Caring for the Bedridden Patient

Mayor's Office of Employee Assistance
Caring for the Bedridden Patient

A person who is bedridden usually needs full-time care and attention. This means that a care team will likely be working together (including family, friends, nurses and other professional help). Because of this, it is important to make sure that every care team member keeps a written record of the patient’s care. Any treatments and medications ordered by the doctor and given to the patient should be recorded. Your healthcare provider may also be interested in a record of the patient’s appetite, bowel movements, body temperature, pulse and respiration.

Comfort

Comfort comes first. Support should be provided for the patient’s back and joints to prevent strain. The arms and legs should be positioned comfortably and supported when necessary. When changing the patient’s position in bed, communicate what you are going to do to gain his or her cooperation. Guide his movements rather than lifting him if he is able to move himself. If the patient is unable to help him- or herself, a draw sheet and a second person is usually required to move the patient around the bed. Maintain good posture and position. Change linens often, providing several pillows for support. A hospital bed that can be adjusted will also make the patient more comfortable, as well as relieving back strain for the caregiver.

Hygiene

Cleanliness of the patient, bed and surroundings are important. A daily bed bath should be given to cleanse, refresh and relax the patient. A bath also promotes circulation, provides a mild form of exercise and cleanses the skin. Allow the patient to bathe himself if he’s able. Keep the bath water warm. You may also need a bedpan. Wash all parts of the body and dry thoroughly. Avoid chilling or tiring the patient. Make a note of anything unusual so these things can be reported to the healthcare provider. Follow up the bath by giving the patient a back rub using either powder or lotion. This rub will stimulate circulation and aid in the prevention of pressure sores. Assist the patient, if necessary, in brushing his teeth or cleaning his dentures. Cleanse the patient’s entire mouth and teeth as often as needed for his comfort, and always after he’s eaten. Brushing and combing the patient’s hair will help maintain the health of the hair, improve the patient’s appearance and morale, and stimulate interest in personal grooming. If a patient looks better, he or she will often feel better. Help the male patient to shave, and help the female patient put on her make-up. A shampoo should be given on a regular schedule. Finger- and toenails should also be cleaned and trimmed. If the skin of the hands and feet becomes dry, apply a lotion after the bath.

Changing the Bed

The patient’s bed linen should be changed every day or more often if it becomes soiled. Select a firm mattress and protect it with a waterproof covering and a cotton pad for the patient’s comfort. A drawsheet across the middle of the bed will protect the bottom sheet from becoming soiled and it can be changed more easily. When changing the bed with the patient in bed, move the patient to one side and make half of the bed at a time. Roll the patient back over the center of the bed where both the clean and soiled linen are gathered and complete making the other half. Be sure to allow toe space when tucking in the top sheet and blanket. The covers should be warm and lightweight. Turn the mattress and air the bedding weekly.

Dangers for Bedridden Patients

There are two critical medical dangers for people who are bedridden. The primary problem is bedsores, or pressure sores (decubitus ulcers). Another danger is blood clotting. Because of inactivity, blood can pool in the veins and lead to blood clots which can lead to a stroke or death by travelling to the lungs, heart or brain.

ULCERS AND BEDSORES

What Are Bedsores?

A bedsore is a breakdown of the skin or a wound over a bony surface. Ulcers develop when blood supply to the skin is reduced over a period of time. It is caused primarily by

  • Lying or sitting in the same position

  • Creases in the bedsheet

  • Friction when a person is dragged and not lifted or turned in the right manner

  • Poor blood circulation

  • Poor nutrition

  • Constant pressure against a particular area of the body

  • What causes bedsores?

    Bedsores are caused by prolonged pressure against the skin. They occur most on the lower part of the body, in places on which the body rests when sitting or reclining.

    Identifying Ulcers and Bedsores

    It is important to recognize the early signs of bedsores.

  • redness

  • blister formation

  • skin breaking down into a sore

  • Early detection is the most effective approach to combat bedsores. If you see a pink area, do not rub it. This will cause further damage. Call a healthcare provider immediately.

    Preventing Bedsores

    Bedsores form easily on the pressure points such as buttocks, spine, elbows, and hips. You can help prevent these by changing the person’s position in bed frequently. A period of stretching and moving joints will also help decrease bedsores, as well as help to stimulate circulation and prevent joint stiffness.

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