該如何讓它不是沉重的壓力，而是最甜蜜的負荷？台灣人口老化極為嚴重，根據資料顯示，在世界排名上名列前茅；人口老化不僅對醫療、長照、政府體系來說是一大挑戰，更是下一代人沉重的負擔，根據《今周刊》刊載專訪壢新醫院聯新運動醫學中心主任林頌凱討論老人議題的相關文章，點出老人的不可孤獨性、家人不可避免的負荷。
根據刊載內容指出，一名80歲年邁的陳老爹，在受傷前幾年某日，因清晨外出運動在街旁站立過久，不料肌力不堪支撐突然跌坐在地，摔斷了髖關節，所幸送醫後手術順利。但從此他對行走深有陰霾，如今長期臥床一年多。「這一摔，讓陳老爹身體每況愈下，也讓身為照顧者的家屬疲累不堪。」
壢新醫院聯新運動醫學中心主任林頌凱說，老人相關問題日漸重要，而在社會上也不乏陪伴父母奔波在醫院的心臟科、精神科、泌尿科、骨科、牙科、神經內科、消化科等，工作之餘也得勞心照顧年邁的至親。
據統計，老人常見的問題、疾病相當多，諸如大家耳熟能詳的跌倒、骨質疏鬆、肌少症、腰椎退化、膝關節退化、缺乏運動造成的問題等等，甚至有失智、三高（高血壓、高血脂、高血糖）等等不勝枚舉。
而其中，「最需要注意的是跌倒。」林頌凱醫師說。
他更精闢地解釋，「一個人可能罹患高血壓40年，雖身體狀況不好，但致死率低；相較跌倒、髖部骨折，這兩者致死率就相當高，甚至可高達50%。」尤其老人家常有器官功能退化、骨質疏鬆等問題，林頌凱醫師點出要點，「死因不在骨折，而是摔倒後不能正常行走、或長期臥床，讓後遺症一個個出現，或因感染致死。」
跌倒易致死 一但受傷恐形成兩代負擔
老人家之所以容易跌倒，主因是肌肉力量普遍不足，若再加上行動不便、中風、眼睛不好、失智等問題，這時跌倒的機率就會大幅增加。對此，林頌凱指出，「因此如何避免長輩跌倒，是除了本身要訓練肌肉之外，照顧者與家屬也應特別在旁注意觀察。」
一旦長輩不慎跌倒，動髖關節手術、住院期間及術後恢復期造成的照顧問題，這對父母與子女兩代都會帶來負擔。林頌凱醫師提醒，「根據觀察，有一半以上的長輩是在家裡跌倒，特別是半夜時分。」他補充，長輩容易失眠，半夜常因上廁所、光線昏暗下、神智不那麼清楚，踢到障礙物等原因，導致跌倒。
降低跌倒風險 照顧者可以怎麼做？
林頌凱醫師建議，以老人家的動線來看，務必挪開所有可能導致跌倒的障礙物、保持地面乾燥，並且加裝夜燈或準備手電筒，使光線充足。
此外，如果和長輩同住在一個屋簷下，當發現父母有異常狀況，不妨讓父母換房間住、或是兒女和父母同房住，就近照顧，他也建議不要省聘請看護的錢，由較為親近的人照顧比較理想。
從做自己喜歡的運動開始 這些營養也需補充
以肌力來說，做符合老人的重量訓練、核心肌群鍛鍊，並強化大腿前、後側。「可從老人家喜歡的運動開始，像是健康操、太極導引等等。」林頌凱醫師說，這對於老人家的神經、肌肉都有助益。
林頌凱醫師也提醒，長輩的營養補充也是必要的，在飲食方面注意，攝取維生素D、鈣。「若提升骨質密度，真的跌倒也不容易骨折。」而半年或一年透過打針也能補骨密，是一項不錯的選擇。
還有透過健檢或看診，也能評估了解長輩的健康狀態。特別的是，復健科、運動醫學科醫師通常會透過觀察走路姿勢、詢問生活狀態等方式，得知長者的情況，有效提供家屬或照顧者相關照護建議。
老人問題不可避免，也應積極面對，家中長輩因身體機能退化、疾病或服藥等原因，或外在環境因素，都可能導致跌倒。身為子女可以多一份貼心，降低長輩跌倒風險，並阻止後續可能帶來的種種問題。照護父母不該是沉重的壓力，而是最甜蜜的負荷。
How to make it not a heavy pressure, but the sweetest load? Taiwan's population is extremely ageing. According to the data, it ranks among the best in the world rankings. Population aging is not only a challenge for medical care, long-term photos, and the government system, but also a heavy burden for the next generation. According to an exclusive interview published in this week's issue. Lin Xinkai, director of the New Hospital Sports New Medical Center, discussed the articles on the topic of the elderly and pointed out the inability of the elderly and the inevitable burden on the family.
According to the contents of the publication, an 80-year-old old man, Chen Laojiao, stood on the street for a long time in the early morning of the injury, but his strength was unbearable and he suddenly fell to the ground and broke his hip. Fortunately, the operation was successful after being sent to the doctor. But since then he has had a deep shadow on walking, and now he has been in bed for more than a year. "This fall makes Chen Laojiao's physical condition worse and makes the family members who are caregivers tired."
Lin Xinkai, director of the New Hospital Sports New Medical Center, said that the problems related to the elderly are becoming more and more important, and there are also many people in the society who are accompanying their parents in the cardiology, psychiatry, urology, orthopedics, dentistry, neurology, and gastroenterology. In addition to work, I have to take care of my elderly relatives.
According to statistics, there are many common problems and diseases in the elderly, such as falls that are familiar to everyone, osteoporosis, sarcopenia, lumbar degeneration, knee joint degeneration, lack of exercise problems, etc., even dementia, three high (high blood pressure , high blood fat, high blood sugar, etc., and so on.
Among them, "The most important thing to pay attention to is falling." Dr. Lin Kaikai said.
He explained in a more incisive way, "A person may have high blood pressure for 40 years. Although his physical condition is not good, his mortality rate is low. Compared with falls and hip fractures, the fatality rate of these two is quite high, even as high as 50%." In particular, elderly people often have problems such as organ function deterioration and osteoporosis. Dr. Lin Kaikai pointed out the main point. "The cause of death is not a fracture, but it is not possible to walk normally after falling, or stay in bed for a long time, so that the sequelae appear one by one, or death due to infection."
Falling is easy to kill, but the injury may form a burden for two generations.
The reason why the elderly are prone to fall is that the muscle strength is generally insufficient. If the problem of inconvenience, stroke, bad eyes, and dementia is added, the chance of falling will increase greatly. In this regard, Lin Yikai pointed out, "Therefore, how to avoid the fall of the elders is that in addition to training the muscles themselves, caregivers and their families should pay special attention to observation."
Once the elders fall down accidentally, the care problems caused by hip surgery, hospitalization and postoperative recovery period will bring a burden to both parents and children. Dr Lin Yikai reminded, "According to observation, more than half of the elders fell at home, especially in the middle of the night." He added that the elders are prone to insomnia. In the middle of the night, they often go to the toilet, the light is dim, the mind is not so clear, and the obstacles are kicked. Causes and other reasons lead to falls.
Reduce the risk of falling What can a caregiver do?
Dr. Lin Kaikai suggested that, in view of the movement of the elderly, it is important to remove all obstacles that may cause falls, keep the ground dry, and install night lights or prepare flashlights to make the light sufficient.
In addition, if you live with an elder in an eaves, when you find that your parents have abnormal conditions, you may wish to let your parents change rooms, or if your children and parents live in the same room, and take care of them. He also advises not to save money for nursing care. The care of the people is ideal.
Start with the exercise you like, and these nutrients need to be supplemented.
In terms of muscle strength, do the weight training for the elderly, the core muscles, and strengthen the front and back of the thigh. "It can start from the sports that the elderly like, such as health exercises, Tai Chi guidance, etc." Dr. Lin Kaikai said that this is beneficial to the nerves and muscles of the elderly.
Dr. Lin Kaikai also reminded that the nutritional supplements of the elders are also necessary. In the diet, attention should be paid to vitamin D and calcium. "If you increase the bone density, it is not easy to fracture if you fall." It is a good choice to replenish the bones through injections in half a year or a year.
It is also possible to assess the health status of the elders through health checkups or visits. In particular, rehabilitation and sports medicine practitioners usually know the situation of the elderly by observing the walking posture and asking about the state of life, and effectively provide advice on family or caregivers.
The problem of the elderly is inevitable, and it should be actively faced. The elders in the family may fall due to physical deterioration, illness or medication, or external environmental factors. Being a child can be more intimate, reduce the risk of elders falling, and prevent subsequent problems. Caring for parents should not be a heavy pressure, but the sweetest load.
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