Caring for bedridden patients - regular activities and necessary funds. Caring for a bedridden patient at home Caring for a bedridden patient after

People caring for seriously ill people face certain difficulties every day, but this task can be made a little easier if everything is organized correctly. Caring for a bedridden patient is not an easy task. Relatives and friends are dear to us, even if their illness does not allow them to move independently and take care of themselves. In such a situation, you can invite a nurse, but often relatives take on all the responsibilities of caring for their sick relatives.

It is important for them to know how to correctly perform all procedures for caring for a bedridden patient.

Medical care for bedridden patients in medical institutions is provided by staff. When patients are discharged home, care responsibilities are transferred to the patient's relatives. Creating a comfortable environment for such patients can improve their quality of life. Caring for bedridden patients at home is difficult work that requires organization, patience and a lot of time. First, let's talk about what requirements a room for bedridden patients must meet.

What should a bedridden patient's room be like?

For a bedridden patient at home, it is advisable to allocate a separate room. It should be quite spacious and bright. If it is south facing, then in summer on hot days it needs to be shaded. It's good if there are blinds on the windows. They protect from the sun when necessary and are easy to clean.

It is good if the room is protected from extraneous loud sounds, but the patient should not feel isolated from society.

The room in which the patient is located should not be cluttered, but everything necessary must be placed at hand. The room should contain the following furniture: a table, a closet or chest of drawers with linen, a chair, and, if necessary, a TV or portable radio (the patient should be aware of all the latest events and not feel like an outcast). Unnecessary items must be removed from the room, as they make cleaning difficult.

Means for caring for bedridden patients should be right there, nearby.

The bed mat should not slide. You can use a bathroom rug; they are usually made with a rubberized bottom, which prevents them from sliding on the floor.

The room should be ventilated in any weather at least twice a day for 15-20 minutes. Wet cleaning is done daily. Bedridden patients are very sensitive to dust and various infections, because they usually have reduced immunity.

Bed for a bedridden patient

If the patient spends a lot of time in bed, it is desirable that his bed be special and functional. Its height is easy to adjust; the head and foot parts can be raised and lowered if necessary. This bed has special side posts that prevent the patient from falling out of it. A functional bed will make caring for bedridden patients easier. Bedsores are best prevented, but they are difficult to treat. The possibility of bedsores forming with such a bed is much less.

But if you cannot purchase such a bed, then the usual one can be somewhat transformed. The desired height can be achieved by placing several mattresses on top of each other. Chairs inserted into the bed frame will prevent the patient from accidentally falling.

The bed should be wide enough, since bedridden patients spend most of their time in it. They should be comfortable. The approach must be ensured from all sides. It is so easy to change bedding and underwear and turn the patient into a different position.

Items needed by the patient

Items for caring for bedridden patients should be nearby. On the bedside table there should always be fresh drinking water and a glass (mug or sippy cup), a TV remote control, the patient’s glasses (if he reads in them), a table lamp (floor lamp or wall sconce). It is convenient if the patient has a bell on his table or bedside table, with which, if necessary, he can call a nurse or relative caring for a bedridden patient to him. All these items must be placed in such a way that the patient can easily reach them on his own.

The drawer of the bedside table should contain a tonometer, a thermometer, cotton pads and swabs, as well as special cosmetics, talc, cream and anti-bedsore products and necessary medications. The lower drawer can accommodate disposable nappies, nappies and trash bags. Items for caring for bedridden patients must be arranged in such a way that, if necessary, the patient himself can reach them. The toilet chair, if used by the patient, should also be located next to the bed.

Basic rules of care

A bedridden patient requires a lot of attention and time. The rules for caring for it are as follows:

patients who have had a heart attack or stroke need to measure their blood pressure every morning and evening, record it, and show these records to the attending physician;
body temperature is measured daily;
it is necessary to monitor the nature and quantity of bowel movements, and if they become pathological (loose stools, streaks of blood, little urine, dark or red urine, etc.), inform the doctor;
the condition of the skin should be assessed daily (the appearance of bedsores, rashes or redness);
All necessary medications must be given to the patient on a schedule or make sure that he does not forget to take them himself.

If it is difficult for a patient to drink from a regular cup, you need to purchase a sippy cup for him.

If a patient is incontinent of urine or feces, it is necessary to stock up on disposable diapers and diapers.

Underwear for a patient should be soft and only made of natural fabric; preferably, it should be seamless, but if it has fasteners or ties, they should only be on the front.

It is always necessary to ask the patient what he wants and, if possible, fulfill his requests. There is no point in arguing; the patient understands better what exactly he needs at the moment.

Ask who he would like to see and invite only these people, but the visits should not be boring.

If the patient gets worse, he should not be left alone, especially at night. Keep the lights dim in the room. If you cannot constantly be present in the room with the patient if his health worsens, then you can hire a caregiver or a nurse. Nurses with medical education provide better care for bedridden patients. You can hire them through an agency or look for them in medical institutions.

Hygienic care for bedridden patients

For seriously ill patients, hygiene is especially important. The immunity of such people is weakened, so any infection can worsen the condition or provoke a concomitant disease, for example, congestive pneumonia.

Hygienic care includes daily washing, hand washing, brushing teeth and hygiene of intimate places. To do this, it is better to use neutral liquid shampoos and detergents for the care of bedridden patients with a pH of 5.5. The body also needs regular washing. Special treatment should be carried out where there are skin folds - these are the back and buttocks (places where bedsores most often form).

To wash the body, you need to use a sponge and a hard towel, which is used to rub and massage the patient’s skin after washing. After the hygiene procedure, the body must be thoroughly dried. On a wet body, bacterial infection grows, which can lead to inflammatory processes. After hygiene procedures, skin folds and places of contact with the bed (where bedsores can form) must be treated with talcum powder or baby cream.

After changing the diaper, the genital area must be washed using gentle detergents, wiped dry and treated with a protective cream (there are special creams for diapers).

When changing bed linen and diapers, they should not be pulled from under the patient, as this can damage the skin and cause the formation of bedsores.

Caring for bedridden patients. Bedsores and their prevention

Bedsores are areas of necrosis (death) of the soft tissues of the body. They can form in bedridden patients as a result of compression of the tissue of protruding areas, these are places above bone protrusions. Typically, bedsores appear in immobilized patients. Typical places of their manifestation are the buttocks, heels, back of the head, elbows, and less often the back and hips. Skin care for bedridden patients, in addition to normal hygiene procedures, includes the prevention of bedsores.

It is needed by both bedridden patients and patients who use a wheelchair for mobility, who are partially immobilized (for example, an arm or leg does not function after a stroke), as well as those suffering from obesity, severe diabetes mellitus, or urinary or fecal incontinence.

Caring for a bedridden patient involves preventing bedsores. It would be a good idea to lightly massage your back area after each body wash. This will increase blood circulation and thereby help improve tissue trophism, which will serve as the prevention of bedsores.

To prevent the formation of bedsores, you must:

eliminate risk factors for the formation of bedsores;
use the necessary devices for the prevention of bedsores (rollers, soft pillows, rubber circle);
careful hygiene of the patient’s skin;
performing physical exercises if the patient is immobilized, but these should be passive exercises (i.e., the person caring for the patient independently flexes and straightens his limbs);
massage, it can be done on your own, it can be a non-professional massage, the main task is to increase blood flow to the places that experience the greatest compression (perform the most common movements - stroking, light patting);
complete nutrition.

How to eliminate risk factors for the formation of bedsores?

Carefully examine the patient’s body every day for redness and changes in the skin, paying special attention to areas of bony protrusions.
Every 2 hours it is necessary to change the position of the patient's body. So, for example, to turn him onto his left side, you need to cross the patient’s arms over his chest and put his right leg on his left. Then approach him from the right and put your one hand under his thigh and put the other on his shoulder, and then turn the lying patient in one motion. Patients should be turned from side to side as carefully as possible to avoid excessive tension or friction of the skin. You can put a soft pillow between your legs, especially for emaciated patients (for obese patients this measure will be unnecessary).
The temperature in the room must be maintained optimal (19-20 degrees) so as not to provoke excessive sweating of the patient and the formation of diaper rash.
Bed linen should always be clean and changed promptly. Use soft underwear and only made from natural fabrics. It is best to place a disposable absorbent diaper on top of it; this will prevent the formation of diaper rash and make it easier to care for a bedridden patient.

Nutrition for bedridden patients

Since a bedridden person moves little, his diet should be moderate, because such an organism does not experience large energy costs. The calorie content of the food is reduced, but the diet is well balanced. The amount of protein and minerals should be sufficient. Protein is a building material for cells; if it is lacking, tissue restoration and wound healing will be poor.

The diet must include meat, fish, dairy products (cheese, cottage cheese), fruits, and nuts. The daily calorie content of foods for bedridden patients should be around 1500 kcal.

Treatment of bedsores

If, nevertheless, preventive measures were not enough or they did not help and bedsores appeared, then their treatment should be started immediately. It consists of three main areas:

Improve blood supply to the places where bedsores form (do not lie on the wound, use a rubber circle, anti-bedsore mattress, turn the patient often).
Clean the wound of pus, dirt and necrotic tissue and treat it with chlorhexidine. Do not touch the wound with your hands, carry out all manipulations with gloves and use auxiliary means (sterile wipes, tweezers), apply the medicine directly from the bottle (do not use hydrogen peroxide, iodine, brilliant green - they dry the skin and interfere with healing).
Take measures to heal the wound as quickly as possible (completely clean the wound of necrotic tissue, since they are a breeding ground for the development of infection), change the dressing once a day.

Features of patient care after a stroke

Often, after a stroke, the patient is cared for by his relatives. Regardless of the severity of the disease, the patient should remain in bed for the first time. An ischemic stroke often leads to partial immobilization of a person. Care for a bedridden patient after discharge from the hospital is carried out by his relatives. In such patients, the right or left side of the body is paralyzed, and when caring for them, certain rules should be followed.

Such patients need to change body position every 2 hours, undergo a complex of physical therapy and massage. These measures are necessary to restore nerve impulses and restore mobility of paralyzed limbs. The more often exercise therapy and massage are performed, the better the dynamics of recovery will be. Ideally, these complexes should be repeated every 3-4 hours. Patients can perform some basic exercises on their own.

When caring for such a patient, it is very important to ensure that the paralyzed limbs are not suspended. To do this, bolsters, pillows or garters should be used, and mobility in the shoulder joint should be maintained, and some distance should be maintained between the arm and the body.

If the patient is turned on his paralyzed side, then the affected arm is placed 90 degrees relative to the body, placing a small pillow under it, and the healthy arm is pulled back.

Sometimes the recovery period lasts a long time, during this time you need to be patient and consistently follow all the doctor’s recommendations. The patient will have to learn to hold objects and move independently again.

When walking, such a patient should always be supported from the affected limbs.

Caring for a bedridden patient requires the presence of certain skills - for example, you need to know what products to treat the skin with, how to organize oral care, what care products will not harm the weakened body.

Table of contents:

cleansing the skin;
prevention of bedsores and inflammatory processes in the anus, genitals and natural folds;
therapy for skin restoration.

Hygiene of bedridden patients

Such procedures for bedridden patients should be carried out twice a day and the optimal time for this would be the period immediately after waking up and before breakfast, before going to bed at night. To ensure that the hygienic procedure does not pose problems for people who care for a bedridden patient, it is worth preparing the following means in advance:

inflatable bath for washing hair;
a jug, or any other vessel, for warm water;
two basins for water;
pelvis stand;
cosmetics and “tools” - gels, foams, mittens and sponges;
absorbent diapers;
gauze napkins;
medical and cleaning gloves;
cotton buds;
paper and/or fabric towels;
toothbrushes (if the patient cannot brush his teeth on his own, then he will need to purchase special brushes);
rubberized diapers and disposable oilcloths;
cotton wool;
colostomy bags;
items for haircuts, shaving and manicure/pedicure;
special devices for the prevention of bedsores - bolsters, circles or mattresses.

This list may vary depending on how severe the patient's situation is. For example, you may need:

gynecological and urological pads;
disposable underwear;
diapers;
stoma care device;
shower chairs or special grab bars for taking a bath;
dry closet;
toilet chairs.

Note:A more specific list of necessary means and devices for caring for a bedridden patient will be compiled by his attending physician, since everything depends on the diagnosis.

Before you begin to perform skin cleansing procedures, you need to get rid of drafts in the room, and the air temperature should be at least 20 degrees. Such rules must be observed, since temperature fluctuations and drafts can lead to exacerbation of chronic diseases in a bedridden patient, deterioration of his condition - in such patients he is very weakened.

Sequence of the procedure

Having prepared all the equipment and means, ensuring the desired temperature in the room, you need to wear rubber gloves and protect the bed with an absorbent or waterproof oilcloth/sheet. The patient's underwear is removed and hygiene procedures are carried out in strict sequence.

Stage 1 – oral care

If the patient is able to sit, then he is placed on a chair or given a sitting position directly in the bed. If the patient is not allowed to change his body position, then you just need to turn his head to the side. Cotton swabs are used to clean the cheek space from accumulated mucus and saliva, but for this you can use disposable spatulas, which will allow you to move your cheeks away and make the procedure easier.

Brushing your teeth follows the same rules as for a healthy person, but only more carefully, without any effort. After the cheek spaces and teeth have been cleaned, it is necessary to rinse the patient’s mouth - this is done with a syringe with a soft tip, which contains either clean warm water or a hygienic solution (hydrogen peroxide, baking soda).

Note:When rinsing the mouth, you need to raise your head above the surface of the bed (if the patient is lying down) to prevent liquid from entering the esophagus and respiratory tract.

Particular attention should be paid to the choice of toothbrush and, since in bedridden patients the oral mucosa becomes vulnerable and sensitive to the effects of hard bristles. For patients after a stroke, it is recommended, which has astringent and hemostatic properties, but such recommendations must be given by the attending physician.

After completing the procedure for cleaning the mouth, the patient should blot their lips with an absorbent napkin and apply hygienic lipstick or moisturizing balm to them - this will prevent drying and cracking of the lips. When choosing such products, you need to be sure that they are hypoallergenic.

Stage 2 – washing

The sponge is moistened in warm water and wiped over the face of the bedridden patient. Then they treat the eyes - using two damp cotton pads (one for each eye), wipe them with movements from the outer corner to the inner.

Cleaning the inner surface of the ears and ear canal is carried out using cotton swabs, and then it is necessary to wipe the skin behind the ears, neck and chest area with a damp sponge, paying special attention to the folds under the chest, the surface of the sides and the stomach of the bedridden patient. In parallel with the described actions, the already cleansed areas of the skin are blotted with a cloth (it must have absorbent properties) and covered with a blanket or towel; as you move down, clothes are put on the upper part of the body.

After this, the bedridden patient is carefully turned on his side and the back area is wiped. Immediately you need to blot the treated areas and apply a product to protect against bedsores, which contains zinc or arginine.

Step 3 – hand washing

Each hand of the patient is placed in a bowl of warm water in turn and washed with a sponge or gloves. Particular attention should be paid to cleansing the interdigital space - it is in these places that a large number of pathogenic microorganisms accumulate.

After washing, each hand is dried with a towel, and a moisturizer is applied to the elbows - it is in these areas that roughening of the skin is often observed, so it is necessary to prevent the appearance of cracks. All that remains is to trim your nails and file them with a file, but this is not done daily, but as the nail plates grow.

Stage 4 – intimate hygiene

Before proceeding to this stage, you need to take off your gloves and put on clean ones, and prepare new warm water. Hygiene of intimate places is carried out according to the following algorithm:

a waterproof diaper is placed under the patient’s pelvis;
the diaper is removed from the patient;
put a washing mitt on your hand, but you can use a special soft sponge;
moisten a mitten or sponge in warm water and wring it out;
spread the patient's legs, position them so that they are bent at the knees, and the heels are moved as close to the pelvis as possible;
treat the perineum with a moistened sponge/mitten, movements should be directed from the pubis to the anus;
dry the treated area with a disposable towel, or a fabric one, but dedicated specifically for these purposes;
turn the patient on his side and dry the body skin by blotting;
take a clean diaper and put it on the patient.

Step 5 – washing feet

After treating the perineum, they proceed to washing the feet, but first you need to change the water in the basin and put on clean gloves, take a clean sponge or mitten. The foot washing procedure is performed as follows:

wipe the legs up to the ankle joint;
lower the feet into the basin, wash thoroughly, paying special attention to the areas between the toes;
feet are dried with a towel;
the patient turns to his side, the skin of the back of the legs is treated with a special remedy for bedsores;
Lay the patient on his back, trim his toenails, and file the edges of the nails with a pedicure file.

Note:All described hygiene procedures must be carried out daily. This is the only way to prevent the occurrence of bedsores and alleviate the plight of a bedridden patient.

Washing head

This hygienic procedure should be carried out as the hair of a bedridden patient becomes dirty. You should prepare the following:

The bedridden patient should be in a supine position, with an inflatable bath placed under the head. If you use a basin, you need to put a small inflatable pillow under your head, and a cushion under your neck so that your head is thrown back. The head of the bed should be covered with oilcloth or a waterproof diaper, and a basin of water should be installed.

The hair washing procedure is carried out in the following sequence:

Warm water from a jug is poured onto the patient’s head and all the hair is wetted;
apply shampoo, foam;
rinse hair;
wrap your head in a towel and carefully remove the basin, oilcloth or inflatable bath;
carefully, but carefully, dry hair;

Caring for seriously ill relatives who are constantly in a supine position is hard work.

But if you organize everything correctly, you can make your work much easier., therefore, before you begin caring for a paralyzed person, you must consult a doctor and familiarize yourself with the recommendations.

Hygiene of a seriously ill patient at home

Hygiene is very important in caring for non-ambulatory patients. Doctors recommend carrying out all activities at least 2 times a day.

Toilet

One of the problems that causes moral inconvenience. Patients require special padding vessel And "duck", that is, urinals. Such containers must be thoroughly washed and disinfected after each use.

Important! It is necessary to explain to the patient that there should be no embarrassment, that it is important to empty the bladder and intestines on time, otherwise this may provoke the development of constipation and exacerbation of urinary tract diseases.

If the patient cannot control urination or bowel movements, he must be wearing diaper, can be used disposable diapers or regular sheets, under which you will need to lay an oilcloth.

Bathing

It is necessary to bathe a bedridden patient every day; if the person can walk to the bathroom himself, then he is escorted and washed in the shower.

Reference! For hygiene, it is best to use baby hygiene products.

After bathing, the patient’s body should be blotted with a dry soft towel or gauze - it is not recommended to wipe the body, as microcracks may appear, which can subsequently trigger the development of bedsores.

It is very important to wipe the body dry; a wet body on the bed can also cause bedsores.

If the patient is unable to move, then they bathe him directly in bed, having previously laid an oilcloth under him:

When bathing, you must use a soft sponge and do not rub your body too much.
After bathing, the body must be thoroughly dried and moisturizer applied.
Camphor alcohol should be applied to areas that are subject to pressure or friction while lying down after bathing.

In order to wash your hair, use an inflatable bath, which comfortably fixes your head and does not put any pressure on your head.

Important! Don’t forget that patients should definitely brush their teeth in the morning and before bed. For bedridden patients, it is best to use a toothbrush with soft bristles so as not to damage the surface of the gums.

How to properly wash a person lying in bed is shown in the video:

Nutrition

The attending physician prescribes a diet depending on what caused the paralysis and on how much chewing skills and swallowing functions have been lost:

If the patient is unconscious, it is recommended to feed him liquid food or food pureed in a blender.
If the patient is in consciousness, then you can feed him soups and cereals. Vegetables and meat must be added to the diet, and all food should be prepared only boiled or steamed. The patient should be fed on a schedule, 5-6 times a day.

It should be given in the required amount of liquid in the form of tea, compote, non-acidic juices. Drinking restrictions apply only for heart and kidney diseases.

The patient should be fed as follows:

If a person is not completely immobilized, then they help him into a sitting position using special levers on the bed or placing pillows under his back, then lay a napkin on his chest and feed him with a spoon. If the patient cannot eat food himself, then a special small table is placed in front of him, food is placed on plates, and he eats the food himself.
It is necessary to turn the patient on his side, spread a napkin and feed him with a spoon.
Drinks should be given in a special drinking bowl or in a glass with a straw.

Reference! After feeding, be sure to wipe the patient's face with a damp cloth, and also shake off crumbs from him and from the bed.

Watch a video that shows how to properly feed a patient in bed:

Prevention of bedsores

Bedsores are one of the most common pathologies in bedridden patients. Bedsores usually develop in places of strong pressure or rubbing. The reason may be a banal fold in the sheet.

Important! The patient's position should be systematically changed and problem areas should be massaged. A regular terry towel will do for this.

Some preventative procedures should also be performed:

It is necessary to purchase an anti-decubitus mattress or pillow. You can use bolsters, pillows or an inflatable ring against bedsores.
Bed linen must be changed daily, and it must be thoroughly ironed.
The patient needs to be bathed every day. After bathing, you need to thoroughly wipe the patient's body dry, then treat the armpits and perineum with talcum powder.
Although the patient may be completely immobilized, passive exercise should be performed. Performing such exercises involves the assistant bending and straightening the patient’s limbs.
Stroking and patting those parts of the body that are most subject to pressure.
The patient's body must be examined every day. It is important to notice any changes in skin color promptly.
To avoid sweating of the patient’s body, and, as a result, the appearance of diaper rash on his body, which can provoke the development of bedsores, it is necessary to constantly maintain the same temperature in the room – 19-20°. At the same time, it is important to ventilate the room several times a day; in the cold season, the patient must first be covered with warm blankets. Cleaning should be done in the morning and evening.
Nutrition should be balanced and easily digestible.

How to prevent the formation of bedsores in a bedridden patient is described in the video:

Prevention of congestive pneumonia

Paralyzed patients constantly remain in one position, as a result of which normal ventilation of the lungs is disrupted, and sputum begins to accumulate in the bronchi.

If the cough reflex in patients is impaired, then sputum cannot be eliminated from the body naturally, which subsequently leads to stagnation of sputum, and becomes the cause of the development of a bacteriological process in the lungs.

Gradually, the patient begins to develop hypostatic or congestive pneumonia, which is virtually impossible to determine at the initial stage of the disease, since it is asymptomatic and is detected only when the disease is already in the midst of its development.

Reference! Often this pathology becomes the cause of death, so it is very important to prevent it in time and prevent further development if pneumonia has already begun.

To prevent the development of congestive pneumonia, the following measures should be taken:

The patient should be seated or given a semi-sitting position every 2-3 hours. Special beds for such patients are equipped with a lifting mechanism for the headboard, or you can use pillows.
It is important to monitor the cleanliness of the room - it is necessary to carry out wet cleaning daily and ventilate the room.
If the doctor allows it, the patient needs to rub his back and chest.
If a person is conscious, then you can perform breathing exercises several times a day; the most effective and simplest method of gymnastics in this case is inflating balloons.

For prevention purposes, using traditional medicine methods, you can use tea with thyme or a decoction of viburnum.

Massage and gymnastics

Gymnastics is a very important aspect; it is carried out to prevent muscle atrophy and to stimulate normal blood circulation in the limbs:

If the patient can move while in bed, then he can do the exercises himself several times a day.
If the patient is completely immobilized, then in this case passive gymnastics is performed, that is, the exercises are performed with the help of a person who is looking after this patient.

Massage is also necessary to stimulate blood circulation and to prevent the development of bedsores.

It is not necessary to do a professional massage; you can simply gently rub and knead problem areas of the skin.

Hygienic and cosmetic products

When caring for a bedridden patient, you will need auxiliary cosmetic products:

Foam. Designed for treating problem areas that are subject to friction.
Napkins. Wet wipes are used mainly after meals to remove food debris from the face.
Lotions. They are used to wash the patient; they need to be used to wipe the face in the mornings and evenings. The lotion is applied with a cotton sponge and then washed off with a cotton swab dipped in water.

You can buy such goods in almost every hardware store, and their cost is low.

Reference! The EliXi company produces cosmetics specially created for the care of bedridden patients.

What equipment you need to prepare to care for a seriously ill person is described in the video:

Hospitals and boarding houses

Hospitals and boarding houses are the first stage of providing assistance to patients who, for some reason, find themselves permanently or temporarily bedridden.

A special feature of inpatient treatment is that there are auxiliary devices that facilitate the care process.

Such devices are:

urine catheter,
feeding tube for the patient.

This situation has certain advantages for those who, after hospitalization, will have to care for a bedridden relative at home.

Reference! The hospital will always tell you what to pay special attention to when caring for you - how to bathe and feed the patient, what needs to be done to prevent the development of bedsores and congestive pneumonia.

Caring for a bedridden patient is hard work, but it is worth it. After all, recovery will come much faster if the patient feels cared for.

Relatives and medical staff should make every effort to achieve positive dynamics.

Vladimir Yashin, a general practitioner, teacher at Moscow Medical School No. 13, and author of the textbook “Healthy Lifestyle,” talks about how to provide professional care for a bedridden patient.

Often, chronic patients do not need active treatment and daily medical supervision. Let's say that during a long stay in the hospital (for example, after a stroke), a person received the necessary qualified assistance. And, of course, he wants to go home, to close people, in a familiar environment.

Indeed, in practice I can say: houses and walls help. Good care and attention can work wonders. An old proverb says: “The doctor heals, the caregiver cures.” It is still quite relevant today. What is important for a caregiver to know?

Hygiene comes first

All manuals unanimously recommend regularly ventilating the room where the patient is lying and carrying out wet cleaning daily. For many people, the second point is difficult to achieve. But try to wipe the dust on the shelves and floor at least once a week - cleanliness and comfort improve the patient’s mood, and this is a direct path to recovery.

Bed linen should be changed weekly - and this is a vital issue. The more the laundry is caked, the more crumbs spilled on it, the more the risk of bedsores increases.

To change linen and straighten the bed, it is necessary, if possible, to transfer the patient to another bed. Overweight people need to be carried by two people: one puts his hands under the head and shoulder blades, the other - under the lower back and hips and lifts them up at the same time.

If it is not possible to move the patient, there is another way. The patient is moved to the edge of the bed, the dirty sheet is rolled up lengthwise in the form of a bandage, and a clean one is straightened in its place. The patient is rolled onto the clean side, the dirty sheet is removed from the other side and a clean one is straightened.

Changing clothes

To change underwear, you need to place your hands under the patient’s sacrum, then grab the edge of the shirt/T-shirt and carefully push it towards the head. Raising both the patient’s arms, remove the shirt over the head and then free his hands.

Dress the patient in the reverse order: first the sleeves of the shirt, then the neckline over the head. By the way, in stores and pharmacies you can buy undershirts for seriously ill patients, for example with myocardial infarction, which are easy to put on and take off.

Skin care

If the condition allows, the patient is seated in bed, and he independently washes his hands, face, neck and ears with soap and water at room temperature. A bedridden patient is wiped using tampons or sponges moistened with water with the addition of vodka or cologne. Seriously ill patients need to wipe the entire body with camphor alcohol, especially the folds in the groin, armpits and areas of skin under the mammary glands in women. If the skin is dry, you need to lubricate it with baby cream every 2-3 days.

Among modern skin care products that are sold in pharmacies, we can, in particular, recommend the following: alcohol-free body lotion (has a softening and soothing effect), foam for washing and body care (provides nutrition and care for irritated skin , removes the unpleasant odor of urine), wet wipes for sensitive skin (they have cleansing and disinfecting properties).

After each meal it is necessary to clean the oral cavity. To do this, you need a cotton swab, a 2% soda solution and a kidney-shaped basin (sold at the pharmacy). The patient should be seated in bed, take a cotton swab with tweezers, soak it in a soda solution and wipe the tongue, teeth and oral surface of the cheeks. After this, the patient should rinse his mouth with warm water, and the caregiver holds a kidney-shaped basin under his chin.

Bathing

A moderately ill patient is washed once a week in a bath or shower, following the doctor’s recommendations. The bath is half filled with water (not lower than 35-37° C). The patient is helped to wash his head, back and legs. When washing in the shower, sit him in the bathtub on a bench and use a flexible hose.

Severe and weakened patients are washed in bed, placing an oilcloth over the sheet. Using a sponge moistened with warm water and soap, wash the upper half of the body, then the stomach, thighs and legs.

For washing (as well as for emptying the bladder and intestines), use a bedpan and warm water (or a solution of furatsilin at a dilution of 1:5000). The procedure must be carried out several times a day. You need: oilcloth (place it under the vessel), a water jug, sterile cotton swabs and a holder. The patient lies on his back with his knees bent. The caregiver pours warm water or a disinfectant solution over the external genitalia in women or the perineal area in men, and then wipes the skin with cotton swabs.

Prevention of bedsores

Bedsores are skin ulcers of varying sizes and depths. Most often they appear in seriously ill patients in the sacral area, less often in the area of the shoulder blades, the back of the head, buttocks, heels and other places where soft tissues are compressed between the bone and the bed. The first sign is pale skin, then redness, swelling and peeling of the epidermis. In the future - blisters and necrosis of the skin. In severe cases, necrosis can affect not only soft tissue, but also cartilage and even bone. The following manipulations can help prevent bedsores:

  if the patient’s condition allows, it is necessary to change his position in bed several times a day;
  Wash areas of possible formation of bedsores with warm water and soap, and then wipe with camphor alcohol;
  do a simple massage of areas of the body where bedsores may form;
  make sure there are no wrinkles or food crumbs on the sheet;
  for seriously ill patients who have been in bed on their back for a long time, place an inflatable rubber circle placed in a pillowcase so that the sacrum is above its opening;
  in case of hyperemia (redness), rub the skin with a dry towel, and to improve local blood circulation, irradiate the affected area with a quartz lamp;
  wash the skin with soap and water at room temperature, and then wipe it with alcohol and powder with talcum powder.

Enemas

Bedridden patients suffering from constipation need it (once every 2-3 days). To do this, use an Esmarch mug (a rubber tank with a capacity of up to 2 liters). The patient is placed on his left side with his legs bent towards his stomach. An oilcloth is placed under the buttocks, the free edge of which is lowered into a bucket. Pour boiled water into Esmarch's mug (the tap on the rubber tube is closed) to 2/3 of the volume, lubricate the tip with Vaseline. Then open the tap to let out some water and air, and close it again. After this, spreading the buttocks, insert the tip into the rectum with rotational movements and open the tap. At the same time, Esmarch's mug is raised higher than the bed. Sometimes, instead of cleansing ones, microenemas with vegetable oil are given at the same frequency - using a rubber bulb. Microclysters are easier for patients to tolerate; the procedure is carried out before bedtime so that the patient has stool in the morning.

Innovation for health

Recently, a lot of inventions have appeared that make it easier: these are a variety of pads (for those suffering from mild forms of incontinence), and absorbent panties, and disposable sheets that can replace the usual oilcloth. Remember, in the use of these means, the main law is expediency. If the degree of incontinence is mild, then there is no need to “steam” in absorbent panties around the clock. The greater the contact of the body with natural tissues, the less the danger of bedsores and diaper rash. However, if incontinence has become normal, then absorbent panties and sheets can save you from the same bedsores - after all, not all caregivers have the opportunity to regularly change their underwear.

Caring for your eyes, ears and nose

If patients develop discharge from the eyes, they should wipe their eyes daily with a sterile gauze swab moistened with a 3% solution of boric acid. It is also necessary to clean the ears from the accumulation of wax in the ear canal. For this purpose, a few drops of a 3% solution of hydrogen peroxide are instilled into the ear, and then a cotton swab is inserted into the very beginning of the ear canal with light rotational movements and carefully, so as not to damage the eardrum, clean it. Weakened patients cannot clean their nose on their own, so the caregiver performs this procedure daily. What is it? The patient should be seated with his head slightly thrown back, placing a pillow under his back. Then a cotton swab is moistened with petroleum jelly or glycerin and inserted into the nasal passage. After holding it for 2-3 minutes, it is pulled out of the nose along with the crusts using rotational movements.

Weather in the house

Naturally, a long stay in bed and the associated discomfort depress a person and traumatize his psyche. He often becomes very irritable and moody. This is fine. I urge you not to break down under any circumstances. After all, your emotional reaction can worsen the patient’s condition - do you need subsequent remorse?

The best way to get rid of irritation is a change of environment. If your ward cannot go outside or at least onto the balcony, do not be afraid to invite guests - friends and relatives. Many are afraid of injuring relatives or tiring the patient. But remember: strangers force the patient to get ready, mobilize, and forget about irritation. New faces practically guarantee an improvement in mood and a feeling of returning to a normal, active life.