Hygienic care for bedridden patients. Caring for a bedridden patient at home How to properly care for bedridden patients

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

It is important for them to know how to properly carry out all procedures for the care of a bed patient.

Medical care for bedridden patients in medical institutions is carried out by personnel. When patients are discharged home, the care responsibilities are shifted to the patient's relatives. Creating a comfortable environment for these patients can improve their quality of life. Caring for a bedridden patient 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 should meet.

What should be the bedside room?

For a bedridden patient at home, it is advisable to allocate a separate room. It should be fairly spacious and light. If this is the south side, then in summer on hot days it is necessary to do shading in it. It is good if the windows have blinds. They protect from the sun when needed 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 you need should be placed at hand. The room should contain the following furniture: a table, wardrobe or chest of drawers with linen, a chair, if necessary, there may be a TV or a portable radio (the patient should be aware of all the latest events and not feel like an outcast). Excess items from the room must be removed, since they make cleaning difficult.

Care products for bedridden patients should be right there, nearby.

The mat by the bed should not slip. You can use a bathroom rug, they are usually made with a rubberized bottom that 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, since they usually have reduced immunity.

Bed of a lying patient

If the patient spends a lot of time in bed, it is desirable that his bed be special, functional. Its height is easy to adjust, the head and leg parts are raised and lowered if necessary. On such a bed there are special side racks that do not allow the patient to fall from it. A functional bed will facilitate the care of bedridden patients. Pressure ulcers are best prevented and difficult to treat. The likelihood of bedsores formation with such a bed is much less.

But if you cannot buy such a bed, then the usual one can be somewhat transformed. The required 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 over to another position.

Items necessary for the patient

Care items for bedridden patients should be nearby. There should always be fresh drinking water and a glass (mug or drinking cup), a TV remote control, patient glasses (if he reads in them), a table lamp (floor lamp or wall sconce) on the bedside table by the bed. It is convenient if the patient has a bell on the table or bedside table, with which, if necessary, he can call a nurse or a relative caring for a bedridden patient. All these objects must be arranged in such a way that the patient can easily reach them independently.

The drawer of the bedside table should contain a tonometer, a thermometer, cotton pads and sticks, as well as special cosmetical tools, talcum powder, cream and remedies for bedsores and necessary medications. The lower drawer holds disposable diapers, diapers and waste bags. Items of care for bedridden patients should be positioned in such a way that, if necessary, the patient himself can reach them. A toilet chair, if used by a patient, should also be next to the bed.

Basic rules of care

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

• patients who have suffered a heart attack or stroke should measure their blood pressure daily in the 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, blood streaks, little urine, dark or red urine, etc.), inform the doctor about it;
• the condition of the skin should be assessed daily (appearance of pressure sores, rash or redness);
• all the necessary medications must be given to the patient on a schedule or make sure that he does not forget to take them on his own.

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

In case of incontinence of patients with urine or feces, it is necessary to stock up on disposable diapers and diapers.

Underwear for the patient should be soft and only made of natural fabric, it is desirable that it be seamless, but if it has fasteners or ties, then they should only be in front.

It is always necessary to ask the patient about what he wants, and, if possible, fulfill his requests. There is no need to argue, 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 tire.

If the patient gets worse, he should not be left alone, especially at night. Leave a dim light in the room. If you yourself cannot constantly be present in the room with the patient in case of deterioration in his health, then you can hire a nurse or nurse. Nurses with medical training are better able to care for bed patients. You can hire them through an agency or look for them in medical institutions.

Hygienic care for bedridden patients

Hygiene is especially important for seriously ill patients. Immunity in such people is weakened, so any infection can worsen the condition or provoke a concomitant disease, for example, congestive pneumonia.

Hygienic care consists of 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 bedside care 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 pressure sores are most often formed).

To wash the body, 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 wiped off. A bacterial infection grows on a wet body, which can lead to inflammatory processes. After hygienic 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 mild detergents, wiped dry and treated with a protective cream (there are special creams for diapers).

When changing bed linen and diapers, they must not be dragged from under the patient, this can damage the skin and provoke the formation of bedsores.

Caring for bedridden patients. Pressure ulcers 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 the protruding areas, these are the places above the bony protrusions. Usually bedsores appear in immobilized patients. Typical places of their manifestation are the buttocks, heels, the back of the head, elbows, less often the back and hips. Caring for the skin of bedridden patients, in addition to the usual hygiene procedures, is to prevent pressure sores.

It is needed by both bedridden patients and patients using a wheelchair for movement, partially immobilized (for example, an arm or leg does not work after a stroke), as well as obese, diabetes mellitus severe or urinary or fecal incontinence.

Caring for a bedridden patient involves the prevention of pressure sores. It would be nice to lightly massage the back area after each body wash. This will increase blood circulation and thereby help improve tissue trophism, which will prevent pressure ulcers.

To prevent the formation of pressure ulcers, you must:

• eliminate risk factors for the formation of pressure ulcers;
• 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 it should be passive exercises (that is, the person caring for the patient bends and unbends his limbs on his own);
• 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 are experiencing the greatest compression (perform the most common movements - stroking, light patting);
• good nutrition.

How to eliminate risk factors for pressure ulcers?

1. Carefully examine the patient's body daily for the appearance of redness and changes in the skin, special attention to give places of bony protrusions.
2. Every 2 hours it is necessary to change the position of the patient's body. So, for example, to turn him over on his left side, you need to cross the patient's arms over the chest and put his right leg on his left. Then approach him on the right and slip one hand under the thigh, and put the other on the shoulder, and then turn the lying patient with one movement. It is necessary to turn patients from side to side as carefully as possible to avoid excessive tension or friction of the skin. A soft pillow can be placed between the legs, especially for emaciated patients (for obese patients, this measure will be unnecessary).
3. The temperature in the room must be maintained at the optimum (19-20 degrees) so as not to provoke excessive sweating of the patient and the formation of diaper rash.
4. Bed linen should always be clean and changed in time. Use soft linen and only from natural fabrics. It is best to put a disposable absorbent diaper on top of it, this will prevent the formation of diaper rash and facilitate the care of the bedridden patient.

Food for bedridden patients

Since a person who is bedridden does not move much, his nutrition should be moderate, because such an organism does not experience large energy costs. The calorie content of food is reduced, but the diet is well balanced. The amount of protein and minerals must be sufficient. Protein is a building material for cells, with a lack of it, tissue repair and wound healing will go badly.

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

Treatment of pressure sores

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:

1. Improve blood supply to the places of formation of pressure ulcers (do not lie on the wound, use a rubber circle, an anti-bedsore mattress, often turn the patient).
2. Cleanse the wound from 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).
3. Take measures for the earliest possible tightening of the wound (completely cleanse the wound from necrotic tissues, 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 illness, the patient should be in bed at first. Ischemic stroke often leads to partial immobilization of a person. Care for the bedridden patient after discharge from the hospital is carried out by his relatives. In such patients, the right or left-hand side body, and when caring for them, you should follow some rules.

Such patients need to change their body position every 2 hours, carry out a complex of physiotherapy exercises and do massage. These measures are necessary to restore nerve impulses and return the mobility of paralyzed limbs. The more often exercise therapy and massage are carried out, the better the dynamics of recovery will be. Ideally, these complexes should be repeated every 3-4 hours. Patients can perform some elementary 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, use rollers, pillows or use garters, and mobility in shoulder joint must be maintained, and some distance must be maintained between the arm and the body.

If the patient is turned on the paralyzed side, then the diseased 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, for all this time you need to be patient and consistently follow all the doctor's recommendations. The patient will have to learn again to independently hold objects and move around.

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

Update: October 2018

Anyone can face a situation where a previously healthy relative has suffered a leg or spine injury or an illness that prevents him from walking and caring for himself. And if you are one of those who cannot hire a professional nurse or nurse for round-the-clock care who knows all the intricacies of handling bedridden patients, as well as male nurses who will change his position in bed several times a day, our article is for you.

We will tell you in detail how home care is carried out for bed patients. We will describe feeding, giving water, taking hygienic measures and helping in the implementation of physiological functions. We will also consider in detail the prevention and treatment of pressure ulcers, the prevention and treatment of stagnation that occurs in the internal organs. We will tell you how professional care for bed patients is carried out - in a hospital.

Dangers of prolonged lying

Staying in a recumbent position for more than 3 days is associated with many diseases. It:

• acute pathologies nervous system (stroke, encephalitis, violation of the integrity of the spinal cord);
• chronic diseases of the nervous system (Parkinson's disease, amyotrophic sclerosis, dementia);
• pathology of joints, bones;
• diseases of the heart and blood vessels;
• ailments accompanied by imbalance,

and many others.

At its core, caring for a bedridden patient at home is a much greater effort than is required for an infant who has not yet learned how to reposition. And it's not a matter of body weight, but of pathological reactions that start very quickly, even a previously healthy person should lie for more than 3 days. Let's talk a little about these processes.

Exchange processes

Internal organs do not function without oxygen: it is a kind of "bargaining chip" that makes it possible to carry out any metabolic processes. Its delivery must be adequate to the needs of the body. For this:

1. those parts of the lungs (alveoli) in which oxygen directly penetrates into the blood, and carbon dioxide into the exhaled air should be continuously ventilated;
2. the membrane of the alveoli, through which oxygen diffuses in one direction, and carbon dioxide in the other, should not be edematous (this is typical for pneumonia of any nature);
3. the blood must be sufficiently liquid. This is ensured by sufficient fluid intake, timely treatment of inflammatory processes in the body (proteins formed during inflammation increase the viscosity of the blood), as well as a sufficient amount of proteins from food;
4. blood circulation should be sufficient, “reaching” every cell;
5. the nervous and endocrine systems involved in the regulation of the respiratory muscles should also not be damaged.

In case of forced prolonged immobilization, each of the points suffers:

Lungs

The air that we breathe does not all go "to work" even in conditions of complete health and normal physical activity. Part of it remains in the dense "tubes" of the trachea and bronchi (otherwise they would "collapse"), another part is a reserve volume in case you have to breathe deeply (for example, when physical activity or running from danger).

Expansion of the lungs, in which in chest negative pressure is created, and air is "sucked" into the incompressible airways, with the help of the respiratory muscles. Most of them are localized between the ribs in several layers, if necessary, additional muscles are connected to the work: neck, sub- and supraclavicular muscles, abdominal press. The main respiratory muscle is the diaphragm stretched like a dome under the ribs. It provides 2/3 ventilation, increasing the volume of the chest cavity, where the lungs are located, vertically.

Since the respiratory muscles are controlled both involuntarily, by commands from the medulla oblongata, and voluntarily, that is, by an effort of will, a person can use chest or abdominal breathing. In the first case, only the intercostal muscles work, the diaphragm is shifted passively, along the gradient of intrathoracic pressure. Abdominal breathing, which mainly involves the diaphragm, is capable of simultaneously lowering intrathoracic and increasing intra-abdominal pressure, improving blood flow from abdominal cavity to the heart and reducing blood congestion in the lungs.

Therefore, for the prevention of stagnation in the chest cavity, if a person is forced to lie down for a long time or move very little, he needs to master abdominal (diaphragmatic) breathing. Periodically, you will also need to perform exercises to improve ventilation: inflating balls, exhaling air with effort through a tube into the water.

Whatever muscles are involved in breathing, ventilation depends on the position of the body. In an upright position, the right lung is better ventilated, the upper sections are worse than the lower ones. If a person is lying, then those areas that lie below are ventilated better. To avoid stagnation, the body must move - now on one side, then on the other side, then on the back. Optimally, the lungs "breathe out", and the mucus that forms in the bronchi (it also becomes more viscous in immobilized people) is better coughing up when a person lies on his stomach. Also, this mucus, in which at the time of lying there are already microbes, is easier to cough up if you tap on the back of a person lying on his stomach in a special way - to carry out vibration massage.

If these features are not taken into account, then a decrease in ventilation volume, more viscous mucus and a deterioration in blood circulation will lead to the development of inflammation - pneumonia in the areas with low ventilation that are constantly at the top.

Vessels

Human vessels are elastic tubes in which the muscle layer is more or less developed. The blood flowing through the vessels is not an ordinary liquid, however, it obeys gravity. This means that in those areas where it should move against gravity, when lying down, stagnation occurs, like a swamp, in which there are no fresh currents.

By “those areas” is meant the lower extremities where blood must always overcome gravity by moving through the veins to reach the heart. Only in a healthy person, blood flow is provided by the "second heart" - the muscles of the lower leg. When the patient lies, the muscles of the lower leg and thighs lose their tone, there is nothing to ensure the outflow of blood from lower limbs, as a result of this "swamp" blood clots form in the veins of the legs. In this case, any attempt to get up or strained (for example, when going to the toilet) can lead to the detachment of a blood clot, which is able to quickly reach the lungs through the vein system and clog the vessels there. This is how a condition called "pulmonary embolism" arises, which is mostly fatal.

This can be avoided in bedridden patients by bandaging the legs with elastic bandages, especially before getting up to use the toilet or taking hygiene measures, as well as massaging them, moving them as far as the disease allows (it is optimal to perform a "bicycle").

In addition to thromboembolism, with stagnation of blood in the lower extremities, a large volume of blood is turned off from the general blood flow. Therefore, an attempt to get up (especially abruptly) can result in loss of consciousness. This is called orthostatic collapse.

The work of the digestive system in bedridden patients

The functioning of the gastrointestinal tract depends in part on the work of the muscles of the body: when forced immobilization, the peristalsis of the stomach and intestines becomes sluggish. In addition, now a person who is conscious, with more or less preserved criticism of what is happening, is forced to walk in a large way in an uncomfortable lying position, and at the same time resort to the help of other people. All this leads to constipation, and they, in turn, cause fecal intoxication (absorption of putrefaction products into the blood). So there is bad breath, coated tongue, loss of appetite, constant slight nausea.

Constipation alternates with diarrhea. The latter are caused by diet disorders, a decrease in the acidity of gastric juice, which makes it easier for various bacteria to enter the digestive tract that cause intestinal infection.

The solution to the problem lies in frequent fractional meals, adherence to a diet, when dishes are served warm, they are prepared from boiled or baked vegetables, meat, fish. The patient is fed with soups without "frying", cooked in the second or third broth or without it at all, cereals. Smoked meats, fast food, salty and fried foods should not be given to a lying person.

Muscle problems

The lack of full-fledged movements leads to relaxation of skeletal muscles, a decrease in their mass (up to 3% of the volume of all muscles can be lost per day with complete immobility). This means that even if after a while it becomes possible to get up, it will not work without outside help.

In order to prevent muscle atrophy, it is necessary to perform muscle massage, passive gymnastics, when a relative moves the patient's arms and legs.

Immobility and joints

As a result of prolonged immobility, the joints "wedge": neither active nor passive movements become possible in them, the limb freezes in some position (this is called contracture). So, the foot is extended to the "tiptoe" position, the hand becomes like a "bird's paw", the knee practically stops bending-unbending. When contracture has developed, severe pain arises when the damaged joint is activated, which is why many refuse to continue working. Then between the bones of the bony articulation, bone fusion is formed, and it becomes motionless. This is called ankylosis.

To prevent the development of either contractures or ankylosis, you need:

• perform passive and / or active gymnastics in all joints, while there should be no violent movements and pain;
• lay the limbs in the correct physiological position on the bed;
• when contracture begins to form or the limb is paralyzed, a plaster cast is applied to it for a while - so that the limb is forcibly in a physiological position.

Immobility and skeletal system

In bedridden patients, blood supply worsens not only to the skin and internal organsbut the supply of nutrients to the bones also deteriorates. This is how osteoporosis develops - the rarefaction of the main parts from which the tubular bones are built - bone beams. This increases the risk of spontaneous fractures. In addition, the red bone marrow inside the bone is affected. Because of this, the production of platelets decreases (this leads to spontaneous bleeding), leukocytes (because of this, immunity decreases) and erythrocytes (anemia occurs).

Urinary tract in bedridden patients

Due to the horizontal position, urine stagnates in the kidneys, contributing to the formation of stones and their infection. In addition, it is more difficult to keep urine while lying down, which is partly due to the unwillingness to ask for help from others. The leakage of urine onto the bed leads to the formation of pressure sores.

Changes in the psyche and nervous system in bedridden patients

If before the illness, which led to the fact that the person fell ill, he was already old and sick, then the forced immobilization will not lead to a violation of the attitude towards life, himself and his relatives. But if the disease has actively laid down a moving person, as a result of immobilization, it comprehends:

• depression;
• insomnia, when even taking sleeping pills does not give a feeling of rest;
• irritability;
• loss of social skills;
• hearing impairment (this is due to the fact that the patient is now lying down, and those who communicate with him are sitting or standing);
• deterioration in mental activity;
• disturbances from the peripheral nervous system, due to which a person freezes more easily, feels significant discomfort when changing clothes, airing, and so on.

If the patient is forced to lie not for tens of years, but for several months (for example, as a result of a fracture), when getting up he will stagger for a long time, which will require the use of crutches, handrails or walkers.

All these problems are especially aggravated by the care of a relative for a bedridden patient: if earlier he was willing to make contact, was benevolent and accommodating, then during immobilization the person becomes demanding, capricious, whining, accuses of inattention to his person. Nevertheless, in order to improve the condition of a loved one and stop suicide attempts, relatives will have to pay attention to him, as well as install a baby monitor at his bedside so that the patient can call for help or can be heard if he thinks to get up or use it for other purposes, for example, cutlery.

What happens to the skin

The integumentary tissue of a person forced to lie down for a long time becomes thinner. This also happens due to the absence of a load on it, which in this case consists in stretching it and compressing it. More pronounced atrophy affects those areas of the skin that are subject to compression. After 2 hours of being in the same lying or sitting position, in those places that are above the bony protrusions or are pressed by the bones to the bed, those that are localized above the fold on the underwear or directly on the hard bed, ischemia begins. Particularly affected are areas of the skin, between which and the muscles there is very little fatty tissue, which is a kind of shock absorber. It:

• in the supine position: sacrum, heels, ischial tubercles, shoulder blades, elbows, back of the head;
• lying on your back: on the side of the thigh, on the knees, on the sides of the ankles, on the lower shoulder, on the temple;
• lying on his stomach: pubic, cheekbones;
• on a hard bed or in a sitting gurney: the area of \u200b\u200bthe tailbone and shoulder blades, heels, and when resting on the entire foot - socks.

Ischemia is exacerbated if the skin is displaced from its normal position, if it is wet with sweat, urine, or not dry after bathing. Then, in places of friction, diaper rash appears very quickly, then maceration, and bedsores form in their place.

The task of relatives who have had a misfortune with a loved one is to pay maximum attention to each of the pathological factors, preventing them from “raising their heads”. And in order to then spend not such huge sums on the treatment of a relative every month, no matter how much you want it, you will have to start leaving the hospital. This should be done with the help of the medical staff of the intensive care unit, and then, upon discharge, continue at home. Step by step instructions Inpatient and home care for bedridden patients below.

Features of hospital care

When relatives have a misfortune, as a result of which they - for a short time or for life - find themselves bedridden, the first stage of assistance is usually a hospital. In order to have fewer health problems for your lying loved one in the future, you need to start caring for your loved one at this stage, especially since now you can even be in the intensive care unit.

In this position, there are not only disadvantages for the caregivers, that they will have to (not everyone wants to do this) to waste time, money and effort now. There are also pluses, which are as follows:

• they will tell you what you need to pay attention to, how to properly wipe, bathe and feed your relative. This will allow you to save money on the purchase of unnecessary drugs and accessories in the future; you will also save time to read the necessary information on the Internet or the waiting time for the district nurse / doctor;
• you will see and begin to navigate with the feeding of a relative: when he can only eat liquid food, and when it is already possible to grind it or allow the presence of pieces. This will help, when a person's condition worsens at home, not to feed him inappropriate food, which can cause blockage of the airways with food and death;
• you have time to get used to the idea that the relative is no longer as independent as before, and you can figure out if you can cope with leaving on your own or you will have to hire a nurse;
• you do not see the suffering of a relative around the clock, there is time to relax mentally;
• the bedridden patient sees and feels the care of his relatives, the feeling that he has become a burden is not added to his depression due to the current situation.

Of course, the medical staff does not force a relative who has come to a bedridden patient to take care of him. Given the poor medical provision of hospitals and the high cost of drugs, it is preferable to bring the necessary medication to the patient. But the paramedics and nurses caring for your relative are actually extremely busy. Nurses and nurses have to take care of several people at once and fill out a huge amount of paperwork. This will not allow you to perform the necessary care procedures for your loved one in the required amount. Then the patient will be discharged, and all the consequences of the lack of care will fall on your shoulders. To avoid this, it is better to allocate at least 1-2 hours a day (optimally in the morning and in the evening) to provide the bedridden patient with the necessary procedures.

A feature of inpatient care is the availability of aids to meet the physiological needs of the patient. It is a feeding tube and urinary catheter for urine discharge. Most likely, you will not have such funds at home: they will be removed in a hospital so as not to create an opportunity for additional (through these tubes) penetration of infection into an already weakened body.

In addition, in the hospital, the patient has a venous access, where the necessary drugs are administered. Before discharge, for the same reason as the urinary catheter tube, it will be removed. All the necessary drugs, already in agreement with a specialized specialist (a neurologist - if a person has had a stroke, a cardiologist - if a heart attack), the patient will be administered by a nurse who comes to the house.

Home care - where to start

Caring for bedridden patients after a stroke or any other condition depends on how immobilized a person is, what social skills he has lost, how long he has not been engaged in. Nevertheless, there are many general rules, after reading which, you will understand what to do for you.

Accommodations

Whatever moral discomfort it may cause, if you cannot afford several shifts of 24-hour nurses with medical education, you will need to live in the same apartment / house with a lying relative. For him, you need to allocate a separate room, preferably on the sunny side, while the windows should be closed with blinds so that the light does not shine into the eyes.

There should not be a lot of furniture in the room, but also completely look like a hospital ward (only a bed and a bedside table next to it) is the wrong decision that causes nervous stress. Imagine yourself in a forcedly inactive position, on a bed, when the rest of the family is active and going about their business, and think about what you like.

If you do not expect that a person will be able to get up in the near future, it makes sense to immediately purchase a special bed. These are two- and three-section functional beds: the first option allows you to raise the headrest or legs, while the three-section design also allows you to bend your knees or give a person a half-sitting position without his help. The second type of bed design is optimal for severe paralysis of a person, especially when he is also overweight or has urinary incontinence.

Place a nightstand next to the bed. If the patient moves a little, put a sippy water bottle, wet wipes, a telephone or (for the older generation) a radio on the bedside table. Nearby there may be a TV remote control or a book, a glass in which his removable dentures will be stored. Also, there should be a baby monitor or a walkie-talkie on the bedside table, allowing caregivers to hear what is happening in the room, and so that the sick person can call.

The room needs to be ventilated three times a day, for 15-20 minutes; for this time, the patient needs to be covered with a blanket or duvet cover (the last one - in summer). It is worth hanging a bactericidal emitter on the wall (preferably one that can be quartz in the presence of a person, without covering him with a blanket over his head). Wet cleaning in the room is a must.

If the patient can get up, even with assistance, put a toilet chair by the bed.

Put in the nightstand:

• thermometer;
• tonometer;
• antiseptics with which the skin is treated;
• cotton buds;
• cotton wool;
• alcohol;
• talc;
• camphor alcohol;
• diapers - if the person is not in control of their bowel movements.

The drugs you take can be put on the bedside table or in it only if you are sure of the mental health of your relative: that he will not deliberately exceed the dosage of drugs.

A boat or a duck can stand under the bed if the patient senses when he wants to use the toilet and can call. A duck, that is, a device for men where they can urinate, can be hung (most have a special hook) on the side of the bed, if there is one (on the side from which the patient does not get up).

If the patient has become inadequate, lost orientation in space, place or time, file the legs by the bed or constantly raise her bed. Also, remove all traumatic objects (sharp, cutting, stabbing) from his room.

It is very important to maintain a decent moral condition of the patient. To do this, you need to go to him as often as possible and talk affectionately while you are carrying out care activities. Leave the night light with a weak light at night, unless a relative asks to completely extinguish the light: he should not feel abandoned.

Lying conditions

The patient should be dressed in soft clothes made from natural materials that will not have buttons, ties, fasteners or zippers - everything that, when lying on it, will form unnecessary squeezing of the skin. It is optimal if there are no seams on the nightgown / T-shirt and underpants or they will be located only in the front.

The patient should lie on bedding made from natural fabrics. In this case, you need to make sure that there are no folds under his back, and that he does not crawl onto an open bed. This is a direct path to bedsores. If the sheet often wrinkles, you can buy or sew one with an elastic band around the edges. This is how the sheet is put on the mattress. If a person has urinary incontinence, it is possible to lay him on an oilcloth, but he should not lie on a “bare” oilcloth. It is better to put a diaper on the person (it should also be straightened out) and periodically give him a break from the material that absorbs urine. Then it is better to lay it with the buttocks on a moisture-absorbing disposable diaper measuring 90 * 60 cm.

To prevent pressure ulcers, the patient needs to be turned every 2 hours, or remind him to do it himself. If a relative is paralyzed and you have to turn him over, lay him - whether on his stomach, side or back - so that he lies comfortably. Under the knees, if a person is lying on his back or honey on his knees, if he is lying on his side, you need to lay a pillow. If you put a relative on their side, place a pillow or several under their back so that they can lean on them. While lying on your back, place small rubber circles (such as circular resistance bands) under your elbows and heels. A special circle can also be placed under the sacrum. You can use anti-decubitus mattresses, which we'll talk about later.

Change the sheet every few days or if it gets wet. In paralyzed patients, this should be done according to the algorithm:

1. turn the person on their side;
2. roll the sheet behind his back into a "tube";
3. in place of the rolled-up sheet, lay a section of a clean sheet, also rolled up in a “tube” or folded “accordion”, unfold it;
4. turn the patient on the other side so that he rolls over, rolling over a roller of two sheets;
5. then you just have to pull out the dirty sheet and straighten the clean sheet.

You can use another method:

• grab the edge of the sheet to be replaced, on which the patient lies, on one side of the bed, pull it so that the patient turns over on the sheet with his back to you;
• throw the freed half sheets over the patient from above;
• spread a new sheet evenly on the vacated surface of the bed, and fold its end intended for the occupied space with a narrow (20-25 centimeters) accordion so that the opposite edge of the sheet looks away from you, i.e. at the back of the patient;
• return the dirty end and the patient to the back;
• turn the patient over to the other side by pulling the other end of the sheet. Place it on top of the patient, as last time;
• spread the accordion. If the accordion is partially under the patient, then by pulling on the protruding edge, you can dissolve the accordion and release the sheet without effort;
• straighten a clean sheet, and fold the end of the dirty sheet like an accordion;
• turn the patient from one side to the other and pull out the dirty sheet.

Do not forget to hold the patient all the time, the position on the side is unstable.

Hygiene measures

A lying patient must be bathed, washed, and combed every day. If he can move on his own, he is taken to the bath, where he is bathed in the shower, it is better if baby soap and baby shampoo are used for washing. Be sure to then thoroughly soak the body with a gauze napkin or soft terry towel, since going to bed with a wet body is fraught with the development of bedsores.

Body wash

If the patient cannot get up, wash him right in bed. To do this, use two basins for water, a support for a basin, a container for heated water, lotions, gels or washing foams. An oilcloth is laid under the part of the patient's body to be washed, washed with a soft sponge, without unnecessary friction; after washing, dry thoroughly, apply moisturizers:

Seni Care Body Gel	Seni Care Arginine Protective Body Cream
Menalind professional protective cream with zinc	Protective body cream Seni Care zinc and others

In places that are subject to friction - camphor alcohol. Only after the funds have dried can the person be laid on the bed, but it must also be dry.

Places that are rubbed or slightly reddened are not treated with ordinary soap, but with a foam for lying down, for example, TENA Wash Mousse or Seni Care foam.

TENA Wash Mousse

Washing head

A special inflatable bath with a pipe for draining water into a bucket is used for shampooing. The head is raised, placed in a special hole in this bath, gently poured on top with warm water and washed. After rinsing the head, soapy water is drained through the tube, and the head is rinsed with clean water, which is also poured out through the tube. Be sure to wipe your hair with a towel and dry it with a hairdryer before putting the person on the bed.

Shaving

Shaving is carried out as follows: shaving foam is applied to the face, a basin of warm water is placed next to it, where they will dip the razor from time to time. After removing excess hair, a moisturizer or lotion is applied to the skin.

Teeth cleaning

The teeth are brushed either with a brush or, if the patient is not conscious, use a latex pad with a brush, which is put on the finger (they are sold in the children's goods department, to care for babies). A paste is applied to the brush, which contains hemostatic and antiseptic substances. These are LACALUT active, SILCA Complete Sensitive, PerioTherapy Healthy Gums Toothpaste, PRESIDENT Sensitive pastes. Brush teeth from all sides, tongue, inner surface of cheeks. You can rinse your mouth with water, a solution of soda (1 tsp per 1 liter of water), a decoction of chamomile, calendula or oak bark. In unconscious patients, this is done with a rubber syringe.

To wash the patient's face, use:

• washing cream TENA Wash Cream
• seni Care cream
• menalind professional care lotion

Do this in the morning and evening with a soft sponge. After rinsing off the cleaning solution with clean cotton pads, wipe the eyes: from the outer edge of the eye to the inner (so that there is no sagging of the eyelids).

Hand washing

Hands are washed with the same detergents as the body. Before washing, each hand is immersed in a bowl of detergent solution and treated with a sponge or foam gloves. The interdigital space is especially cleaned - a large number of microorganisms-pathogens accumulate here. After washing, the hands are dried with a towel and a special care agent is applied to the elbow area (as a rule, coarse skin is often observed on them) - Seni Care cream for dry and rough skin. After that, the patient's nails are trimmed and filed with a special file. Further, nail care is carried out as they grow back.

Hygiene of intimate areas

It is carried out in the following sequence:

• a moisture-absorbing diaper is laid under the patient's pelvis;
• the diaper is removed;
• a soft sponge is taken with a gloved hand, dipped in water with a detergent solution. It can be TENA Wash Mousse or Seni Care;
• the patient's legs move apart, bend at the knees;
• the perineum, genitals, and then the anus are washed in the direction from the pubis to the anus;
• the cleaning solution is washed off;
• the washed area is dried with a specially selected soft towel;
• the patient turns on his side, his buttocks are also dried with blotting movements;
• bepanten cream or Sudocrem is applied to the skin.

After each urination, women should wipe the perineum with Seni Care wet wipes.

Hygiene of the feet

Feet are washed in a basin of warm water. With a sponge or mitten, the caregiver should "pass" from the heels to the lower leg, washing away all the dirt, especially between the toes. Next, dry the feet with a towel, apply (especially on the heels) baby cream, baby cream mixed with oil vitamin A, Bepanten ointment.

Feeding, nutrition

The diet is prescribed by the attending physician and depends on common disease and the extent to which chewing and swallowing skills were affected. If the patient's consciousness is unclear, he does not answer questions or does it inappropriately, he needs either liquid food, or food boiled and rubbed through a sieve or blender. If he is lucid and adequate, he is fed with cereals, soups in the second broth, in which there are medium-sized pieces of vegetables. The daily diet is divided into 5-6 meals, it must be given out strictly according to the schedule. Proteins in the form of a soufflé, meat puree or steam cutlets must be mandatory, otherwise protein-free edema will appear, over which the skin will tear, forming bleeding and poorly healing wounds. It is imperative to give water, compote, tea and non-acidic juices, it is necessary to limit the liquid only with a heart, renal failure, cirrhosis and liver cancer.

They are fed as follows. If the patient is not completely paralyzed, then with the help of pillows or raising the headrest of the functional bed by 30 degrees, he is given a semi-sitting position. A diaper is laid on the chest and fed from a spoon (you can put a special table, which often comes with functional beds and, if a person is able to serve himself, they put food on him in plates (with suction cups), which should stand firmly on the table.

If the patient is paralyzed and it is not possible to give him an elevated position, then they turn his head to one side, spread a diaper on his shoulder and feed him.

After feeding, wipe the patient's face with wet wipes, be sure to shake off the crumbs from the bed.

The liquid is given from a drinker or from a glass in which the cocktail tube is located.

Physiological functions

If the patient is able to get up and feels the urge to urinate and defecate, a toilet chair is placed near his bed, where he is helped to transfer if necessary.

If a person is unable to get up, but feels the urge to urinate and defecate, he is given a vessel (for women - for both types of physiological functions, for men - only for defecation) or a duck (for emptying the bladder in men.

If the patient suffers from urinary or fecal incontinence, he needs an adult diaper.

Massage

In order to avoid muscle atrophy, it is imperative to carry out massage - classical and vibration. Kneading, stroking and rubbing movements work out the muscles of the back and limbs so that it does not hurt. This should be done after the massage oil is applied to the skin.

Vibration massage is performed after the patient is turned on his side. Camphor alcohol is applied to his back on both sides of the spine. Further, starting from the lower sections, a palm is placed on each area, on which the fist of the other hand is lightly tapped. So every day the lungs are worked out to prevent pneumonia.

Physiotherapy

It consists in passive and active movements in each joint. So, circular movements with a brush, clenching and unclenching of fists, bending of the neck and turning the head, movements of the feet, knees, hips are performed to prevent contractures and treat paralysis.

In those joints in which a person cannot make movements, the caregiver helps him, while the rest of the patient must move himself. The main task of the caregiver is to encourage and remind of the need for physical therapy.

If contractures have developed, after performing massage and exercises, removable plaster splints are applied to the limbs (any rehabilitation doctor will tell you how to do them). The legs are then wrapped in elastic bandages. In case of varicose veins, the skin of the lower extremities is treated with Lioton or Heparin gel in combination with Troxevasin gel.

Medical problems

A bedridden patient needs to measure temperature and blood pressure daily. If the temperature is elevated, it is necessary to give "Paracetamol" or "Ibuprofen", and then call a doctor. If the pressure is increased (above 140/99 mm Hg), 10 mg of "Enalapril" or previously prescribed drugs "for pressure" are given.

Also, relatives are forced to record on paper:

• the amount of fluid you drink;
• the volume of daily urine;
• frequency and nature of bowel movements.

If loose stools appear, blood is found in the urine or feces, the amount of urine decreases or it changes color and odor, and a rash or non-healing wounds appears on the body, call a doctor.

Bedsores

This is the name of the ulcerative-necrotic defects of the skin and underlying fiber, which occur mainly with defects in the care of a bedridden patient. They also appear if he has been lying for quite a long time, and his psycho-emotional state has changed so much that he interferes with relatives in the implementation of care procedures. Pressure ulcers are problem number 1 in bedridden patients. It takes not only time, effort and money from relatives, but can be complicated by suppuration, as a result of which blood poisoning (sepsis) develops rather quickly with damage to most internal organs.

The risk of developing ulcerative necrotic defects is significantly increased in the following cases:

• being overweight;
• if the person is severely emaciated, did not eat or drink enough;
• diabetes mellitus;
• smoking;
• pathology of the heart and blood vessels;
• incontinence of urine and feces;
• high body temperature;
• diseases or injuries of the brain or spinal cord;
• if you are allergic to bed care products;

and also in case of such violations of care, when there are buttons, seams or folds on the bed or underwear, dirt on the body (or the body is sweaty or wet), crumbs or small particles come across in the bed. Such patients in particular need prevention of pressure sores, and with the slightest redness on:

• sacrum;
• knees;
• nape;
• temples;
• shoulder blades;
• heels and bones in front of the toes;
• elbows;
• shoulder joints,

you need to immediately start treatment of pressure ulcers (about it - below).

To prevent the development of necrotic skin changes

For the prevention of pressure ulcers, care for bedridden patients should mainly include those activities that have been discussed in detail below. It:

• compulsory spreading of bed linen under the patient;
• food rich in proteins, iron, zinc and ascorbic acid: boiled chicken meat, chicken broth, dairy products, vegetables, fruits;
• seamless and buttonless underwear and underwear;
• change in position in bed every 2 hours;
• laying under bony protrusionsthat rub against the skin, rings, bags of tissue filled, for example, with buckwheat husk or sand;
• timely change of diapers;
• daily bathing, after which a moisturizing cream is applied to the skin, and drying agents (for example, Sudokrem) in places where redness is visible;
• massage;
• rubbing the back and limbs with camphor alcohol;
• thoroughly wiping the skin before putting the patient on the bed;
• periodic being without a diaper.

Treatment of pressure sores

The optimal situation is to examine the skin of the whole body, especially in those places that are in contact with the bed or with each other, and take appropriate measures at the slightest appearance of redness. But this is not always possible, so below we will consider what stages of pressure ulcers are and what to do on each of them.

Stage	What does it look like	What to do
0	Slight redness that disappears with finger pressure	Lotions with camphor alcohol
I	Redness that does not disappear when pressed with a finger from above may be accompanied by swelling, but there is no violation of the integrity of the skin	The patient's extremity is placed on an anti-decubitus pillow with memory shape or an anti-decubitus cellular mattress. The wound is washed with chlorhexidine, sprinkled with Baneocin powder, and this alternates with the application of a Branolind mesh with Peruvian balm, which can be cut to the size of the pressure sore and fixed to the skin with a hypoallergenic plaster. Alternate these activities with the application of the gel "Actovegin" or "Solcoseryl", "Levomekol" or "Oflokain". Inside: multivitamins.
II	The skin is swollen, blisters form on it, which partially flake off. The process involves subcutaneous tissue	The activities are the same as in the previous stage The patient should lie on a cellular type anti-decubitus mattress Antibiotics - in the form of tablets or intramuscular injections In addition, detoxification is needed, which consists in the intravenous administration of solutions
III	Deep wound, in the depth of which fatty tissue and muscles are visible	Removal of dead tissue by surgery, followed by drainage of the wound. After that, dressings with such drugs as Collagenazine, DNase, Chymotrypsin, Vulnuzan, Argosulfan, Sulfargin, Iruksol or Intrasite are applied to the wound. The patient should lie on a balloon-type anti-decubitus mattress Intravenous administration of a combination of 2 antibiotics, which are selected at the beginning of a wide spectrum ("Ceftriaxone", "Ceftazidime" with "Metronidazole"), then change to those to which there is a sensitivity of the microflora from the wound (found out using bacterial culture) Detoxification - intravenous administration of solutions
IV	Inflammation "eats away" the tendons, can spread to bones, the wound is filled with pus	The same as in the previous stage. Before surgical treatment can be applied: "Proteox-TM", "Biaten AG", hydrocolloidal agents. In addition, to stimulate healing, not only ointments should be used here, but also physiotherapy procedures: ultrasound, phonophoresis of antiseptics, darsonval of tissues surrounding the wound. After the healing of the pathological process, autodermoplasty can be performed

For the treatment of stage 2 pressure ulcers, you can also use the following algorithm:

1. Stop sweating fluid into the wound. This is done using trays with Delaskin or Baneocin powder. After such baths, it is not necessary to blot the skin, wait for it to dry on its own.
2. After 2 days, a local antimicrobial therapy is connected: "Fuzikutan", "Levsin", "Levomekol", "Iruksol".
3. On the 9th day from the start of therapy, agents that improve tissue restoration are connected: Vulnostimulin, Actovegin, Solcoseryl.

Thus, after a stroke, caring for bedridden patients will require the acquisition of at least:

Wet wipes
Ducks or ship
Diapers
Toothbrush Finger Pads
Anti-bedsore mattresses
Circles for protruding body parts
Special detergents
Elastic bandages - for bandaging paralyzed limbs
Moisturizers - for dry skin areas, heels, sacrum, hands
Means for improving blood circulation in rubbing areas, as well as in the area of \u200b\u200bthe lungs
Desiccants - if any surface of the body touching the bed or other part of the body begins to redden

The need to care for a sick person who cannot get out of bed and needs the care and attention of relatives and friends always makes us think about the need to acquire some skills to help cope with this difficult problem. How to organize proper care, using only your strength? How to alleviate the suffering and worries of a loved one or loved one? How to take care of the patient so that they do not form on the skin? What care products should you choose so as not to harm?

• gentle cleansing of the skin;
• effective and inflammatory reactions in the genital area, anus and in the natural folds of the skin;
• therapeutic measures that contribute to the restoration of the skin.

In this article, we will introduce you to these important aspects of caring for bedridden patients, and this information can help you avoid mistakes in this difficult and important matter.

Hygiene procedures

Hygienic measures for patients who are forced to spend a long time in bed should be carried out in the morning and evening. Doctors recommend doing them before breakfast and before bedtime, because these are the time intervals that are most favorable for performing such procedures.

To perform hygiene procedures, it is necessary to prepare the following hygiene products:

• two basins for water;
• inflatable bath for shampooing;
• support for the pelvis;
• a jug for heated water;
• special cosmetics and devices for the care of bedridden patients: gels, foams, lotions, creams, foaming mittens and sponges (for example, Tena Wash, Seni Care, Menalind, etc.);
• gloves for medical and cleaning;
• tissue and paper towels and napkins;
• rubberized diapers and disposable oilcloths;
• absorbent diapers;
• cotton wool;
• gauze napkins;
• cotton buds;
• special toothbrushes (if the patient himself cannot brush his teeth);
• items for haircuts, manicure, pedicure and shaving;
• male or female urinals;
• colostomy bags;
• circles, rollers or mattresses to prevent pressure sores.

If necessary, other hygiene products can be added to this list:

• bibs for neat feeding;
• diapers;
• urological and gynecological pads;
• dry closets;
• shower chairs or bath seats and handrails;
• toilet chairs;
• devices for the care of stomas;
• disposable underwear and bedding, etc.

The doctor can help determine the need for certain means for caring for a bedridden patient, since their range largely depends on the patient's diagnosis.

Before starting skin cleansing procedures, it is necessary to eliminate all possible sources of drafts and make sure that the air temperature in the room is at least 20 degrees. Such a precaution in caring for bedridden patients is never superfluous, since due to illness, their immunity becomes weakened, and sharp fluctuations in temperature can lead to an exacerbation of chronic diseases.

In what sequence should the procedures be carried out?

Before carrying out hygiene procedures, it is recommended to put on the first pair of medical gloves and protect the bedding with an absorbent or waterproof sheet and oilcloth. After that, the nightgown is removed from the patient and stage-by-stage hygiene procedures begin.

Stage 1 - caring for the patient's oral cavity

If the patient's condition allows, then he can be seated on a chair or give his body a semi-sitting position. If the patient cannot change the horizontal position of the body, then his head must be turned to one side and, using cotton swabs (pagavit), clean the cheek space from accumulated saliva and plaque. To facilitate the performance of hygienic procedures for the oral cavity, you can use special disposable plastic spatulas, with which you can alternately and gently move the left and right cheeks.

To clean the teeth of a sick person, you can follow the same rules as for cleaning the teeth of a healthy person, but the movements of the toothbrush in such situations should be more gentle and performed with the utmost care.

After completing the procedure, it is necessary to rinse the patient's mouth with water or a hygienic solution (special solutions for rinsing the mouth, solutions of soda, hydrogen peroxide, borax, etc.). To do this, you can use a rubber syringe and a soft tip or special rubber balloons to rinse the patient's mouth. When performing this procedure, the head must be slightly raised above the surface of the bed so that liquid does not enter the esophagus and respiratory tract.

A special approach is also recommended when choosing a toothbrush and toothpaste for the care of a bed patient. In most cases, in such patients, the oral mucosa becomes vulnerable and sensitive to the effects of stiff bristles, and the toothpaste should be selected in accordance with the age-related needs and characteristics of the patient's diagnosis.

Anti-bleeding gums

• LACALUT aktiv;
• LACALUT fitoformula;
• Parodontax;
• Parodontax F, etc.

For patients with increased sensitivity of tooth enamel, the following toothpastes are recommended:

• SPLAT;
• LACALUT Extra Sensitive;
• PRESIDENT Sensitive;
• SILCA Complete Sensitive;
• Oral-B Sensitiv.

• a series of DIADENT toothpastes: DiaDent Regular, DiaDent Active;
• PerioTherapy Healthy Gums Toothpaste.

For seriously ill children forced to lie down for a long time, it is recommended to choose toothpastes that are able to match their age and have the necessary properties that are determined by the diagnosis.

The duration of the use of medicinal toothpastes for seriously ill patients is determined individually, since some of their active components with prolonged use can have a negative effect on the health of the oral cavity. After their use, the use of hygienic toothpastes is recommended.

After completing this procedure, it is necessary to blot the patient's lips with an absorbent napkin and apply hygienic lipstick or moisturizing balm to them, which prevents dry and chapped lips. For this, the following means can be used:

• balm EOS;
• lip balm BABE Laboratorios SPF 20;
• fatty oils: shea butter (shea butter), jojoba, cocoa, soy;
• hygienic lipstick "Morozko".

When choosing such balms and hygienic balms, be sure to make sure that they are hypoallergenic.

Stage 2 - washing

The following solutions can be used to wash the patient's face:

• seni Care washing cream;
• washing cream TENA Wash Cream;
• EHAdez;
• washing lotion Menalind professional;
• ElekSi and others.

One of the above solutions is diluted in water and moistened with a sponge or hygroscopic glove. After that, they wipe the patient's face, and then proceed to the hygienic treatment of the eyes. It is recommended to use two wet cellulose discs for this procedure (use a separate disc for each eye). In this case, movements should be directed from the outer corner of the eye to the inner one.

You can use cotton swabs to clean the inner surface of the ears and ear canal. After that, using a damp sponge, it is necessary to cleanse the skin behind the ears, the area of \u200b\u200bthe neck, chest (including the folds under the breast), the surfaces of the sides and the abdomen of the patient. In parallel with these actions, the cleansed areas of the skin are blotted with a well-absorbing cloth and covered with a towel (blanket) or put on clothes on the treated areas of the body.

After this, the patient is gently turned over on his side and the back area is wiped with the same washing solution. The treated skin areas are dried with a towel and one of the means to protect the skin from pressure ulcers is applied to them:

• seni Care body gel;
• protective cream Menalind professional with zinc;
• protective body cream Seni Care with arginine;
• protective body cream Seni Care zinc, etc.

In the absence of contraindications, after cleansing the skin and applying care products, it is recommended to perform percussion massage.

Sometimes, to wash the irritated areas of the patient's skin, you have to use special products that provide gentle cleansing of the skin. These include:

• tENA Wash Mousse foam;
• seni Care foam, etc.

Stage 3 - washing hands

Use the same detergent solution for hand washing as for body wash. Each hand of the patient is alternately immersed in a basin with a washing solution and washed with a sponge or gloves. Close attention is paid to the cleansing of the areas of the interdigital space, since it is in it that a large number of pathogenic microorganisms often accumulate.

After washing, the hands are dried with a towel and a special care product is applied to the elbow area (as a rule, coarseness is often observed on them) - Seni Care cream for dry and rough skin. After that, the patient's nails are trimmed and filed with a special file. Further, nail care is carried out as they grow back.

Stage 4 - changing diapers and hygiene of intimate areas

Before you start cleansing this area of \u200b\u200bthe body, you must change the gloves and prepare a new solution for washing.

• lay a waterproof diaper under the patient's pelvis (if the bed was not previously covered with a waterproof oilcloth with an absorbent sheet or an absorbent sheet);
• remove the diaper and wrap it in a bag;
• put on a hand for washing or take a special soft sponge for treating intimate areas;
• moisten a mitten or sponge in a detergent solution and wring it out;
• spread the patient's legs and put them so that they bend at the knees, and the heels are as close to the pelvis as possible;
• process the perineal area so that the movements of the sponge are directed from the pubis to the anus;
• dry the crotch area with a soft towel (for this, only a specially selected towel or disposable absorbent diaper can be used);
• turn the patient on their side, wipe the body and dry the skin with a towel (special attention should be observed when drying natural folds);
• apply a protector (protective foam or cream) to the skin;
• take a clean diaper, unfold, fold it along and gently unfold the protective cuffs and fasteners;
• put on a diaper on the patient.

To treat the crotch area, you can use wet wipes for intimate hygiene or cleansing foams. To do this, you can purchase the following tools:

• wet wipes Seni Care or TENA Wet Wipe;
• seni Care foam or TENA Wash Mousse.

Step 5 - washing your feet

To wash your feet, prepare a new detergent solution and change the sponge or washing mittens. Further, the procedure is performed in the following sequence:

• wipe your feet with a sponge or washing mitten up to the ankle;
• dry your feet with a towel
• the patient's feet should be lowered into the pelvis and washed, paying close attention to the areas between the toes;
• dry your feet with a towel;
• turn the patient on his side and apply anti-pressure sores on the back of the legs;
• put the patient on his back;
• trim your toenails and finish them with a pedicure file.

After completing all the stages of washing the patient on the rough skin areas (for example, on the elbows, heels or knees), you can apply special products to effectively soften them - Seni Care cream for dry and rough skin. The completion of hygiene procedures should end with putting on a shirt, giving the body a comfortable position in bed and, if necessary, placing rollers or special inflatable rings to prevent bedsores. After that, cover the patient with a blanket. In some cases, after the completion of hygiene procedures, it is recommended to carry out therapeutic measures (for example: treatment, prevention, etc.).

All the above stages of hygiene procedures for the care of a bedridden patient should be performed daily. Compliance with this rule always positively affects the patient's condition and has a positive effect on the condition of the skin, preventing the appearance of bedsores and the development of infectious complications.

Washing head

Washing the patient's head should be carried out as the hair becomes dirty. To perform this procedure, you must prepare the following accessories:

• a basin for washing (for this it is more convenient to use special inflatable baths for washing your hair);
• support for the pelvis;
• a jug of water at a comfortable temperature;
• shampoo;
• oilcloth;
• towel;
• comb;
• kerchief or hat.

The patient is placed on his back and a pillow is placed under his shoulders in such a way that its upper edge is at shoulder level, and the head is slightly thrown back. A roller is rolled out of a towel and placed under the neck. The head of the bed is covered with oilcloth, on which a basin of water is installed.

Relatives should treat a serious illness of a loved one with understanding and participation.... The motionless bed patient needs special care.

It is very important for him to always feel well-groomed and clean. Untidiness and unpleasant odor can significantly worsen an already disturbed psychological state of a person

In severe cases, it is not possible to wash the ward in the bath or shower, which not only keeps the patient clean, but also brings many pleasant moments.

For debilitated patients, washing in bed is the only option.... The procedure is quite complicated, so loved ones should know how to properly wash a bed patient at home.

After all, the hygiene of a person in this state requires patience and certain skills from the carer.

Before carrying out the procedure, you should carry out the following actions:

In order to know how to properly bathe a lying patient at home, you need to familiarize yourself with the preparation for the procedure described above.

It is important to adhere to the sequence of actions:

If the ward cannot handle the intimate area himself, then before moving on to the perineum, it is imperative to change the water.

In addition to carrying out daily hygiene procedures, you have to periodically wash your hair... If a person is completely motionless, then it is rather difficult to do it alone.

But if you want, you can do everything, so it is important to know how to wash the head of a bedridden patient at home. Difficulties arise only the first time, then, if everything is done correctly, it is easy to adapt to it.

The ward may have long or short hair... For shorter ones, care is easier. Long ones require effort.

In many cases, they are shortened, especially if it is assumed that immobility will be prolonged. In addition, in seriously ill patients, the hair structure is disturbed, and a haircut will allow them to recover faster.

There are several ways to wash the head of a lying person:

An intimate hyena of a lying patient should be carried out without the presence of strangers, an immobile person already feels uncomfortable. Before the procedure, lay a diaper with an oilcloth base on the bed.

The patient must be laid on his back, the legs at the knees must be bent. Place a vessel under the sacrum.

A hygienic procedure for a woman is carried out using a washing mitt, which is moistened with warm water. A small amount is applied detergent and the crotch area is gently processed.

It is convenient to use a soft cotton swab for washing men. The washed parts of the body should be dried with a towel and applied with an emollient cream or lotion.

Special diapers for adults ease the patient's condition... They protect the skin from irritation and diaper rash, prevent the appearance of an unpleasant odor.

The teeth of a lying person, like a healthy person, should be brushed twice a day.

To perform this procedure, you need to raise the head of the bed so that the patient is in a half-sitting position. Place a rolled up towel under your chin.

Use only soft toothbrushes for the procedure... You can clean the areas between your teeth with dental floss.

After cleaning, the ward should be helped to rinse the mouth. The use of mouth rinses will give you a feeling of freshness.

If you have dentures, remove them from your mouth, clean them with a soft brush and rinse thoroughly with water. Dentures are stored in a container with water, which is closed.

There are special hygiene products that make it possible to atone for a lying patient at home. Their use provides cleanliness and comfort to an immobile person.

The most popular environments are:

All of the above means greatly facilitate caring for seriously ill loved ones... In addition, their use makes it possible to redeem an immobile person with maximum efficiency.

IN modern world a variety of products are available that are used when washing bedridden patients. They greatly facilitate this procedure and make it as pleasant as possible.

Relatives and friends should provide support and necessary care motionless person... The correct preparation for bathing and the sequence of actions ensure the comfort of the ward and improve his well-being.

A serious illness of a family member or a deterioration in health due to advanced age is a serious test for all relatives. In our country, bedridden patients are discharged home, provided there is no need for inpatient treatment. For the first time in a similar situation, the patient's relatives are lost and do not know how to organize their life and establish timely implementation of medical prescriptions. Meanwhile, caring for bedridden patients at home is a daily job that requires mastering a number of rules, provided that it is performed by a non-professional.

Room preparation

Regardless of the living conditions, the bedridden patient should be allocated a separate room. If an improvement in the condition is not expected in the near future, it makes sense to immediately purchase a special bed. For such furniture, the total height and separately the legs / headboard are adjustable. Position the bed so that you can approach it from both sides. It is convenient to put a bedside table or table next to the bed. This is where the care supplies will be stored, and above, in the reach of the recumbent, water and the things he needs. The room in which the bedridden patient is located, it is better not to force a lot of furniture. Be sure to monitor the air temperature and light level. If possible, use devices that purify and humidify the air.

Communication method

If the sick person does not get up on his own, it is necessary to figure out how he will attract attention to himself. In this age of high technology, it is easiest to leave a separate cell phone on the bedside room and charge it regularly. Choose simple models with a large enough screen and large print, as well as convenient buttons. The classic option is to use a bell or battery powered. If the care of bedridden patients at home is carried out on the territory of a large apartment or house, the rational decision is to purchase a walkie-talkie or a baby monitor. These funds work permanently and completely free of charge.

In the room where the patient is, do wet cleaning daily, and disinfection every 10 days. If an air conditioner or other air-purifying equipment is not installed in the room, it is necessary to open the vents or windows for ventilation. Regularity depends on the air temperature outside the window and the wishes of the patient. Try to organize your leisure time as varied as possible. If the person is conscious, suggest watching TV or listening to audiobooks. If there are no problems with the functioning of the upper limbs, be sure to provide the sick person with a personal computer and bring new books. No miracle of technology can replace live communication - ask who the patient would like to invite and try to fulfill his wishes.

Caring for bedridden patients at home: means

One of the biggest challenges in caring for bed-bound relatives is organizing a toilet. If there is no problem of incontinence and the person can get up, place a special portable toilet near the bed. For those who cannot always control their natural desires, it is useful to use an oilcloth under the sheet. In such a case, it is convenient to use disposable absorbent diapers and diapers. Purchase modern electronic devices - tonometer and thermometer. It is also convenient to put his cosmetics in the patient's personal bedside table and medications... Home care for bedridden patients should be done on schedule. If you need to take more than one daily medication, write down a schedule for yourself and follow it clearly. Be sure to carefully read the annotations to pharmacological products, some funds must be given before meals, and others only after.

Hygiene procedures

The sick person's daily routine should be as close to normal as possible. Be sure to save your morning and evening washings. It is good if a person is able to wash himself and brush his teeth. If this is not possible, help him with this. The whole body must be washed daily. To do this, add a little vodka or cologne to warm water and wipe the skin with a swab soaked in this liquid. Use baby cream or special ointments from time to time after showering. You need to clean your nose and ears daily, use cotton wool soaked in oil or glycerin for this. Trim your nails as they grow back, it is also advisable to cut your hair short, this will make it easier to care for them. The head should be washed as it gets dirty. If the average length of the hair is still maintained, comb it daily, do a comfortable hairstyle - a braid or a pair of loose tails.

How to avoid pressure sores

Bedsores appear in places where the blood supply to the skin is impaired. Aggravating factors are constant contact with rubbing cloth, dry skin, or accumulation of sweat. The main prevention of this unpleasant phenomenon is daily hygienic care in combination with massage and exercise therapy as prescribed by your doctor. When immobilizing the patient's body, it is necessary to regularly turn over, give the opportunity to be in different poses. For example, if there was a stroke, caring for a bedridden patient necessarily includes a daily examination of the body. Most often, bedsores appear in the groin, armpits and other folds of the skin. They are often found on the legs. All of these places need to be given special attention - to remove sweat in a timely manner and lubricate with cream, if the skin dries up - this is regular care for bedridden patients. Bedsores can be treated with special ointments and creams. If skin lesions are already visible, you should purchase special pads for these places. Without this accessory, you will not be able to effectively heal damage. There are many folk recipes against bedsores. Keep in mind - you can use them only after consulting your doctor.

Daily regime

Home care for bedridden patients should have a clear schedule. Develop and write down an individual schedule, taking into account the needs of the sick person, their well-being and capabilities. Set aside time for hygiene, meals, treatment, and rest. If the patient is in control of the upper limbs and is awake most of the day, negotiate with the patient to restrict TV viewing and reading. Remember, even pleasant overwork will not be beneficial during illness. Most often, caring for bedridden elderly patients is associated with the greatest number of difficulties. There are two reasons for this, one of them is the aggravation of the underlying disease with other age-related health impairments. We also all know that in old age, many people become quite capricious and demanding. The task of the person caring for such a patient is to treat with the greatest attention and reasonably fulfill all wishes. Try to captivate and occupy your ward as much as possible. As practice shows, people quite successfully master computers and the Internet. This means that if you don’t want to listen to your grandmother’s life story for the hundredth time, try organizing a video call for her with her friend living on the other side of the country.

Catering

A bedridden patient should eat a varied diet, approved by the attending physician. The consistency of the dishes is selected depending on the safety of the chewing function. But even if it is difficult for a sick person to swallow, almost any dish can be changed to a puree consistency using a blender. Vegetables and fruits can be mashed or chopped into small salads. Souffle and cutlets are made from meat. Soups should be served at lunch. Don't forget about drinks - juices, tea, clean water, milk and kefir. The entire daily diet should be divided into 5-6 meals. These are standard meals: breakfast, lunch and dinner, as well as snacks in between - afternoon tea and lunch. If the patient does not eat enough and asks to eat "at the wrong time" do not refuse him, but satisfy this desire. A lying patient should be fed in a sitting or reclining position. If he can eat on his own, get a special bed stand. Use simple, stable dishes, it is convenient to serve special sippy cups or straws for cocktails for drinking.

Home care for bedridden patients: service price

In order to independently take care of a registered relative, you will have to leave your job. In such a situation, constant observation is important, because the sick person is essentially completely helpless and he may need something at any time. Keep in mind that bedside care items and medications are expensive, which means quitting a high-paying job is unprofitable (and in some situations simply not possible). Finding a professional caregiver is a good solution. The cost of this service will depend directly on the duties of the employee and the requirements for his qualifications, for Moscow the price will be from 1 thousand rubles per day. Many caregivers advertise themselves as registered nurses. But, as practice shows, it makes sense to choose such an assistant only if it is necessary to give injections or put droppers to the patient. To monitor the patient, fulfill his requests and household procedures, it is enough just an experienced nurse, and perhaps a non-professional who previously had to take care of seriously ill people.