Taking Care of Bedridden Patients

General instructions:

If the patient is totally bedridden then try to arrange Hospital bed at home. Preferably the bed should have wheels and all the necessary gears/levers for posture adjustment. Air mattress is necessary to prevent pressure sores. Air mattress should be put over regular mattress. Air mattress should be turned on all the time while patient is on bed. Patient should be educated to change sides after every 30 minutes. If patient is unable to do so, family should help changing sides of patient. This will minimize the chances of developing bed sores. Back and hips of patient should be inspected regularly to see any signs of bed sores. If any redness of skin or any break in skin is noted, medical advice should be sought. Head end of bed should be kept slightly higher than foot end. Bed sheets should be changed daily. Those patients who can walk or move with help of aid should be discouraged from lying in bed all times. They should only be on bed at night time or may be for couple of hours after lunch. Patients who have severe weakness and cannot stand unaided should be put in wheel chair or sofa or any other chair during day time. Legs should not hang down for prolonged period of time. For example, if patient has to sit for long time, another chair or table etc. should be kept under the legs of patient and legs should be extended at knees.

Patient may be given bath twice a week. Patient may be bathed daily if need arises. Patient should be kept as clean as possible. Special care should be given to patients who are on diapers or have urinary catheters. Cleanliness and dryness of perineal area should be ensured all times. Seepage of urine from catheter should be brought into notice of doctor/nurse when it occurs. Patient should be kept dry at all times especially after bath and after attending toilet needs. Patients should also brush their teeth at least once daily. They can also use hair oil, moisturizers and deodorants like healthy persons.

Physiotherapy:

Physiotherapy plays major role in early recovery. It should be done at all joints of paralyzed leg(s) and/or arm(s). Each joint should be gently stretched to the range of motion several times a day. It should be continued indefinitely until affected leg/arm becomes fully functional. Chest physiotherapy should be done in bed ridden patients.

Diet:

Bedridden patients usually have other illnesses like diabetes, hypertension and problems with blood cholesterol. They should observe all the dietary precautions for these medical conditions. For example, they should avoid sugary, salt and oily foods. Overweight patient should lose weight to have better chances of recovery. Patients who are bed or wheel chair ridden need less calories than normal humans and hence should not over-eat. Well balanced diet should be given containing right amounts of proteins, carbohydrates and fats. Water intake should be adequate, especially in summers.

NG feed:

Some patients who have difficulty with swallowing are put on NG feed. It is very important that attendants should not try to give food or drink through mouth when doctor has put patient on exclusive NG feed. Noncompliance with doctor’s advice can result in spillage of food/water into lungs and result in DEATH of the patient. NG feed should be given as advised by doctor. Preferably patient should be made to sit before giving NG feed. Anything that can pass through NG tube and does not block it can be given like water, juices(if not diabetic), milk, soup, chicken broth, milk shake, tea/coffee, thin porridge, any dietary supplement( Ensure or Glucerna) mixed in water or milk. Patient should be kept sitting for at least 30 mins after NG feed. This will help proper food passage and will prevent reflux.

Diet Chart for Non-Diabetic Patients:

bedridden-patients-ng-diet-table

Toilet needs:

If the patient can walk with help then he should be taken to toilet. Necessary arrangements can be made in toilet like putting on railings or handles near the toilet seat or bath area. If patient cannot go to toilet and if patient can sit, toilet chair should be used. Patient should be washed and dried adequately afterwards. If patient is not fully conscious or passes urine/stool without informing, then diaper can be used but it should be used as last option. Diaper should be frequently changed. Patient on diapers are more prone to infections.

Miscellaneous:

1. Being bed ridden does not mean isolation. Patient should not be confined to just one room. Patient should be taken to TV room, terrace, lawn etc. Patient who can be managed on wheel chairs should be taken on outings, dinners and family gatherings when possible. Patients should be taken regularly to parks so that they can enjoy sunshine and fresh air. It is very important for mental health and early recovery of patient.

2. Lot of bedridden patients go in depression due to their disease and disability. All family members should spend time with the patient, talking and gossiping with him/her. Preferably television should be kept in patient’s room. Bedridden patient can do many meaningful jobs/work like teaching, working online etc. and arrangements should be made for him to work with his disability. Even though he may not earn enough but at least it will give him a sense of satisfaction of being a useful member of society.

3. Necessary vaccinations like pneumonia and flu shot should be given after consultation with the treating doctor.

Disclaimer:
The information given here is intended for use of general public . It should not be taken as standard medical reference.