Seeing a family member or loved one tied to the bed is an emotionally draining experience. Being unable to do much to help their suffering and provide the best care makes the feeling worse. This article strives to offer some solutions and understanding for the lay person caring for bedridden patients in the context of home care.
Bedridden patients face a variety of problems, from labor support, mental illnesses such as depression, basic cleanliness and hygiene, bed sores, to chronic illnesses such as hypertension. Of this list, labor issues usually rank high.
Most bedridden patients in Singapore stay at home and are cared for by relatives. Over time, this can be exhausting to family members and understanding home care will be of great help to both family and patient.
Understanding the cause of staying in bed
A patient may become confined to bed for a multitude of reasons. A spinal fracture, paralysis and post-traumatic coma, surgery, head injury, end-of-life causes, old age, and the common stroke are situations that can cause patients to become bedridden. Understanding the causes can help prevent the problem from occurring in the first place, while adjusting the care of such patients will improve the quality of life for these patients.
Common problems
Nursing Issues
- Ulcers or bedsores: Pressure sores and pressure sores, if left unchecked, can cause serious complications over time.
- Basic hygiene and cleanliness. Basic cleanliness of patients, regular diaper changing, bowel control, are all important but physically demanding.
Medical problems
- Muscular atrophy. After prolonged periods of inactivity, the muscles eventually lose their strength and muscle weakness sets in, making it a vicious cycle. The bedbound patient becomes more bedbound with each passing day.
- Common infections: Due to the sitting/reclining posture, the lungs cannot fully inflate with each breath and therefore respiratory infections are common. Due to prolonged use of diapers, the urinary tract is easily infected.
- Mental illness. It is common for patients who are bedridden to become depressed. Love, care and attention, frequent companionship and empathy will go a long way in treating these patients.
- Insomnia. It is common for bedridden patients to sleep poorly.
General problems due to lack of activity:
- Bedridden patients usually report loss of appetite, loss of interest in all things big and small, and a general decline in all functions.
Challenges for caregivers
Caring for a bedridden patient is challenging. Over time, the daily routine of caring for the bedridden patient will take its toll on the caregiver.
Enforcing personal hygiene, administering the correct medications, serving proper food, ensuring regular exercise, and providing companionship to bedridden patients are just the basic fundamentals required.
To go beyond the above, change the bedridden patient every 2 to 4 hours to prevent bedsores throughout the day, suction and clear the airway, feed through tubes, bandage sores and open skin wounds , caring for urinary catheters are other challenges faced. by caregivers in the face of patients with complicated medical problems.
Therefore, it is normal for a caregiver to feel overwhelmed at some point, leading to high levels of stress in the caregiver. So the provision of manpower, just an extra pair of hands, will make a world of difference when it comes to home care.
Risks Faced by Bedridden Patients
Common risks include:
- Development of bedsores or pressure sores that, if left untreated, get worse.
- Formation of blood clots in the veins of the lower limbs. If these clots break off and lodge in the heart, lungs, or brain, they can cause further complications.
- Muscular atrophy.
- Frequent infections and complications from the general lack of activity.
As an aside, keep in mind that bedsores rank highest where nursing care is lacking. It usually starts with a mild reddening of the skin, but if left unchecked, pressure sores will infiltrate deeper into the skin layers and can erode the skin down to the bone if left unchecked.
Rules
- Do a daily skin inspection to check the skin for redness, especially in bony areas such as knees, hips, shoulders, ears, tailbone, and buttocks.
- If a pressure sore is identified, place it immediately and seek medical help if the skin is broken.
- Keep skin clean and dry. Clean skin with mild soap and water; I know that.
- Moisten the skin: Use body lotion to keep the skin lubricated. Use powder to dry folds of skin, such as the armpits and under the breast.
- Bed linen and sheets must be changed daily. If you do wet the bed, change the wet sheets immediately.
- Keep the patient hydrated.
- Having a balanced diet: A healthy and nutritious diet is very important to boost the immunity of the patient. Keep a journal to record all meals eaten.
- Exercise the patient: To prevent muscle weakness, exercises should be performed taking into account the patient’s condition. If the patient can walk a little, help him walk at his convenience.
- Massage: Deep massages can help prevent complications related to blood circulation. Light massages are ideal for sore muscles and the prevention of bedsores.
- Positioning: Repositioning of the patient every 2 hours. Never drag the patient; always lift.
- Keep extremities elevated: both hands and legs should be kept slightly elevated to prevent swelling and help blood circulation.
What to do in case of bedsores?
Unless you are experienced or trained, first contact with pressure sores should be managed by medical professionals whenever possible.
However, for a first response, the best treatment for pressure ulcers is to leave it open to air and relieve any pressure on the pressure ulcer as much as possible.
With sufficient experience with the type of bandages to be used, the caregiver should learn from each episode and become familiar with the treatments and methods available to clean pressure ulcers.
The best method of treating bed sores is prevention. So constant vigilance is the key.