4.4 General Care for the Bedridden Adult |
| A person may be confined to bed for a variety of reasons. He
may have had surgery, be convalescing after a stroke, have a long-term
illness such as cancer, have a short-term illness such as the "flu"
(influenza) or be frail.
It is important to meet the older person's human needs of. love
and affection, recognition, acceptance, security, trust, socialization,
food, clothing, shelter, rest, activity, avoidance of pain and escape
from danger.
Caregivers should pay special attention to the environment of the
bedridden person. Smoking should not be allowed in bed unless someone
is in the same room. Essential items, such as good lighting and
a system to signal the aid of a family member (which may be no more
than a bell or a glass and spoon), should be within easy reach.
Electric cords should be checked for frays or loose connections.
Gas room heating should be ventilated. All heaters should have a
front guard to keep objects away from the coils or flames. Drafts
should be avoided.
A fire escape route should be familiar to the person in bed and
all family members. Smoke detectors should be installed. In some
communities, the fire department will install special labels on
the windows of the disabled. |
Body Mechanics and Lifting |
| Before lifting a person, caregivers should review the principles
of body mechanics with a trained health care professional. Often
your local home health agency, American Red Cross or Area Agency
on Aging have videotape guides or access to professionals to assist
you with learning proper techniques of body mechanics.
Good posture should be maintained at all times: head erect, buttocks
pulled in, stomach muscles tight, chest high and shoulders pulled
back. Use a wide base of support, with feet apart and one foot forward
when standing for a long period of time. The broader and the base
of support, the lower the center of gravity and the easier it is
to maintain balance.
Keep the back straight and the knees and hips flexed. When reaching
down to lift an object, use the leg's large muscles for strength.
Never bend from the waist to pick up or move a person. Work with
gravity, not against it. Point the feet in the direction of the
movement for side and forward motion. This prevents twisting of
the spine and allows movement with the body in good alignment.
Stay close to the person to conserve energy and prevent strain.
Work at waist level if possible.
Comfort and position are important to the bedridden person. Comfort
is increased by aligning the person's body correctly in normal contours.
Procedure
- Give support to the curves of the spine with a pillow under
the head and neck; the pillow should reach down to the shoulder.
- Place a small flat pad, such as a rolled towel, under the small
of the back.
- Support body joints using pillows, folded towels and wash cloths.
- Legs should be supported to relieve pressure on hip joints
with a small pillow or pad placed under the person's ankles and
knees to prevent pressure on heels and legs. If the person cannot
move himself, change his position at least every hour. This helps
to:
- improve circulation
- improve muscle tone
- prevent joint deformities
- provide some diversion
- prevent pressure sores
- prevent strain and fatigue
A person, when confined to bed, often experiences a tremendous
emotional upset brought on by inactivity and dependence. Help the
person express his feelings. Encourage and praise him whenever possible.
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Positioning a Person in a Semi-Sitting Position, and on His
Back |
| The semi-sitting position may be attained by raising the head
of the bed or raising the person to a sitting position by locking
arms. Use a back rest or pillows to maintain this position. Place
a small pillow or flat pad under the small of the person's back
and a pillow under each arm for support. Add a handroll made from
a washcloth if the person clenches his fist due to hand paralysis.
Use a pad or pillow at the side of the hips to keep the feet from
rolling outward.
Positioning the person on his back is the same, except that the
back rest and pillows are removed and/or bed lowered. Place a pillow
beneath the head, reaching down to the shoulders to keep them forward.
Ask other family members to assist you when turning and positioning
the person. If there is no help available, the person should always
be turned toward you.
Procedure:
- Explain to the elderly person what will be done.
- Move the person to the side of the bed near you.
- Flex the person's arms and place them across his chest.
- Place his knees together in flexed position, supporting joints
from below. Place one hand on his hip and the other on his shoulder.
- Roll him gently but quickly from his back to his side.
- Adjust the pillow for his head so it reaches down to his shoulders.
- Position his arms where comfortable at sides or raised.
- Use handrolls as needed.
- Place a pillow behind person at waist level to prevent roll-back.
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Making an Occupied Bed |
- A clean, fresh bed is an essential part of personal care and
grooming for the bedridden person.
- Choose a convenient time for making the bed. After the bath
may be a good time.
- Gather all equipment needed.
- Place soiled linen in a bag, hamper or on a chair protected
with newspaper. Never put it on the floor where it could be contaminated.
- Store soiled linen in a closed container until it can be laundered.
- Place a board under the mattress to add firmness.
- Use a waterproof mattress pad if extra protection is needed.
- Use warm, but lightweight blankets.
- Pillows should be firm enough to maintain body posture, but
soft enough to be comfortable.
- Do not tuck in top linens so tight that they pull or press on
the toes and feet.
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Preventing Pressure Sores |
| Help the person with proper exercise or activity that is included
in the care plan developed by the doctor.
- Turn the person frequently if he is unable to move himself.
- Make sure the bottom sheet is pulled taut, checking for any
possible skin irritant such as crumbs or wrinkles.
- Keep the person's skin clean and dry.
- Massage pressure areas frequently to stimulate circulation including
bony areas such as the tailbone, shoulders, heels, and elbows.
- Washable sheepskin or chamois skin may be placed under the person
to help absorb moisture, relieve pressure and protect the skin
from irritation. Foam rubber under bony areas will also help relieve
pressure.
- Encourage good nutrition to help nourish and heal body tissues.
- Report any redness at pressure areas to the doctor.
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