Care for Bedridden Clients 

It is important to remember that being bedridden can be a tough experience. For a once active person, being confined to a bed all day can cause mental and emotional strain since they may no longer feel independent. For a caregiver, there are many ways you can improve your loved one’s time confined to their bed.

Being a caregiver takes a lot of work, but, if you are ever frustrated with your “job”, think of the perspective of your client.

Put yourself in their shoes: Understanding what a person confined to bed may be going through is the first step that caregivers should acquaint themselves with. Draw up a daily schedule of what needs to be done and make a chart of medicine and food timings. Schedule time for reading, watching TV programs and bathing. This will provide a sense of purpose to the person. The caregivers should involve themselves emotionally as emotional dependence is as important as physical dependence. Make sure you both take time to communicate your feelings so you can better understand each other’s needs.

Preventing bedsores: Bedsores, also known as a pressure ulcer, pressure sore, or decubitus ulcer, occur when clients are immobilized and confined to bed for a prolonged period of time. Unrelieved pressure on specific areas of the body can result in an injury that causes skin breakdown and an open sore. Bedsores typically form over a bony area such as the back, tailbone, buttocks, hip, heels, elbows, and shoulders. If left untreated, bedsores can require surgery and result in complicating health conditions including sepsis, bone and joint infections. A way to prevent bedsores is to take great care with good hygiene and also to reposition how your client lays in bed every 2 hours. It  is very important to make sure that the person is moved gently and his/her position changed regularly to avoid them. Pillows help you support and maintain the client in specific positions. For example, plave several behind the client’s back to help maintain a lateral position or between the client’s knees and ankles for comfort and to keep them from rubbing together and possibly causing skin breakdown. Use pillows to elevate the client’s extremities or upper body as well.  Use pressure-reducing aids such as cushions, mattresses, beds, booties, and elbow pads to reduce pressure on the skin. Cushions that contain foam, gel or air are particularly effective. Do NOT use any donut type devices because they create uneven pressure that can lead to pressure ulcers. Perform a daily skin inspection to identify vulnerable areas. Look for signs of redness in areas where bedsores are more likely to occur: bony areas including the buttocks, tailbone, knees, shoulders, hips, and ears. After bathing or sponging, keep the skin dry, using talcum powder or moisturizer. If an area of skin appears pink, it is the first sign of an ulcer so get medical attention and do not rub the spot as it will worsen the condition.

All about hygiene: Pay attention to dental care and make sure the client brushes teeth at least twice a day. For bedridden clients it may be too tiring to have a full bath daily. So, shampooing the hair twice a week and bathing every other day will suffice with sponges given on the other days. If the person uses a bedpan, make sure that the peri area and/or rectal area is wiped clean after each use.

Changing sheets: As the client spends almost all his time in bed, the sheets get dirty due to food particles, hair and skin flakes, so change the linen regularly including pillow covers. Make sure the mattress and blanket are dusted and aired periodically.

Give some thought to the menu: A bedridden client’s diet needs to be customized. An old person may not be able to have excessively spicy or fatty food. Give small amounts of food frequently as the client’s appetite will be less due inactivity. Ask the doctor if a protein supplement or health drink is useful for additional calories and vitamins. Monitor fluid intake. Adequate hydration is critical for skin health. The average person needs to consume at least eight glasses of water per day. Pay attention to signs of dehydration such as darker urine, dry mouth, and constipation.

Choose an appropriate room: Since the client will be confined to his room most of the time, make sure the room has good natural light and is well ventilated. Place the bed a little away from the window so that the client does not feel chilly at night. Choose a room with an attached bathroom which is big enough to accommodate a bedpan and stool for bathing.  N

Nursing care: If the client is being fed through a tube or if he has a urinary catheter, ask the doctor when it has to be replaced and what is the daily care for it. Keeping a tube or catheter for too long may lead to infection. A trained nurse can deflate a urinary catheter before taking it out and put in a new one.

Grooming: Grooming must play a part in the client’s daily schedule. Nails and hair must be filed regularly, no clipping, male patients must be shaved every alternate day on the face, and women patients should be allowed to shave their arms and legs to look presentable. Looking after them this way keeps their morale high and encourages them to help themselves to get better soon. Remember, a positive attitude is half the battle won.

Exercise: If the client needs to slowly regain the use of his muscles, it is important to have a physiotherapist’s input. The exercises and manoeuvres should be explained to the caregiver and the patient so that the same can be replicated as often as prescribed.