kutyisa. Kunyange zvazvo ichokwadi kuti munhu akwegura ane dambudziko rakakura rematambudziko panguva uye mushure mekuvhiyiwa, izvozvo hazvirevi kuti munhu anofanira kutarisira chakaipisisa panguva kana kuti mushure mekuvhiyiwa nekuda kwekuti vasisiri muhuduku hwavo.
Kana iwe kana mumwe munhu waunoda ari akwegura uye achida kuvhiyiwa, pane mashoko akanaka: Utano hwehutano huri kuita basa rakanaka zvikuru rekutarisira vakwegura, uye izvi zvinoreva zvibereko zviri nani mushure mekuvhiyiwa. Izvozvo zvakati, zvakakosha kuziva nenyaya dzinogona kutarisana nevarwere vakwegura vakwegura pamwe nezvo zvinogona kuitwa kubatsira kudzivirira zvinetso muboka rezera iri.
Ndiani Anofunga Kuti Akwegura?
Iyo tsanangudzo yakasimba yevakwegura ndeye munhu ane makore makumi matanhatu nemashanu kana kupfuura. Iyi tsanangudzo yakanyorwa, uye iyo inoramba yakarurama, muzuva rino nemakore kune vakawanda vane makore makumi matanhatu nemashanu vane marathons, vachishanda nguva yakazara, uye vanonakidzwa noupenyu zvakakwana. Izvozvowo ndezvevanhu vari mumakore makumi manomwe nemakore makumi manomwe, uye kupfuura kupfuura kare, vanhu vane makore makumi mapfumbamwe nemashanu vari kurarama vari voga uye vanofarira upenyu hunoshingaira. Izvi zvinotarisirwa kuti zvienderere mberi sezvo vanhu vachiri kurarama kwenguva refu.
Maonero edu emashoko aya akwegura akashanduka sezvo upenyu huripo huchiwedzera uye sezvo vanhu vari nani zvakakwana mumuviri wavo.
Kune vamwe, munhu akwegura munhu akwegura akwegura, vamwe vanongotarisa vhudzi chena, asi kana zvasvika pakuvhiya kune zvimwe zvakakosha kune pfungwa yokuti iwe wakangokura sezvaunonzwa.
Geriatrics: Specialty's Surgeon's Specialty?
Geriatrics ndiyo inokosha yekutarisira vanhu vakuru 65 nekure. Sezvo vagari voruzhinji vari kukwegura, chokwadi chiri nyore ndechokuti vashandi vanovhiya vanoporesa vanhu vakuru, pasinei nezvinokosha, vari kunyanya kutarisira kune vakwegura.
Izvi hazvirevi kuti ivo vari kutsvaga kudzidziswa kwakawedzerwa mumunda wegeriatrics; ivo vari kuve vashandi vekugadzirisa nekutadza sekupfuura hafu yezvese zvekuvhiya zvakaitwa muUnited States zviri kuitwa kune vanhu vakuru vanopfuura 65.
Zvechokwadi mamwe anokosha anoita upiyona huri nani kupfuura vamwe. Semuenzaniso, chirwere chechiremba chichigadziriswa pakugadziriswa kwekubatana chikaona varwere vakwegura zvikuru kupfuura chiremba wepuropiti wepurasitiki anozivikanwa pakuwedzera kwezamu, asi kazhinji, varwere vakawanda vanorwara vakwegura kupfuura kwete.
Iko kuchinja uku muhutano hwevarwere vane chirwere chakabvumira kufambira mberi kwakanyanya muhutano hwehutano hwakapiwa kuvanhu vakuru. Hazvisi nyore, kana mumwe achiita chimwe chinhu, munhu ari nani anowana pane chimwe chinhu, uye icho chinosanganisira zvipatara zvinotarisira chirwere chekare chirwere.
Chronological Age vs. Physiological Age
Kana iwe unyanzvi hwekukwegura, usingaiti nguva yako ingava chinhu chikuru. Apo patinotaura pamusoro pezera, pfungwa nemuviri hazviwanzoviki. Zvechokwadi unoziva kuti wechiduku "anoita zvekare" kana munhu akwegura uyo anoita seane simba rakawanda kupfuura vanhu makumi emakore vaduku.
Nguva yezviitiko ndeyechokwadi chiri nyore. Iwe une makore __. Nguva yezvinyorwa ndeyekuti muviri wako wakareba zvakadini pakupfeka uye kubvarura, uye izvi zvakaoma zvikuru kuverenga.
Motokari muenzaniso wakanakisisa wekanguva yezvizvarwa zvichienderana nenguva yehupenyu. Imotokari yako imakore maviri-zvakanaka here? Asi "physiologic" makore emotokari yako? Izvo zvinowirirana kana iine makiromita 10 000 pairi kana mazana maviri emakiromita, uye kuti yakawanda sei njodzi dzave dziri mukati, uye kana motokari yako inofuta sembwa yako, kana iwe kana kwete iwe wakashandura mafuta maererano nezvinoitwa nemugadziri, uye kuti zvakatsika sei matairi ako anotarisa.
Semunhu anofungidzira chirwere, muduku muhupenyu uye munguva yezviitiko, zviri nani. Ichi ndechokuti, zvinhu zvose zvakasara zvakaenzana, zvakachengeteka kuti upiwe kana iwe uri makumi mashanu pane apo uri 90.
Mukomana anowanzove ane utano hwakanaka kudarika mumwe munhu ari pakati nepakati.
Kuenzanisira musiyano pakati pezera remakore uye nguva yepanyama , fungidzira zvakafanana nehanzvadzi mbiri dzine makore 85:
- Mumwe haana kumbobvira aputa, achivhidzira kweawa imwe pazuva, anodya zvokudya zvakaderera zvine mafuta zvakanyanya pamashizha nemichero, uye akaongororwa ane high cholesterol uye kukwirira kweropa mumakore ake makumi mashanu asi akatevera zano rechiremba uye akashandura kudya kwake uye haana kumbodikanwa mishonga chero mamiriro.
- Hanzvadzi yake inopesana: Anoputa paki yefodya zuva rimwe nerimwe, anorega kushandisa zvese zvinobvira, anoda kudya kudya kwakakwana, nyama, cheese, uye zvokudya zvakabikwa uye kazhinji haadyi michero nemiriwo. Anotora mishonga yepamusoro yehavha yepamusoro, yakasarudzwa nehotera, yakave nekurwadziwa kwepfungwa, uye yakamboudzwa kuti inogona kutora mushonga wechirwere cheshuga munguva yemberi iri mberi.
Apo zvinosvika panguva yezvakaitika nguva hanzvadzi idzi dziri maminetsi mashoma. Physiologically, hanzvadzi # 2 yakakura zvikuru, muviri wake wakarwara zvikuru uye zvirwere uye zvinokuvadza kupfuura muviri wehanzvadzi # 1. Kana vose vari vaviri vachida kugadziriswa kwechiuno, ndeupi iwe waunofunga kuti uchava nehuwandu hwezvinetso panguva yekuvhiyiwa uye zvinetso pashure pekugadzirisa?
Kufanotaurira Ngozi yeUkuvhiya Muvanhu Vakwegura
Mumuenzaniso wedu wepamusoro, hanzvadzi # 2 ine ngozi yakawanda kwazvo yezvinetso panguva yaanodzoka kubva pakuvhiyiwa . Hatidi chiremba yezvokurapa kuti tinzwisise kusiyana kukuru pakati pehanzvadzi mbiri uye mararamiro avo uye nhoroondo yehutano. Mumakore achangopfuura, vanachiremba vakafunga kuti vaida nzira iri nani yekufanotaura nezvehutano hwekuti vatana vakwegura vanotarisana kana vavhiyiwa, nokuti kungotarisa pazera ravo kwakanga kusina kunaka. Vaida nzira yekuziva kuti ndiani, chaizvoizvo, akanga ari hanzvadzi # 1 uye uyo aiva hanzvadzi # 2, uye akasika Chirongwa Chizere cheGeriatric chishandiswa vasati vavhiyiwa.
Vakatarisa boka guru revarwere vakwegura vakwegura uye zvavakagamuchira mushure mekuvhiyiwa uye vakaongorora maitiro avo ega kuti vaone kana zvaikwanisika kufanotaura kuti ndiani aizoita zvakanaka uye ndiani aizorwisana munguva mbiri-mwedzi wokutanga wekuvandudza pakarepo unotevera kuvhiyiwa uye mwedzi 11 yakatevera.
Apo vakatarisa kuvhiyiwa varwere vaiva nemakore makumi matanhatu nemashanu, vakakwanisa kuziva zvinhu zvakawanda zvakabatsira kufanidzira dambudziko rekufa panguva yekuvhiyiwa .
Zviitiko izvo zvakapeteredzwa mukana wekufa mumwedzi mushure mekuvhiyiwa:
- Zera 75 kana kupfuura
- Mukadzi: izvi zvinonyanya kuitika pane imwe nzira yekuvhiya- yakazaruka mwoyo
- Angina akaremara (kurwadziwa kwepfupa) vasati vavhiyiwa
Zviitiko izvo zvakapetwa katatu kana katatu mukana wekufa:
- Moyo arrhythmias (kusagadzikana kwemwoyo)
- Kuora kwepyiyo
- Mwoyo wemapapu inopfuura kupfuura maminitsi 97 panguva yekuvhiyiwa
Zviitiko zvaive zvakajairika kune avo vakafa:
- Cancer
- Low albumin levels: iyi ipurotini muropa, mazinga akaderera anogona kuva chiratidzo chekushaya zvokudya
- Kuvimba nemabasa ekugara kwezuva nezuva : Murwere anokwanisa kuzvitarisira zvaanoda asati avhiyiwa ane kodzero yakakura yekuchengeta zvavanoda mushure mekuvhiyiwa, uye kazhinji inotengeswa mukuchengetedza rusununguko.
- Dhementia : Kusuruvara kunoderedza kukwanisa kwomurwere kuita sarudzo dzakanakisisa, kubatanidzwa mukugadzirisa uye kuva ivo pachavo vakanakisisa cheerleader munguva yekudzorera.
- Delirium : Kunyange zvikamu zvishomanana zvekuvhiringidzika zvinogona kudzivisa kupora
- Muchidimbu pakati pemaoko kumativi ose: Ichi chiratidzo chekushaya simba, uye rutivi rwakapetwa rutivi runogona kuratidza hutsika hutsika huzhinji, huwandu hunowanikwa (kazhinji mumadzimai) kana kusagadzikana.
- Kusadya zvakakwana
Kudzivisa Kuvhiya
Zviri nyore kutaura kuti vakwegura havafaniri kuvhiyiwa, kana kutora nguva yavo vachigadzira nzira yekuderedza dambudziko ravo, asi kuvhiyiwa kwepamusoro hakugadzirwe uye kwakakosha, uye haigone kunonoka zvachose. Kudzivisa kuvhiyiwa kana zvichikwanisika kuva nehutano husina kuvhiringidza mazano akanaka kumurwere, pasinei nezera. Izvozvo zvinogona kureva kuedza mishonga, kurapwa kwepanyama, uye zvishoma zvisingasviki maitiro asati asarudza kuvhiyiwa.
Nyaya imwe neimwe yakasiyana-siyana: Nemhaka yokuti kudzivisa kuvhiya pfungwa yakanaka haireve kuti nguva dzose inogoneka, kana kuti ndiyo sarudzo yakanakisisa. Kukurukurirana kwakananga nechiremba chiremba kurumbidza nzira yacho inogona kubatsira kujekesa kana chirwere chakakosha zvachose kana kana mamwe marapirwo aripo.
Kubata Vakwegura Zvakanaka
Murwere akare anofanirwa nehutano hwakafanana hwekutarisira uye kufanana kwakadaro kune ruzivo runodiwa kuti uite zvisarudzo zvehutano sevaduku vaduku. Izvozvo zvinoreva, kutanga uye zvakakosha, kwete kuita zvisarudzo zvekuvhiya zvichibva pane chimwe chezvinhu: nguva yenguva.
John, 85, ane appendicitis. Appendicitis haigoneki kune vakwegura, asi zvinoitika. Anokundikana kurapwa nemishonga inonzi IV, iyo ndiyo nzira yokutanga yekurapwa panzvimbo yekuvhiyiwa mune zvimwe zvipatara. Kubwinya kwake kunowedzera kuipa, iye ari kurwadziwa zvikuru, asi chiremba anotaura kuti haafaniri kuvhiyiwa nokuti ari pangozi yepamusoro yezvinetso zvinouraya. Izvi zvinenge zvisina musoro, asi muenzaniso wakanaka kwazvo wekusarudzira izvo vakwegura vangatarisana nazvo mune utano hwehutano.
Johane anoda kuvhiyiwa, pasinei nezera rake, uye kuvhiyiwa inzira inoponesa upenyu. Chizvarwa chaJohane hachibatsiri panguva ino, nokuti hupenyu hwake hunoenderana nezvinoitwa. Upenyu hwaJohane huchawedzerwa nekuve nekugadzirisa, uye hupfupika zvinoshamisa kunze kwahwo. Chimwe chido chekuvhiyiwa chinowanzovapo kune avo vanoda kuvhiyiwa kwemoyo, kuvhiyiwa majoka izvo zvichaita kuti varambe vakagadzirira kufamba, uye mamwe maitiro akaoma uye anodiwa.
Nguva yezvakaitika ndeye chikamu chimwe chepikicha, sezvakaitwa nemurwere wehutano hwehutano hwekushungurudza kwakakomba kana rufu mushure mekuvhiyiwa, zvikomborero zvekugadziriswa, uye kukwanisa kwomurwere kupora zvakakwana mushure mekuita.
Kugadzirira Chirwere Kana Zvichiitika
Mukuru akwegura, anopfuura rimwe boka rimwe nerimwe, anobatsirwa zvikuru nekutora nguva "kumira zvakanaka" hutano hwavo vasati vavhiyiwa. Izvi zvinoreva kuvandudza hutano hwevarwere munzira shoma uye huru pamberi pokuvhiyiwa.
Maitiro ehutano hwomurwere anogadziriswa zvakasiyana pakati pevanhu. Zvinogona kureva kuwedzera kuwedzera kwehutachiropa muhutachiona hwechirwere cheshuga , kusvuta kusvuta kwepombi inopisa, nekuvandudza simbi muhutachiona hwehutachiona. Izvi kuedza kuvandudza hutano, kunyange munzira duku, kuripa huru kune vakwegura nokuti vanotsungirira zvinetso pashure pokuvhiyiwa zvisina kunaka. Kudzivirira zvinetso zvinoreva kuderedza muviri mupfungwa panguva uye shure kwekuvhiyiwa.
Kugadzirira Kuwanazve Pashure Kokuvhiya
Vakuru vakura vanowanzoita kuti vashandise kugadziriswa kusanganisira kurapwa kwemuviri , kana kunyange kugara mune imwe nzvimbo yekugadzirisa, kupfuura chirwere chinowanzovhiyiwa chirwere. Ivo vari pangozi yakakwirira yekuvhiringidza kurara pamusana pemishonga, kurwadziwa uye kuchinja kwakatipoteredza, izvo zvinogonawo kuita kuti pave nerurimi, rudzi rwekuvhiringidzika mushure mekuvhiyiwa.
Muzhinji, murwere akare achava nenguva yakareba yekudzidzira kupfuura murwere muduku, uye anotarisirwa kuva nezvimwe zvinetso. Muchidimbu, chirwere chekare chirwere chinochera chichitsvaga rubatsiro rwakawanda kupfuura rwechidiki, kubva kune vese vadzidzisi vehutano hwehutano uye nevamwe vanhu mumhuri dzavo uye munzanga. Kunyora rubatsiro rwemashamwari nemhuri mushure mekuvhiyiwa kunobatsira kuve nechokwadi chokuti zvinodiwa nemurwere zvinosangana mushure mekuita.
Paunenge uchigadzirira kuvhiyiwa, murwere akare angadawo kufungisisa urongwa huchazodiwa mushure mekuvhiyiwa. Somuenzaniso, kana chiremba chiremba achiratidza kuti kugara muimba yekuvandudza kuchave kwakakodzera, murwere anokwanisa kusarudza nzvimbo yavanosarudza vasati vavhiyiwa, uye kunyange kushanya kana vakasarudza.
Nyanzvi Dzinobvumirana Kuramba Iyi Kuvhima Kwemajoini
Mapurisa akawanda emakirini, ayo mapoka echiremba anoita zvakaenzana zvakafanana uye achishanda kunzvimbo yakanakisisa inogoneka muzvinhu izvi, unorayira kurwisa kuvhiyiwa mutachiona akwegura ane chirwere cheAlzheimer kana chirwere chikuru chekuora mwoyo. Mazhinji mapoka anotora hupenyu hwehupenyu pamusoro pehuwandu hwehupenyu hunoenda, uye vanopesana nemasimba uye zvinowanzotambudza nzira dzevanhu vasingazivi ivo pachavo. Izvi zvinowanzobatanidza kuponesa upenyu uye hupenyu-kuparadzanisa nzira, asi zvinoparadzaniswa kubva kuboka kusvika kuboka.
Imwe nyaya iyo inobvumirana pamusoro payo ndeyekurudzira kunopesana nemitemo iyo inobatsira kutsigira hupenyu kune varwere vasingachagadziri kana kurongeka nekuda kwedhementia. Aya mapoka anotaura kuti kupindira kwakafanana nehuputi hwekudya hahukodzeri munyaya iyi yekuderera kukuru kwekuziva. Kutsvakurudza kunoratidza kuti kudya mabhesi hakuregi kuwedzera kwehupenyu hwehutano hwemazuva, asi zvinoshamisa kuwedzera dambudziko ravo rekuita decubitus ulcers (bedsores).
IAlzheimer's Association inobvumirana, ichitaura kuti "tsika inobvumirwa kusachengetedza kudya uye kushandiswa kwemajini kunogadziriswa nehupfu kana gastric tube apo munhu ane chirwere cheAlzheimer kana kuti chirwere chemangwana chiri kumagumo anotaura nezvechirwere uye haakwanisi kugamuchira zvokudya kana mvura muromo. "
Varwere vakawanda vanofunga zvakasimba kuti havaisi kuiswa muvheti kana kuva nechikwata chokudya vanopedza chirongwa chepamusoro chekuchengetedza utano , gwaro repamutemo rinojekesa zvakajeka zvido zvevarwere, vasati vavhiyiwa.
Mashoko Mashomanana Anobva
Ichokwadi kuti vakwegura vanowanzova nezvinetso zvehutano zvakanyanya kupfuura varwere vaduku, uye vanogona kunge vane chido chakakura chekuvhiyiwa, asi vanotarisana nezera rinosangana nezera pavanenge vachiongororwa nokuda kwezvokurapa uye zvekutsvaga kwavo. Zera inongova chinhu chimwe chete chekuongorora chirwere chemurwere chekuita, uye haifaniri kuva chinhu chimwe chete chinoita kuti chirwere chiitwa kana kwete. Hungu, zera rinokosha, asi hutano huripo, hutano hwehutano, kukwirira kwezvirwere zviripo uye zvimwe zvinhu zvakawanda zvinofanira kufungwawo zvakare.
> Sources:
> Kubatsira kunyorera kudya uye tube feedling. Alzheimer's Association. http://www.alz.org/documents_custom/statements/assisted_oral_tube_feeding.pdf .
> Naughton C, Feneck RO, Roxburgh J, Kufanotangira nekupedzisira kwekupedzisira kwekufa kwekutevera-pamapuroni yemajoini arteria kuburikidza nekuvhiyiwa kwemafuro kune vakwegura kana vachienzaniswa nevechidiki. http://ejcts.oxfordjournals.org/content/36/4/621.long. 2009.
> Filardo, G, et al, Kuwedzera kwekufa kwenguva shomanana kuvakadzi mushure mekuvhara artery yechipfuwa nepass chirurgical surgery. Vhura Mwoyo . https://www.ncbi.nlm.nih.gov/pubmed/27042323. March 2016
> Kim, SW, Multidimensional Frailty Score nokuda kwekufanotaura kwePopoperative Mortality Risk. JAMA Surgery . 2014.