How to care for bedridden (paralyzed) patients after a stroke at home. Care of the bedridden patient at home. Rules for medical, hygienic care for bedridden patients after a stroke Caring for bedridden patients at home

Update: October 2018

Everyone can face a situation when a previously healthy relative has an injury to his legs or spine or a disease that prevents him from walking and serving 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 dealing with bedridden patients, as well as male orderlies who will change his position in bed several times a day, our article is for you.

We will describe in detail how home care for bedridden patients is carried out. We will describe feeding, water supply, hygiene measures and assistance in the implementation of physiological functions. We will also consider in detail the prevention and treatment of bedsores, the prevention and treatment of congestion that occurs in the internal organs. We will tell you how professional care for bedridden patients is carried out - in a hospital.

The Dangers of Prolonged Lying

Staying in a supine position for more than 3 days is due to many diseases. It:

• acute pathologies of the 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 the joints, bones;
• diseases of the heart and blood vessels;
• ailments accompanied by imbalance,

and many others.

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

metabolic processes

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

1. those areas of the lungs (alveoli) should be continuously ventilated, in which oxygen directly penetrates into the blood, and carbon dioxide into the exhaled air;
2. the membrane of the alveoli, through which diffusion of oxygen takes place 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 fluid. This is ensured by sufficient fluid intake, timely treatment of inflammatory processes in the body (proteins formed during inflammation increase blood viscosity), as well as a sufficient amount of proteins from food;
4. blood circulation should be sufficient, "reaching" to each cell;
5. the nervous and endocrine systems involved in the regulation of the respiratory muscles should also not be damaged.

With 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 “tubules” of the trachea and bronchi (otherwise they would “collapse”), another part is a reserve volume in case you have to breathe deeply (for example, during exercise or running from danger).

The expansion of the lungs, in which negative pressure is created in the chest, and air is "sucked" into the incompressible airways, occurs 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, abdominals. 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 willpower, a person can use the thoracic or abdominal type of breathing. In the first case, only the intercostal muscles work, while the diaphragm moves passively along the intrathoracic pressure gradient. Abdominal breathing, which mainly involves the diaphragm, can simultaneously lower intrathoracic and increase intra-abdominal pressure, improving blood flow from the abdominal cavity to the heart and reducing blood stasis in the lungs.

Therefore, in order to prevent congestion 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 balloons, 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 the vertical position, the right lung is better ventilated, the upper sections are worse than the lower ones. If a person lies, then those areas that lie below are better ventilated. In order to avoid stagnation, the body must move - first to one side, then to the other side, then to the back. Optimally, the lungs are “breathed”, and the mucus formed in the bronchi (it also becomes more viscous in immobilized people) is better coughed up when the person lies on his stomach. Also, this mucus, in which there are already microbes at the time of lying, is easier to cough up if you tap on the back of a person lying on his stomach in a special way - to conduct a vibration massage.

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

Vessels

Human vessels are elastic tubes in which the muscular layer is more or less developed. The blood flowing through the vessels is not quite an ordinary liquid, however, it obeys gravity. This means that in those areas where it must 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 limbs, where the blood must always overcome gravity, 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 the lower extremities, as a result of such a “swamp” blood clots form in the veins of the legs. In this case, some attempt to stand up or strain (for example, when going to the toilet) can lead to the separation 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, in the majority ending in death.

This can be avoided in bedridden patients by bandaging the legs with elastic bandages, especially before getting up to the toilet or to perform hygiene measures, as well as massage them, move them to the extent that the disease allows (optimally - 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 circulation. Therefore, an attempt to stand up (especially abruptly) may 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: with forced immobilization, the peristalsis of the stomach and intestines becomes lethargic. In addition, now a person who is conscious, with more or less preserved criticism of what is happening, is forced to walk more 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 decay products into the blood). This is how bad breath, coated tongue, loss of appetite, constant slight nausea appear.

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

The solution to the problem lies in frequent fractional nutrition, dieting, when dishes are served warm, they are made from boiled or baked vegetables, meat, fish. The patient is fed soups without "frying", cooked on 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 recumbent.

Muscle problems

The lack of full-fledged movements leads to relaxation of the 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 be possible to do this without outside help.

In order to prevent muscle atrophy, it is necessary to perform muscle massage, passive gymnastics, when a relative moves the hands and feet of the patient.

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 “on tiptoe” position, the hand becomes like a “bird's paw”, the knee practically stops bending and unbending. When a contracture has developed, when the damaged joint is involved, severe pain occurs, which is why many refuse to continue their studies. Then, between the bones of the bone joint, bone unions are formed, and it becomes motionless. This is called ankylosis.

In order not to develop 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 a contracture begins to form or the limb is paralyzed, a plaster splint is temporarily applied to it - so that the limb is forcibly in a physiological position.

Immobilization and the skeletal system

In bedridden patients, not only the blood supply to the skin and internal organs worsens, but the supply of nutrients to the bones also worsens. This is how osteoporosis develops - rarefaction of the main parts from which tubular bones are built - bone beams. This increases the risk of spontaneous fractures. In addition, the red bone marrow located inside the bone suffers. Because of this, the production of platelets decreases (this leads to spontaneous bleeding), leukocytes (due to this, immunity decreases) and red blood cells (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. It is also more difficult to hold urine while lying down, partly due to the reluctance to ask for help from others. The outflow of urine on the bed leads to the formation of bedsores.

Changes in the psyche and nervous system in bedridden patients

If before the illness that led to the fact that a person fell ill, he was already old and sick, then forced immobilization will not lead to a violation of his attitude to life, himself and relatives. But if the disease has laid down actively before that 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 behavior skills;
• hearing impairment (this is due to the fact that the patient is now lying, and those who communicate with him are sitting or standing);
• deterioration of mental activity;
• violations of the peripheral nervous system, because of 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 decades, 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 friendly and accommodating, then during immobilization a person becomes demanding, capricious, whiny, accuses of inattention to his person. However, 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 decides 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 lack of load on it, which in this case consists in stretching it and compressing it. More pronounced atrophy are those areas of the skin that are subjected to squeezing. Already after 2 hours of being in the same position lying or sitting, in those places that are above the bone protrusions or are pressed against the bed by the bones, those that are localized above the crease in the linen or directly on a hard bed, ischemia begins. Particularly affected 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, occiput;
• lying on the back: on the side of the thigh, knees, on the sides of the ankles, on the lower shoulder, on the temple;
• lying on the stomach: on the pubis, cheekbones;
• on a hard bed or in a seated wheelchair: the area of ​​​​the coccyx and shoulder blades, heels, and when relying on the entire foot - socks.

Ischemia is aggravated if the skin is displaced from its normal position, if it is wet from sweat, urine, or not dried after bathing. Then diaper rash appears very quickly in the places of friction, then macerations, and pressure sores 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, not allowing them to “raise their heads”. And in order to spend not so huge amounts on the treatment of a relative every month, then, no matter how much you would like to, you will have to start leaving even from 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. You will find step-by-step instructions for caring for bedridden patients in the hospital and at home below.

Features of inpatient care

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

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

• they will tell you what you need to pay attention to, how to properly wipe, bathe and feed a relative. This will further save money on the purchase of unnecessary drugs and accessories; time will also be saved for reading the necessary information on the Internet or 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, if a person’s condition worsens at home, not to feed him with unsuitable food, which may cause blockage of the respiratory tract with food and death;
• you have time to get used to the idea that a relative has ceased to be as independent as before, and you can figure out whether you can handle the care on your own or have to hire a nurse;
• you do not see the suffering of a relative around the clock, there is time to relax mentally;
• a bedridden patient sees and feels the care of relatives; his depression due to the current situation does not add the feeling that he has become a burden.

Of course, the medical staff does not force a relative who has come to a bed patient to a hospital to take care of him. Given the poor medical supply of hospitals and the high cost of drugs, preference is given to bringing the necessary medicines to the patient. But the middle and junior medical staff caring for your relative is actually extremely busy. Nurses and caregivers have to care for several people at once, as well as 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 lost 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 bed patient with the necessary procedures.

A feature of care in a hospital is the availability of aids to ensure the physiological needs of the patient. This is a feeding tube and a urinary catheter for urination. 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 venous access, where the necessary drugs are administered. Before discharge, for the same reason as the tube with the urinary catheter, it will be removed. All the necessary drugs, already in agreement with a 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 them. However, there are many general rules, after reading which, you will understand what to do for you.

Accommodations

No matter how uncomfortable it may be, if you cannot afford several shifts of round-the-clock nurses with medical education, you will need to live in the same apartment / house with a bedridden 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 looking completely like a hospital ward (only a bed and a bedside table next to it) is a wrong decision that causes nervous stress. Imagine yourself in a forced inactive position, on the 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 semi-sitting position without his help. The second type of bed design is optimal for severe paralysis of a person, especially when he also has excess weight or urinary incontinence.

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

The room should be ventilated three times a day, for 15-20 minutes; at this time, the patient should be covered with a blanket or duvet cover (the latter in the summer). A bactericidal emitter should be hung on the wall (preferably one that can be quartzed in the presence of a person without covering him with a blanket with his head). Wet cleaning in the room is a must.

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

Put in the nightstand:

• thermometer;
• tonometer;
• antiseptics that treat the skin;
• cotton buds;
• cotton wool;
• alcohol;
• talc;
• camphor alcohol;
• diapers - if a person does not control his bowel movements.

Taken drugs can be put on the nightstand or in it only if you are sure of the mental health of your relative: that he will not exceed the dosage of drugs intentionally or not.

A ship or a duck can stand under the bed, if the patient feels when he wants to go to 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 old bed, if there is one (on the side where the patient does not get up).

If the patient has become not quite adequate, has lost his orientation in space, place or time, file the legs by the bed or constantly raise her former. In addition, remove all traumatic objects (sharp, cutting, piercing) 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 taking care of yourself. At night, leave a night light that shines with a weak light, unless a relative asks to turn off the light completely: he should not feel abandoned.

Lying conditions

The patient should be dressed in soft clothes made of natural materials that will not have buttons, ties, fasteners or zippers - all 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 shorts or they are located only in front.

The patient should lie on bed linen made of natural fabrics. At the same time, you need to make sure that there are no wrinkles under his back, and that he does not slide onto an uncovered bed. This is a direct path to bedsores. If the sheet often crumples, you can buy or sew one with an elastic band around the edges. So 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 “naked” oilcloth. It is better to put a diaper on a person (it should also be straightened) and periodically give him a break from the urine-absorbing matter. Then it is better to lay it with the buttocks on a moisture-absorbing disposable diaper measuring 90 * 60 cm.

To prevent bedsores, the patient should be turned every 2 hours, or reminded to do it himself. If a relative is paralyzed and you have to turn him over, lay him down - whether on his stomach, on his side or on his back - so that he lies comfortably. Under the knees, if a person is lying on his back or under his knees, if he is lying on his side, you need to lay a pillow. If you have a relative laid on his side, place a pillow or several under his back so that he can lean on them. In the supine position, under the elbows and heels, put rubber small circles (such as circular expanders). You can also put a special circle under the sacrum. You can use anti-decubitus mattresses, which we will talk about later.

Every few days, or if the sheet becomes wet, it needs to be changed. 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 sheet, lay a section of a clean sheet, also rolled up with a “tube” or folded “accordion”, unfold it;
4. turn the patient on the other side so that he, turning over, rolls over the roller of two sheets;
5. then you just have to pull out the dirty and straighten the clean sheet.

You can use another method:

• grasp the edge of the changeable sheet 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-sheet over the patient from above;
• spread the new sheet evenly on the freed 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. into the back of the patient;
• return the dirty end and the patient to his back;
• turn the patient over to the other side by pulling on the other end of the sheet. She, like last time, lay on top of the patient;
• straighten the accordion. If the accordion was partially under the patient, then by pulling the protruding edge, you can dissolve the accordion and release the sheet without effort;
• straighten a clean sheet, and fold the end of a dirty sheet with 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 bedridden patient must bathe, wash, comb his hair every day. If he can move on his own, he is taken to the bath, where they bathe in the shower, it is better if they use baby soap and baby shampoo for washing. After that, be sure to thoroughly blot the body with a gauze napkin or a 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, they wash him right in bed. For this, two basins for water, a support under the basin, a container for heated water, lotions, gels or foams for washing are used. An oilcloth is laid under the washed part of the patient's body, washed with a soft sponge, without unnecessary friction; after washing, dry thoroughly, apply moisturizers:

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

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

Washing head

To wash the head, a special inflatable tub with a pipe for draining water into a bucket is used. The head is raised, placed in a special hole in this bath, gently poured over with warm water and soaped. After washing the head, the soapy water is drained through the tube, and the head is washed with clean water, which is also poured out through the tube. Be sure to dry your hair with a towel and dry it with a hair dryer before laying the person on the bed.

Shaving

Shaving is performed as follows: shaving foam is applied to the face, a basin with warm water is placed nearby, 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 or brushed or, if the patient is unconscious, a latex pad with a brush is used, which is put on the finger (they are sold in the department of children's goods, for the care of 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. They clean their teeth from all sides, tongue, inner surface of the 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 douche.

To wash the face of the patient use:

• TENA Wash Cream
• Seni care cream
• menalind professional care lotion

Do this morning and evening with a soft sponge. After washing off the washing solution, wipe the eyes with clean cotton pads: 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 basin of detergent solution and treated with a sponge or foaming gloves. The interdigital space is especially cleaned - a large number of pathogenic microorganisms accumulate here. After washing, the hands are dried with a towel and a special care product is applied to the elbow area (as a rule, roughening of the 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 nail file. Further, nail care is carried out as they grow.

Hygiene of intimate areas

It is carried out in the following sequence:

• a moisture-absorbing diaper spreads under the patient's pelvis;
• the diaper is removed;
• a soft sponge is taken with a gloved hand, dipped in water with a cleaning 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;
• washing 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 wetting movements;
• Bepanthen-cream or Sudocrem is applied to the skin.

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

Foot hygiene

Feet are washed in a bowl 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 fingers. Next, you need to dry your feet with a towel, apply (especially on the heels) baby cream, baby cream mixed with vitamin A oil, Bepanten ointment.

Feeding, nutrition

The diet is prescribed by the attending physician and depends on the general disease and how much the chewing and swallowing skills have been affected. If the patient's consciousness is unclear, he does not answer questions or does it inappropriately, he needs either liquid, or boiled and rubbed food through a sieve or blender. If he is in a clear mind and adequate, he is fed with cereals, soups on 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 strictly according to the schedule. Proteins in the form of soufflé, meat puree or steam cutlets must be required, otherwise protein-free edema will appear, over which the skin will tear, forming bleeding and poorly healing wounds. Water, compote, tea and non-acidic juices must be given, it is necessary to limit the liquid only in case of heart, kidney failure, cirrhosis and liver cancer.

Feed as follows. If the patient is not completely paralyzed, then with the help of pillows or raising the headrest of a 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 in plates (possibly with suction cups), which should stand steadily on the table.

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

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

Liquid is given from a drinking bowl or from a glass in which there is a cocktail tube.

Physiological departures

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 served 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 - classic 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 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 section, which is lightly tapped with the fist of the other hand. So every day the lungs are worked out to prevent pneumonia.

Physiotherapy

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

In those joints in which a person cannot move, 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 physiotherapy exercises.

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 with elastic bandages. With varicose veins, the skin of the lower extremities is treated with Lyoton 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), give 10 mg of Enalapril or previously prescribed drugs "for pressure".

Also, relatives are forced to record on paper:

• the amount of liquid drunk;
• 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 smell, and a rash or non-healing wounds appear on the body, you need to call a doctor.

bedsores

This is the name of ulcerative-necrotic defects of the skin and underlying fiber, which occur mainly with defects in caring for 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. Bedsores are the #1 problem 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 quite quickly with damage to most internal organs.

The risk of developing ulcerative-necrotic defects increases significantly in the following cases:

• the presence of excess weight;
• if a person is severely malnourished, did not eat and drink enough;
• diabetes;
• 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;

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

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

you need to immediately begin treatment of bedsores (about him - below).

To prevent the development of necrotic changes in the skin

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

• obligatory straightening 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;
• changing position in bed every 2 hours;
• laying under the bone protrusions that 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 moisturizer is applied to the skin, and in places where there is redness - drying agents (for example, "Sudokrem");
• massage;
• wiping the back and limbs with camphor alcohol;
• thorough wiping of the skin before laying the patient on the bed;
• periodically being without a diaper.

Treatment of bedsores

The optimal situation is to examine the skin of the entire 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 bedsores are and what to do on each of them.

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

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

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

Many diseases have such severe consequences as complete or partial immobility of the patient. The most common disease with such disorders can be attributed to a stroke. The first 2-3 weeks the patient is in the hospital under the constant supervision of medical staff. And after discharge, caring for him falls entirely on the shoulders and hands of his relatives. But not everyone knows how to properly help a loved one and what to be afraid of.

The main danger that lies in wait for patients who are unable to move is bedsores. They are dead skin areas and are formed in places of tissue compression between the bone and the bed. The main places where bedsores appear are the shoulder blades, the area of ​​​​the sacrum and heels. At first, a slight reddening appears in these areas, which gradually increases, the skin in these areas becomes thinner, and after a while a wound forms in this place.

The main care of the bedridden patient should be aimed at preventing the formation of bedsores. First of all, this is a constant turning over of the recumbent. Change of body position should be carried out every 2-3 hours. In this case, it is desirable to lay paralyzed limbs on special rollers, which can be made from folded bedspreads. So that the patient from the “lying on his side” position does not roll over onto his back, a larger roller, folded from a blanket, can be placed under it.

A good solution to the problem can be the purchase of an anti-decubitus mattress. Its cells are inflated with air and are alternately blown off and refilled, providing a constant massage of the skin.

Constant turning in bed can also be a good preventive measure against the development of congestive pneumonia.

Patient hygiene plays an important role in the prevention of bedsores. It must be done daily. It is clear that it is impossible to bathe a person who is not able to move every day. But it is necessary to wipe the body with napkins moistened with warm soapy water. For patient care, practicing nurses working in rehabilitation centers and departments recommend making the following solution: into an empty 1.5-liter bottle, pour a bottle of vodka, a bottle of liquid baby soap and add the rest of the volume with water. The use of such a talker helps to solve several problems at once - soap cleanses the skin, and alcohol dries it.

We must not forget about intimate hygiene. It should be done twice a day. If the patient is in diapers, then at each change, the inguinal region is wiped with a napkin and treated with powder.

If, nevertheless, despite all efforts, redness has formed on the skin, then it must be dried. The patient is laid on his side, if the bedsore is on the sacrum, then the diaper is opened and the skin is allowed to “breathe”. The place of redness is treated with powder and special sprays and creams that can be bought at the pharmacy.

Also, pharmacies offer a wide variety of care cosmetics for bedridden patients. It can be selected based on the problems that a person encountered when leaving.

Nutrition for the bedridden patient

Nutrition of a patient who has had a stroke should not overload the gastrointestinal tract. At the same time, the diet should fully meet the needs for essential trace elements.

Fried, smoked, spicy, salty foods are almost completely excluded. During the period of treatment of the disease, the patient receives a large amount of drugs. After discharge, treatment continues. All this has an extremely negative effect on the condition of the liver. Improper nutrition can only exacerbate the situation.

It must be remembered that if a person lies or his motor activity is limited, intestinal function is disturbed, constipation occurs. Therefore, as many fiber-containing vegetables as possible should be included in the diet. Soups and crumbly cereals are obligatory. It is very important to observe the drinking regimen. The patient should drink 1.5-2 liters of fluid per day. If all these measures do not help, and the patient begins to have problems with the stool, then a cleansing enema is done once every 3 days.

It happens that during a stroke, swallowing is disturbed in patients, and they cannot eat on their own. In the hospital, they are given a special nasogastric tube through which feeding is carried out. This function is not restored soon, and the patient can be discharged home with a probe. How to feed such a patient at home, is obliged to show and teach the medical staff at discharge.

It must be remembered that only thoroughly ground food without lumps can be introduced through the probe. Otherwise, it may clog. It is best to pass everything through a blender. Another option is to boil meat broths and add a jar of baby food to them. You can also buy special nutrition for parenteral nutrition at a pharmacy. It is necessary to feed patients through a probe fractionally, 5-6 times a day, 200-300 ml of food at one time. After each feeding, the probe is washed with boiled water. Simply enter it through a special syringe.

If the probe is still clogged, then ambulance staff can replace it.

If the patient's condition stabilizes and movements appear in the paralyzed limbs, then exercise therapy is recommended to him. When to start classes, how to conduct them and what exactly needs to be done - the attending doctor tells at the time of the patient's discharge. But there are a few general rules.

The basic principle of exercise therapy is gradualness. Sitting up in bed begins gradually and for a very short time. The legs don't move at first. They simply put pillows under the back, and for 2-3 minutes a person is in this position. There should be several such approaches per day.

After 3-4 days, they begin to lower their legs from the bed. Before that, they must be wrapped with elastic bandages or put on special stockings. Start wrapping with bandages from the toes, while stretching the bandage. The legs are lowered for the first time for 2-3 minutes, after which the patient is laid down. Gradually increase the time, focusing on his condition. Exercise therapy begins after the patient begins to feel confident in a sitting position.

Passive physiotherapy exercises can also be carried out with the patient completely lying down. It includes flexion and extension of paralyzed limbs, massage.

When is a doctor needed?

Care of a bedridden patient includes not only feeding and hygiene, but also its treatment. All drugs that the patient must take are prescribed by the doctor. They must be given strictly according to his recommendations.

The first time the local therapist is called to the house immediately after discharge from the hospital. Then as needed. It is necessary to carefully monitor the patient's condition. If the body temperature rises, the person “withdraws into himself”, stops responding to treatment and other stimuli, or, conversely, attacks of aggression and motor excitation occur more unmotivated, then the specialist is called immediately. If the condition has changed dramatically, and there is no way to call a doctor (for example, weekends or holidays), then an ambulance team is called.

Caring for a patient who has lost the ability to move is hard work that requires great physical and psychological strength. Therefore, the support of the whole family is very important at this moment. By joint efforts, it is possible not only to provide everything necessary for such a patient, but also to significantly improve his condition.

Caring for a sick person is not an easy task, and if an elderly person needs care and care, then twice as much strength and patience from relatives and medical personnel is required. Often, older people are bedridden as a result of various diseases and their complications, sometimes they are not only unable to take care of themselves (eat, drink, perform hygiene procedures), even movements in bed are impossible. The situation can be complicated by mental disorders, even in old age it is difficult for a person to accept his helplessness, this can be expressed by depression, apathy, aggression, sudden mood swings, elderly patients are often capricious and irritable.

Fortunately, in most cases, elderly people are in this state temporarily, during the acute period of diseases (heart attack, stroke, immobilization as a result of a hip fracture and other injuries). The general principles of caring for bedridden patients of any age are the same, but the elderly should be given increased attention. Due to weakened immunity and a large number of various chronic diseases, they develop various complications faster. Good care and concern for loved ones often help to reduce the period of involuntary bed rest and improve the outcomes of the rehabilitation of older patients. That is why patience and strict implementation of the recommendations of medical personnel are so important.

To date, there are many devices (functional beds, special mattresses, exercise equipment, etc.) and hygiene products that facilitate the care of bedridden patients (disposable diapers and pads, absorbent diapers, wet wipes soaked in antiseptic solutions, and much more).

Patient hygiene

Like healthy people, bedridden patients need daily hygiene procedures. If it is not possible to clean the teeth and oral cavity traditionally with a toothbrush and paste, you can use special wipes for oral hygiene or a bandage soaked in a 1% hydrogen peroxide solution. We should not forget about the disinfection of dentures, if any (at night they are removed from the oral cavity, thoroughly washed with a toothbrush and placed in a glass of clean water or a special solution).

Every week, and in the hot season and several times a week, a bath or shower is necessary. If the patient is able to sit, then he can be washed in the shower, sitting on a stool or chair. If this is not possible, then the body is rubbed in bed (first with swabs dipped in warm soapy water, and then in clean warm water). You also need to monitor the condition of the patient's nails and hair.

Every day (if necessary more often) the bed and underwear of the patient is changed.

Toilet

One of the most delicate problems that causes the greatest moral discomfort to bedridden patients is the emptying of the bladder and intestines. They have to use special bedpans and urinals (“ducks”). After each use, these devices must be thoroughly washed and disinfected.

It is very important to explain to the patient that timely emptying of the bladder and intestines is necessary, otherwise constipation and exacerbation of urinary tract diseases may occur.

If the elderly patient is unconscious or unable to control these natural processes, then it is better to use special disposable adult diapers and underpads. This greatly facilitates the care of elderly bedridden patients and helps to keep bed linen clean.

Prevention of bedsores

Another of the problems in caring for bedridden patients is that which form in places subject to pressure (nape, shoulder blades, elbows, sacrum, buttocks, shins and even heels). The appearance of bedsores is facilitated by folds on bed linen and clothes, wet linen (which is why it is so important to replace it in a timely manner). Unfortunately, in older people they form much faster than in young people, and they heal, even with good treatment, for a very long time. This is the case when it is easier to prevent than to treat later.

There are special mattresses filled with foam, water or air that prevent constant pressure on the same area of ​​the body, but, unfortunately, this pleasure is expensive and often inaccessible. That is why relatives and medical staff have to make a lot of efforts, including physical ones, to prevent the appearance of bedsores in an elderly patient.

The patient needs to be helped as often as possible to change position in bed, put rollers and inflatable circles under the sacrum, buttocks, legs. This should be done almost constantly, at least once every 2 hours, especially if the patient is constantly in a supine position and cannot even sit supported on pillows.

The skin should be dry, moisture (especially if it is urine or sweat) is an excellent breeding ground for pathogenic microorganisms and a factor contributing to the violation of the integrity of the skin. That is why, if necessary, you need to use powders (even baby powders with talc or zinc are suitable), and for dry skin, moisturizers.

If you notice red spots on the patient's body that do not disappear after the pressure is removed, then you need to sound the alarm. These are most likely to be treated already at the onset stage in order to prevent the process from deepening. The skin in these places should be “ventilated”, wiped with warm water, gently wiped with a soft cloth, wiped with camphor alcohol, applied Solcoseryl or Actovegin gel or ointment, Xeroform powder or ointment. If the process has gone deeper, more serious and expensive treatment is required, so it is better not to allow and not to start bed sores.

Prevention of congestive pneumonia

Due to physical inactivity in bedridden patients, the ventilation function of the lungs may be impaired, and a large amount of sputum accumulates in the bronchi. In older people, the cough reflex is impaired, so sputum stagnation occurs, which is a favorable environment for the development of bacteria.

Gradually, patients develop hypostatic pneumonia, which at the beginning of the disease practically does not give symptoms. It is diagnosed when the infectious process in the lungs is already in full swing.

Treatment requires various drugs, including antibiotics. Unfortunately, a complication such as congestive pneumonia sometimes causes the death of elderly bedridden patients.

In order to prevent congestion in the lungs, it is necessary to give the patient a sitting or at least half-sitting position several times a day. You can raise the headboard by adjusting the functional bed or, at home, pillows. The room where the patient is located must be frequently ventilated; if the air is dry, it must be humidified.

With the permission of the doctor, the patient can be massaged back and chest. For conscious patients, the doctor may recommend breathing exercises, the simplest method is to inflate balloons.

There are also folk recipes for the prevention and treatment of congestive pneumonia in the elderly. Tea with thyme and an infusion of viburnum berries are considered useful.

Massage and gymnastics

These procedures are essential for elderly bedridden patients. If the patient is not able to move his limbs on his own while lying in bed, then this is done passively, with the help of a caregiver and medical personnel. Such gymnastics should be carried out several times a day, this helps prevent the formation of joint contractures, muscle atrophy, and stimulates blood circulation in the limbs.

Massage is also necessary to activate the movement of blood through the vessels, especially in those places where there is a high probability of pressure sores. In order to perform a simple massage for preventive purposes, it is not necessary to have special skills. Gentle rubbing and kneading will only benefit the patient.

Food. Prevention and treatment of constipation

It is also an important aspect in the care of elderly bedridden patients. Of course, good nutrition is necessary for patients to restore strength and prevent complications. If a person is not able to eat on their own, then nutrition is made through a tube or parenterally. If an elderly patient is "bedridden" after abdominal surgery, then nutrition issues should be clearly agreed with the doctor.

In older people, metabolism slows down with age, the absorption of nutrients from food and bowel function deteriorate. Prolonged physical inactivity aggravates the situation by the fact that the intestines begin to work even worse, as a result of which patients develop.

The nutrition of bedridden patients should be complete, rich in protein, vitamins and minerals. Food should be easily digestible and, if necessary, additionally crushed. It is necessary to ensure that the patient receives a sufficient amount of fluid. If tolerated and there are no contraindications, prunes, raisins, sour-milk products and foods rich in fiber (vegetables, fruits, chopped bran) should be added to the diet.

constipation treatment

The caregiver should monitor the frequency of stools, sometimes doctors advise keeping a diary. If necessary, the patient is prescribed laxatives or cleansing enemas.

Pharmacies have a huge selection of laxatives, but not all of them can be used for older people. For them, you should choose products that act gently and gradually, based on lactulose (Duphalac, Normaze, Portalac, Goodluck, etc.) or polyethylene glycol.

Not so long ago, Microlax appeared in the form of microclysters, it is convenient to use and practically does not cause discomfort to the patient.

A serious illness of one of the family members 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. Having found themselves in such a situation for the first time, the patient's relatives are lost and do not know how to organize life and arrange the timely implementation of medical prescriptions. Meanwhile, caring for bedridden patients at home is a daily job that requires the assimilation of a number of rules, provided that it is performed by a non-professional.

Room preparation

Regardless of the living conditions, a bedridden patient should be allocated a separate room. If you can’t expect an improvement in your condition in the near future, it makes sense to immediately purchase a special bed. For such furniture, the overall height and separately legs / headboard are adjustable. Position the bed so that it can be approached from two sides. It is convenient to put a nightstand or table next to the bed. Care supplies will be stored here, and from above, in the reach zone of the recumbent, water and the things he needs. It is better not to force a room in which a bedridden patient is located with a large amount of furniture. Be sure to monitor the air temperature and light levels. If possible, use devices that purify and humidify the air.

Communication method

If the sick person does not get up on his own, you need 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 in the bedside room and charge it regularly. Choose simple models with a fairly large screen and large fonts, as well as convenient buttons. The classic option is to use a bell or a battery powered one. If care for bedridden patients at home is carried out on the territory of a large apartment or house, a rational decision is to purchase a walkie-talkie or a baby monitor. These tools work constantly and completely free of charge.

In the room where the patient is located, do wet cleaning daily, and once every 10 days - disinfection. 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. The regularity depends on the air temperature outside the window and the wishes of the patient. Try to organize your leisure time as diversely as possible. If the person is conscious, invite them to watch TV or listen to audio books. In the absence of problems with the functioning of the upper limbs, be sure to allocate a personal computer to the sick person and bring new books. Not a single miracle of technology can replace live communication - ask whom the patient would like to invite to visit and try to fulfill his desires.

Care of bedridden patients at home: means

One of the biggest challenges in caring for bedridden relatives is organizing the 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 can not always control natural desires, it is useful to put an oilcloth under the sheet. In such a case, it is convenient to use disposable absorbent diapers and diapers. Get modern electronic devices - a tonometer and a thermometer. It is also convenient to arrange cosmetics and medicines in the patient's personal bedside table. Bedridden care at home should be scheduled. If you need to take several medications every day, write a schedule for dispensing them and strictly follow it. Be sure to carefully read the annotations to the pharmacological products, some funds must be given before meals, while others - only after.

Hygiene procedures

The patient's daily routine should be as close to normal as possible. Be sure to save your morning and evening washes. It is good if a person is able to wash himself and brush his teeth. If this is not possible, help him with this. It is necessary to wash the whole body daily. To do this, add a little vodka or cologne to warm water and wipe the skin with a swab dipped in this liquid. Periodically use baby cream or special ointments after a shower. Every day you need to clean your nose and ears, use cotton flagella soaked in oil or glycerin for this. As you grow, cut your nails, 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 preserved, comb it daily, make a comfortable hairstyle - a braid or a pair of loose tails.

How to avoid bed sores

Bedsores appear in places where the blood supply to the skin is impaired. Aggravating factors are constant contact with rubbing tissue, dry skin or accumulation of sweat. The main prevention of this unpleasant phenomenon is daily hygiene care in combination with massage and exercise therapy as prescribed by the attending physician. When immobilizing the patient's body, it is necessary to turn it over regularly, to give the opportunity to be in different positions. 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. Often they are found on the legs. All of these places require special attention - remove sweat in a timely manner and lubricate with cream, if the skin dries - this is a regular care for bedridden patients. Bedsores can be treated with special ointments and creams. If skin lesions are already noticeable, you should purchase special pads for these places. Without this accessory, it will not be possible to effectively heal damage. There are many folk recipes against bedsores. Keep in mind - you can use them only after consulting a doctor.

Daily regime

Bedridden care at home should have a clear schedule. Develop and write down an individual schedule based on the needs of the sick person, their well-being and capabilities. Set aside time for hygiene, meals, medical procedures and rest. If the patient is in control of the upper extremities and is awake most of the day, still agree with him to limit TV viewing and reading. Remember: during an illness, even a pleasant overwork will not do any good. Most often, the care of 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 by other deterioration in health associated with age. Also, we 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 in quite successfully master computers and the Internet. And this means that if you don’t want to listen to the story of your grandmother’s life for the hundredth time, try organizing a video session for her with her friend who lives on the other side of the country.

Catering

A bedridden patient should eat a varied diet according to the diet approved by the attending physician. The consistency of dishes is selected depending on the preservation of the chewing function. But even if it is difficult for the sick person to swallow, almost any dish can be changed to a puree consistency using a blender. Vegetables and fruits can be given in the form of purees or finely chopped salads. Soufflé and cutlets are prepared from meat. Soups are a must for lunch. Do not forget about drinks - juices, tea, pure 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 second breakfast. If the patient does not eat enough and asks to eat “at the wrong time”, do not refuse him, but satisfy this desire. A bedridden patient should be fed in a sitting or reclining position. If he can eat on his own, get a special bed table-stand. Use simple, stable utensils; for drinking, it is convenient to serve special drinking bowls or straws for cocktails.

Care of bedridden patients at home: the price of the service

In order to independently take care of a relative who is registered, you will have to leave your job. In such a situation, constant monitoring is important, because the sick person is essentially completely helpless and he may need something at any moment. Keep in mind that bedside care items and medicines are expensive, which means that quitting a high-paying job is unprofitable (and in some situations simply not possible). A good solution is to find a professional babysitter. The cost of this service will depend directly on the duties of the employee and the requirements for his qualifications, for Moscow the price is from 1 thousand rubles per day. Many nurses 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 on the patient. To monitor the patient, fulfill his requests and household procedures, just an experienced nurse, and perhaps a non-professional who had previously had to take care of seriously ill people, is enough.

It is important to regularly perform hygiene procedures so that the patient feels comfortable.

• Every day, morning and evening, you need to wash his body with water and liquid baby soap. It is undesirable to add alcohol to the soap solution. It dries out the skin, which can cause bedsores to develop on the body. Lotions, creams, foams and other body care products for a bedridden patient are acceptable. They moisturize the skin, relieve discomfort, itching.
• Every week it is important to wash your hair in a bowl of warm water and regular shampoo. Dry shampoo can be used once, for example, in the middle of the week, if the immobilized person feels uncomfortable.
• Men need to shave regularly. The main thing is to use the razor very carefully so as not to injure the patient, and after shaving, apply a moisturizing lotion to the skin. A neat appearance pleases both the immobilized person and his relatives.
• If the ward has teeth, they should be brushed and toothpaste every day. Severe patients rinse their mouth with a syringe using warm water, herbal decoction. If a bedridden patient has problems with swallowing, or he is not fully aware of what is happening to him, they refuse to brush their teeth, as there is a danger that the person will choke. Instead, you can wipe the teeth and residual mucus around the mouth with a gauze pad.
• Regular nail clipping is also important in caring for the sick. Firstly, bacteria accumulate under them, and secondly, a person can get hurt by inaccurate movement, and the skin of patients in old age heals very slowly. After shearing, the nail plate can be further treated with a disinfectant spray.
• Ears are washed with soap every time during general hygiene procedures with water. But if there is damage, for example, perforation of the eardrum, when washing the hair and body, the ear canals are closed with a cotton swab. If there is an accumulation of sulfur in the ear, it is better to show the patient to the otolaryngologist, he will carefully remove it.
• Cleaning the nasal passages is best entrusted to a nurse with experience. The inner surface of the nose is very sensitive, but crusts form on it, which are removed with a cotton swab dipped in petroleum jelly. Hardened contamination in severe bedridden patients is softened with oil and saline sea water. The remaining mucus is collected with an aspirator.
• A separate place in the care of immobilized patients is occupied by cleaning the eyes from oxides. The eyes are wiped with a cotton pad with a special solution, but before that, hands must be treated with a sanitation solution.

In the boarding house "Tula grandfather" we provide bed patients with the necessary nursing care. All hygiene procedures are regularly performed by experienced junior medical staff.