The patient who has to stay in bed at all times has the same needs as any healthy person, however the patient will need help in caring for his needs. He needs to be comfortable, to be kept clean, to be well nourished and to have his disabilities treated. He needs encouragement and emotional support. Tolerant understanding from his family and the acceptance of him as an individual family member will make him happier.

The main responsibility of his care is in the hands of the family member taking the part of the home nurse, however every family member can assist in the bedridden patient's care.

Comfort comes first-this is usually what he complains about the most. His position in bed is important to his comfort. Support should be provided for the patient's back and his joints to prevent strain. A change in the body position from time to time will promote circulation and prevent pressure sores. The arms and legs should be positioned comfortably and supported when necessary. Pillows and sandbags can be used to supply this support. When changing the patient's position in bed, tell him what you are going to do to gain his cooperation and help. Guide his movements rather than lifting when he is able to move himself. If the patient is unable to help himself, a draw sheet and a second person is usually required to move him around in the bed. Maintaining good posture and position for both the patient and the home nurse is important.

Cleanliness of the patient, of his bed and of his surroundings is so important to his comfort. A daily bed bath should be given to cleanse, refresh and relax the patient. A bath also promotes circulation, provides a mild form of exercise and aids in removal of some body wastes through cleansing the skin. Allow the patient to bathe himself as he's able. Keep the bath water warm for him and change the water when it is too soapy. Avoid the patient's chilling or becoming too tired during the bath. Wash all parts of the body and dry thoroughly. Make a note of anything unusual so these things can be reported to his doctor. Follow up the bath by giving the patient a back rub using either powder or lotion. This rub will stimulate circulation and aid in the prevention of pressure sores.

Assist the patient, if necessary, in brushing his teeth or cleaning his dentures. Cleanse the patient's entire mouth and teeth as often as needed for his comfort, and always after he's eaten.

Brushing and combing the patient's hair will help maintain the health of the hair, improve the patient's appearance and morale, and stimulate interest in personal grooming. If a patient looks better, he or she will often feel better. Help the male patient to shave, and help the female patient put on her make-up. A shampoo should be given on a regular schedule. Attention should also be paid to the finger and toenails. They should be cleaned and trimmed. If the skin of the hands and feet becomes dry apply a lotion after the bath.

The patient's bed linen should be changed every day or more often if it becomes soiled. The mattress should be firm. Protect the mattress with a waterproof covering and a cotton pad over it for the patient's comfort. A draw-sheet across the middle of the bed will protect the bottom sheet from becoming soiled and it can be changed more easily. When changing the bed with the patient in bed, the procedure is to move the patient to one side and make half of the bed at a time. Roll the patient back over the center of the bed where both the clean and soiled linen are gathered and complete making the other half. Be sure to allow toe space when tucking in the top sheet and blanket. The covers should be warm and lightweight. Turn the mattress and air the bedding frequently.

Keep the patient's room clean, fresh and attractive. Maintain good ventilation without draft and at a comfortable temperature. The room should be well lighted but without glare or direct light in the patient's eyes.

The bed patient should be well nourished, however he may not eat as much as he did when he was in good health since he is not exercising. His meals can be small and well balanced containing servings of the four basic food groups. They should include milk or milk products, meat or eggs, fruits and vegetables, breads or cereals. Unless the doctor has ordered a special diet for the patient, there's no reason he cannot eat the same foods as the rest of the family. Serving food attractively will aid in stimulating the patient's appetite.

Plan the patient's care so that he will have periods of activity followed by periods of rest and quiet. Respect the patient's feelings and help him to learn how to accept and live with his disabilities. Include him in family activities as much as possible. Do not talk about him within his hearing, but talk to him. Visitors are good for the patient but should not interfere with his rest. Sick people of all ages react emotionally to illness. Much tender loving care is required by the patient.

A written record should be kept by the home nurse on the patient's care. Any treatments and medications ordered by the doctor and given to the patient should be recorded. The doctor may be interested in a record of the patient's appetite, bowel movements, body temperature, pulse and respiration.

Your local Red Cross offers community classes in home nursing. It teaches how to better care for the sick person at home. It will also suggest to you how to make needed equipment out of cardboard boxes that can aid you in caring for the sick in the home. Call your chapter of the Red Cross for more information.

 
See Also: Caring for the bedridden patient (pdf download)