Patients become bed-bound because they are either too weak or have lost most of their bodily functions to move out of bed on their own. When this happens, there is a rapid decline in muscle mass and strength. These patients become dependent on their caregivers for many of their everyday activities. Some of these patients, such as those with late-stage dementia, have altered thinking abilities, too. Their mental condition and immobility make work as a nursing assistant even more challenging.
For the patients, being bedridden takes away most of their independence, which puts them in a difficult situation. It also results in mental anguish, which is quite understandable. The combined effect of the loss of function and low self-esteem in the patient can cause considerable stress in both the patient and the CNA.
If you are a nursing assistant who cares for bed-bound patients, you have a lot on your hands. But by knowing what to expect and what to do, you can make your job a lot more manageable and still give your patient the best care possible.
Ways to care for your bedridden patient:
1. See to their comfort.
A bedridden patient’s comfort should come first. Use soft pillows, blankets, and sheets to make them comfortable. Position the patient's arms and legs properly by supporting and propping them with pillows.
You may also adjust the head of the bed to suit their needs. If your patient is awake and active, ask them if they prefer to have the head of the bed raised, or lowered when they are ready to sleep. During mealtimes, assist the patient into a sitting position to prevent accidentally getting food or water into their airways.
2. Ensure hygiene.
Bathing, mouth care, a change of fresh clothes, and other hygiene measures benefit the patient in many ways. A bath, for example, is relaxing, refreshing, and it also improves circulation. When the patient is clean and smelling nice, they are more relaxed and confident. Also, cleanliness prevents the spread of infections.
Give patients regular baths and let them wash themselves if they are able. Provide mouth care, too.
If the patient is using incontinent pads, change them as soon as they are soiled and clean their genital areas, and buttocks during every change. It is important to wash the areas with soap and warm water and then pat dry to get rid of the unpleasant smell. Help your patient put on a fresh set of comfortable clothes, too.
As you perform hygiene procedures, don’t forget to pay extra attention to skin changes and be sure to report noteworthy findings.
3. Prevent bedsores.
Bedsores or pressure ulcers commonly develop in patients who are confined to their beds. A bedsore is a type of skin breakdown caused by too much pressure. It is the result of prolonged immobility and poor circulation to the bony areas where it usually starts.
Pressure sores hurt so bad in their early stages. They also lead to infections. It’s best to avoid this problem altogether. To prevent bedsores and their consequences, reposition the patient at least every two hours to relieve pressure on the vulnerable parts.
The buttocks are a common site for these ulcers to appear, and incontinence complicates matters even more. Skin soaked in urine and feces breaks rather easily. With prolonged pressure, skin breakage is likely to happen. Changing the patient's incontinent pads as soon as they are soiled is one great way to prevent this complication.
Also, be very careful when moving patients. Never drag them in any direction because the friction caused by the movement can disrupt the already fragile skin. Be aware of the early sign of skin breakdown, which is redness that does not blanch when pressed.
4. Provide stimulation.
Bed-bound patients remain in their rooms most of the time, and so isolation is another hindrance to better health. To keep patients aware of their environment and the outside world, find creative ways to stimulate them.
Whereby possible, position the patient’s bed near a window to give them a good view of the outside. Engage your patient in meaningful conversations and encourage them to verbalize their feelings.
Keep the TV remote within reach so the patient can watch the news and their favorite shows. You can also play some of their favorite music. Encourage family members to visit or call, too.
5. Don’t let the patient waste away because of inactivity.
Prolonged immobility causes muscle wasting and joint stiffness. To prevent the consequences, help bedridden patients exercise.
Any joint movement that does not result in pain is good exercise. Bending, twisting, and lifting cause muscles to contract as well as promote circulation. Stretching exercises improve muscle tone, too.
You can also exercise the paralyzed limbs as long as you have the orders to carry them out.
6. Provide nutritious meals.
The body needs nutrients to heal, to recover, and to fight infections. Other than preparing healthy foods for the patients, it is also crucial to encourage them to eat and make sure that every meal is a pleasant experience.
7. Keep the patient hydrated.
Water is essential for all major body processes. It also helps regulate body temperature regulation and maintain proper circulation. To prevent dehydration, offer the patient a glass of water to drink, especially after meals.
8. Put a call bell within easy reach.
Patients confined to their beds need a lot of help. When they are alone, the patient must be able to call for attention easily. To make it easy for the patient to ask for assistance, place a call button, or bell nearby.
By anticipating patient needs and preventing complications early on, you'll help the patient have the quality of life they deserve.
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