Congestion in the lungs in bedridden patients treatment - when the patient is at home - a directory of articles - useful tips for the home. Pulmonary edema in bedridden patients

Congestive pneumonia is a secondary inflammatory process in the lungs, which develops as a result of hemodynamic and ventilation disorders. It must be understood that a person who is forced to stay in bed for a long time can experience many rather serious disorders and complications. Congestive or hypostatic pneumonia is one of them in full measure.

Bedridden patients, due to their condition, cannot move, get out of bed, change the position of the body. In this regard, the lungs are poorly ventilated, the bronchi accumulate a large amount of sputum, which the patient cannot cough up. All this contributes to the development of the inflammatory process. It should be noted that this disease is very dangerous for a person, as it develops gradually and at first does not have clear symptoms, and does not cause concern to the patient.

In order not to miss the disease, not to risk the life of a loved one, you need to notice its signs in time and take measures for treatment. Therefore, we decided to devote our conversation today to this pathology. Let's find out what congestive pneumonia is in bedridden patients and find out the prognosis of the disease. Let's talk about the treatment of pathology, including folk remedies. Learn how to avoid this dangerous disease.

Treatment prognosis

The prognosis depends on the severity of the inflammatory process in the lungs, the duration of the development of inflammation. A favorable or unfavorable prognosis also depends on the severity of comorbidities, the state of the immune system, the presence of complications (the presence of a lung abscess or pleural empyema). Much depends on the age of the patient. For example, older patients have a higher risk of death.

If the disease is detected on time, measures are taken for adequate treatment, and therefore no serious complications develop, the prognosis is usually favorable and recovery occurs after 3-4 weeks. But for this you need to notice the symptoms of the onset of the disease in time and consult a doctor.

Signs, symptoms

As we have already said, the onset of the inflammatory process in the lungs does not reveal itself in any way, proceeds imperceptibly, usually hiding behind the symptoms of the patient's underlying disease. Body temperature is usually normal, not elevated.

But after a while, the symptoms become much brighter. The main symptoms of pneumonia suddenly appear: shortness of breath occurs, breathing becomes hard, often wheezing, signs of fever appear. Congestive pneumonia is also manifested by coughing. Moreover, sputum at the same time contains blotches of blood, often - pus. The patient breathes heavily, wet rales are clearly audible.

Treatment

Treatment is complex, includes the destruction of infection, ventilation of the lungs, elimination of swelling. Use expectorant drugs, diuretics, drugs. Prescribe medications that improve the condition of the heart muscle. In addition, the treatment of congestive pneumonia in a bedridden patient is not complete without antibiotics.

Almost always, oxygen treatment (oxygen therapy) is used, back massage sessions are prescribed. To clear the bronchi from sputum, special bronchoscopy procedures are performed, bronchoalveolar lavage is performed. In each individual case, the doctor may prescribe additional procedures and medical manipulations. For example, they correct those pathologies that caused or contributed to the development of secondary inflammation in the lungs.

Folk remedies

Along with drug treatment, after consulting a doctor, you can use folk remedies for treatment:

For example, you can prepare an infusion of their thyme herb. To do this, pour into the pan 2 tbsp. l. finely chopped grass, pour 500 ml of boiled water only. Leave for a while until the infusion cools down. Then strain. Drink the patient 4 times a day for half a glass.

To cleanse the bronchi of sputum, prepare an infusion of dried viburnum berries. To do this, pour 2 tbsp into a clean thermos in the evening. l. crushed, crushed berries, add 200 ml there. boiling water. In the morning the infusion will be ready. It is drunk, mixed with linden honey, in a sip after a meal.

It is very useful to carry out steam inhalations with soda and decoctions of medicinal plants (with the permission of a doctor).

Prevention

To avoid the development of congestive pneumonia, purchase a special orthopedic mattress on which the bedridden patient will be comfortable.

Provide him with a varied, wholesome, healthy diet rich in vitamins.

On the advice of a doctor, do breathing exercises, massage the chest and back.

Make sure that the air in his room is humidified. This is very important in the prevention of pneumonia, as dry air contributes to the development of breathing problems. To increase humidity, ventilate the room more often, especially in rainy weather. When it's hot outside or the central heating is on, turn on an electric humidifier or just hang wet sheets on the radiators.

Constantly listen to the breathing of a bedridden patient, which should be even, without wheezing. If you are worried about extraneous wheezing, gurgling sound when breathing, call a doctor. Remember that the treatment of a disease detected in time is always effective. Be healthy!

The appearance of a bedridden patient in the family always becomes a difficult test not only for himself, but also for all relatives. Due to the fact that the patient is constantly in a motionless position, stagnation develops in the body. This is fraught with the occurrence of many pathologies, one of which is pneumonia.

As a rule, the focus is formed in the lower parts of the body. In such people, pneumonia is extremely severe, as they usually have serious comorbidities.

Inflammation of the lungs in such patients occurs due to the fact that blood stagnates in the pulmonary circulation. The amplitude of the chest during breathing is limited in a horizontal position. During the act of breathing, negative pressure is created in the chest cavity. This leads to the fact that the alveoli are filled with air, and blood flows to the pulmonary arteries.

After gas exchange, exhalation should occur, however, due to a decrease in the volume of the chest cavity, an increase in pressure occurs in it. Such a violation leads to the removal of air from the alveoli, followed by the expulsion of oxygenated blood from the pulmonary circulation. The lungs do not get enough air, and mucus accumulates in them, which is an excellent breeding ground for pathogenic bacteria.

Signs of pneumonia: how not to miss the symptoms

Pneumonia of bedridden patients is usually not accompanied by pronounced manifestations. They develop gradually, and its first signs often do not stand out against the background of the underlying disease. Therefore, relatives should be extremely attentive to the slightest changes in the condition of a sick person. The main symptoms of the disease are:

The appearance of a slight cough with scanty sputum;
The occurrence of increasing shortness of breath, which is most often the only clear sign;
A slight increase in body temperature or its normal values;
Pain in the side on the side of the affected lung;
Gray-bluish coloration of the skin;
The appearance of hard breathing with wheezing.

If the patient has heart disease, heart failure may develop.

Additional Information! If timely medical care was not provided to a sick person, the inflammatory process passes to another lung, bilateral pneumonia develops.

This pathology is characterized by the following symptoms:

The occurrence of severe shortness of breath;
The appearance of wet rales and a prolonged cough;
Separation of mucopurulent sputum or hemoptysis;
Development of fever;
Violation of the function of the cardiovascular system: arrhythmia, changes in blood pressure, tachycardia.

Such signs indicate a severe course of the disease and a high risk of adverse effects.

Is bedridden pneumonia contagious? Risk factors

It is believed that this form of pneumonia is not contagious, since it occurs due to stagnation of blood in the small circle, followed by activation of the bacterial flora. However, there is a category of people who are at risk of contracting a dangerous disease. These include the following persons:

Previously transferred any other type of pneumonia, but the disease was not treated to the end;
Having a history of complex operations, forcing patients to stay in bed for a long time;
Having concomitant chronic diseases: heart defects, atrial fibrillation, bronchial asthma, coronary heart disease, diabetes mellitus;
Serious illnesses: stroke, malignant neoplasms.

How to confirm the diagnosis?

The therapist can determine the first signs of congestive pneumonia. He listens to the patient's lungs, in which he distinguishes wheezing and hard breathing. The diagnosis should be made on the basis of a chest x-ray. It must be performed in two projections.

Additional laboratory and instrumental research methods are used to confirm the diagnosis. They help the specialist to distinguish pneumonia from other similar diseases and develop the best tactics for treating a sick person.

General blood analysis

Allows you to assess the severity of the inflammatory process due to the increased content of leukocytes, the shift of the leukocyte formula to the left and accelerated ESR.

Blood chemistry

In patients with pneumonia, there is an increase in the amount of reactive inflammatory proteins, seromucoid. In addition, respiratory alkalosis and hypoxemia develop.

Microscopy of sputum in preparations

Allows for differential diagnosis with other similar diseases: tuberculosis of the lungs, malignant neoplasm. Thanks to the analysis of sputum, altered cancer cells, mycobacteria are detected and the nature of inflammation is determined.

Bacteriological culture of sputum

The causative agent of the infection is cultivated with further identification of its sensitivity to antibacterial drugs.

CT scan

It is performed in cases where the diagnosis is in doubt, and it is necessary to conduct a differential diagnosis with other similar diseases.

ECG, ultrasound of the heart

It is used for people with concomitant cardiovascular pathology.

Treatment of pneumonia in bedridden patients: how to deal with the disease?

Antibiotics. Since this disease is inflammatory, first of all, the specialist recommends a course of these drugs. They suppress the bacterial flora, which is the source of infection. First, the specialist prescribes broad-spectrum antibiotics. A few days later, when the results of a bacteriological examination of sputum are known, he changes them to such medicines to which microbes are sensitive.

Important! The dosage and frequency of use is prescribed exclusively by the attending physician. Self-administration or withdrawal of the drug is prohibited, since such actions can aggravate the pathological process or cause bacterial resistance to antibiotics.

Antifungal medicines. They are needed to treat congestive pneumonia, which is most often caused by a combination of bacteria and fungi.
Expectorants. Bronchicum, Dr. MOM. They include extracts of coltsfoot, yarrow, anise, thyme, thyme, thermopsis. The group of direct action includes baking soda, essential oils. Their effect is to influence the quality of mucus and its production by the respiratory organs.
Mucolytic drugs: Acetylcysteine, Ambrobene, Lazolvan, Bromhexine. The therapeutic effect is based on their penetration into the sputum, leading to the destruction of the structure of the protein molecule. Due to this, the discharge becomes liquid and easier to remove from the lungs.
Diuretics and cardiac glycosides: facilitate the work of the heart.
Immunomodulators: Arbidol, Imudon, Timalin. This group of drugs is used to increase the body's defenses in the fight against infection.

Additional Information! Important therapeutic actions are to ensure ventilation of the lungs and reduce their swelling. For this, oxygen therapy is used. If the patient's condition is severe and the signs of respiratory failure are severe, the doctor puts him under anesthesia and transfers him to artificial lung ventilation.

Prognosis and possible complications of the disease

Congestive pneumonia in bedridden patients is a serious and severe disease. It can not only reduce life expectancy in the elderly, but also be fatal. In 60% of these patients, death occurs. With untimely and inappropriate therapy, undesirable consequences may appear.

If the inflammation of the lungs has not been completely or not completely treated, an abscess may form. It is a cavity in the respiratory organ containing pus that can break into the bronchus.

In addition, exudative pleurisy and pericarditis may develop, which aggravate respiratory failure and cause cardiac dysfunction.

Note! In order to reduce the risk of getting pneumonia, it is necessary to approach the issue of prevention with responsibility. Vibration massage should be carried out regularly and in no case should the patient be overheated or hypothermic. For a better discharge of sputum from a bedridden patient, it is necessary to spread it on the stomach three times a day. You can rub the lung area with camphor alcohol without affecting the spine area. In addition, one should not forget about a balanced and rational diet, which will help the patient get the necessary nutrients, vitamins and trace elements.

Conclusion

Pneumonia of bedridden patients is a serious test for their family. The disease is characterized by a severe course, a high probability of death. Pathology can lead to the development of various adverse effects. To protect the patient from the occurrence of pneumonia, special preventive measures are required. Relatives should be attentive to any changes in the state of health of a bedridden patient, even if they are minor.

It must be remembered that the earlier pneumonia was diagnosed in a person and adequate therapy was prescribed, the higher the likelihood of recovery and the absence of any complications.

Pneumonia is a severe, in most cases of infectious origin, disease in which the tissues of the lung are affected. There are several reasons for the occurrence - bacteria, fungi, viruses, the ingress of a foreign body into the lung (aspiratory pneumonia) or paracancer inflammation that occurs with lung cancer. Pneumonia can lead to serious consequences, even death, therefore, at its first signs, you should immediately consult a doctor and immediately begin treatment.

People who are bedridden due to a chronic disease (stroke, Alzheimer's disease), advanced age or injury require special attention for pneumonia. In bedridden patients, the risk of getting sick increases for the following reasons:

shallow breathing;
the work of the diaphragm is difficult;
lung ventilation is insufficient;
inhalation of food (aspiration pneumonia);
violation of blood supply;
insufficient performance of drainage functions by the bronchi.

Viscous sputum accumulates in the organs, in which bacteria and other harmful microorganisms multiply, infecting the lungs. Due to the inability to move normally, the fluid stagnates, the number of pathogens of pneumonia increases. In bedridden patients, this process can lead to more severe consequences than in an ordinary person, due to the fact that the body is weakened.

Due to the constant intake of drugs prescribed for the treatment of the underlying disease, resistance (resistance, body resistance) to them appears, which also complicates the treatment process. Therefore, timely and correct diagnosis is so important.

In bedridden patients, the disease has a pulmonary and extrapulmonary manifestation. Pulmonary - this is shortness of breath and cough, disorders of the central nervous system. Extrapulmonary - lethargy, mood swings, apathy and speech disorders. Urinary incontinence, loss of appetite, depression, arrhythmia, increased heart rate, exacerbation of chronic kidney disease can also be observed. These signs are often similar to those of the underlying disease, so it is difficult to diagnose pneumonia in the early stages.

Also, especially after a stroke or in Alzheimer's disease, the symptoms of pneumonia at the initial stage do not appear clearly, the disease proceeds sluggishly and the patient has no complaints. It can be only a slight cough without fever, shortness of breath, weakness and a feeling of incomplete exhalation.

Symptoms of aspiration pneumonia:

cough, usually nocturnal;
increased salivation;
dyspnea;
in some cases, the loss of food during chewing:
lack of high temperature;
the presence of wheezing, which are fixed when listening.

To correctly diagnose and prescribe adequate treatment, the patient must be examined by a doctor. At this stage, it is desirable to do an x-ray examination, conduct an analysis of sputum, urine, general and clinical blood tests.
An ECG and ultrasound of the pleural region is also done.

Unfortunately, sometimes the diagnosis is carried out late, when the disease has already passed the initial stage. In this case, symptoms appear - severe shortness of breath, wheezing, hemoptysis, severe cough with purulent sputum. A high temperature appears, the work of the heart is disturbed, pressure decreases or rises, consciousness is confused; from the digestive system - nausea and vomiting, diarrhea and weakness, the kidneys cease to function normally.

Remember! In half of the cases in bedridden patients, pneumonia becomes chronic, and untimely treatment can lead to death.

At the first signs of the disease, you should definitely consult a doctor.

Treatment

The success of treating bedridden patients depends on several factors:

How weakened is the human body.
In a complicated form of pneumonia.
What chronic diseases does the patient suffer from?
From the age of the patient.

For treatment, the components are important - identifying the causative agent of the disease, adjusting lung ventilation and reducing mucosal edema. For this, antibiotics (Penicillin, Cephalosporin), expectorants and immunomodulators are prescribed; in atypical pneumonia, drugs are added - erythromycin or metronidazole. In the first few days, injections are prescribed, then they switch to oral (by mouth) treatment.

In the event that the patient suffers from cardiovascular insufficiency, drugs are needed to improve blood circulation and strengthen the heart muscle. Trental, Digitalis, Furosemide, Veroshpiron are prescribed. It should be borne in mind that when taking these drugs, there is a loss of potassium, so the doctor prescribes Panangin or other means of similar action.

Healthy ! Eat foods high in potassium - raisins, dried apricots, cottage cheese, beans, peas.

Most often, bedridden patients are hospitalized at the first sign of pneumonia, especially if symptoms are present:

fuzzy creation;
exacerbation of chronic diseases;
arterial hypertension;
fever.

With a disease, fluid accumulates in the lungs, which gradually leaves the body with a cough, sputum, but if there is too much of it and it worries the patient, they make a puncture and pump out the fluid with a syringe with a long needle. This procedure is performed using local anesthesia. The patient feels significant relief immediately after the procedure, which, if necessary, can be done at home.

At this time, care and the exact implementation of all the prescriptions of doctors are important. After the acute stage of pneumonia has passed, the patient is prescribed a course of physiotherapy exercises and physiotherapy, in particular, they use:

magnetophoresis with the use of antibacterial drugs;
chest massage is a physiotherapy procedure to improve sputum discharge and bronchial drainage;
electrophoresis with drugs that promote expectoration of sputum;
ultrasonic aerosol inhalation - with mucolytics, heparin and antibiotics.

Remember! Physiotherapy cannot be used in the acute stage of the disease, with a malignant tumor, exacerbation of a cardiovascular disease, hemophilia, atherosclerosis of cerebral vessels.

Treatment of pneumonia with folk remedies

It is necessary to treat pneumonia with medicines, but as an auxiliary treatment, folk remedies help patients. Before using them, it is advisable to consult your doctor.

Tincture of thyme. Pour two tablespoons of dry grass with 500 ml of hot water, insist, strain and drink 100 g four times a day.
Brew a handful of crushed berries in a thermos, leave for 10 hours, strain. Drink with the addition of honey after meals, 3 tablespoons.
Mix equal amounts of flax seeds and peeled walnuts. Grind the ingredients, transfer to a dry container for storage. To prepare a healthy and tasty product, put one tablespoon of the mixture in 100 g of butter and heat over low heat, then cool and add honey to taste. You can eat with bread, pancakes - tasty and healthy!
To prepare the infusion, take a mixture of dry plants - marigold flowers, plantain grass, nettle, calamus and elecampane, eucalyptus leaves and raspberry fruits. Pour two full tablespoons of the mixture with 500 ml of hot water, put in a water bath for 20 minutes. Cool and drink 100 g daily. Take for two months, then take a break.

Nutrition for pneumonia for bedridden patients

Special nutrition in the treatment of pneumonia is not required, but it is recommended to limit the consumption of spicy and salty foods. Eating should be frequent and in small quantities.

The patient's diet should contain protein - meat, fish, beans, chicken. It is good to use sour-milk products, vegetables and fruits, berries. With this disease, it is advisable to eat fatty foods daily - a piece of lard or brisket. It is advised to drink acidified water, juices and fruit drinks from black currants, lingonberries. A decoction of rose hips is very useful.

Preventive measures

A bedridden patient should more often take a half-sitting position. To do this, he needs to raise the headboard by placing a few pillows.
Do a set of breathing exercises daily:
- - inflate baby balloons in the morning and evening, first do it for one minute, then increase the time to five minutes;
  - blow air into a tube placed in a glass of water;
  - raise your hands up while inhaling and exhale sharply, lowering them.
These exercises are not only a preventive measure, they must also be done with an existing disease.
- At home, inhalations with infusion of herbs help well.
- Bedridden patients with pneumonia benefit from therapeutic massage. To carry it out, you should lightly tap on the chest and back with your fingers several times a day.

Remember! Massage can not be performed with some heart diseases. Before sessions, be sure to consult with your doctor.

You should ventilate the room more often and make sure that the air is not dry. When the central heating is on, it is advisable to use electric air humidifiers. If there is no humidifier, cover the batteries with a wet cloth.

Pneumonia is a serious disease, but if the patient is lying down, it is even more dangerous. Therefore, relatives and friends should carefully monitor the patient's condition and consult a doctor at the first signs of pneumonia. In this case, the prognosis of physicians is much more optimistic.

A person's life path ends with his death. You need to be prepared for this, especially if there is a bed patient in the family. Signs before death will be different for each person. However, the practice of observations shows that it is still possible to identify a number of common symptoms that portend the imminence of death. What are these signs and what should be prepared for?

How does a dying person feel?

A bedridden patient before death, as a rule, experiences mental anguish. In sound consciousness there is an understanding of what is to be experienced. The body undergoes certain physical changes, this cannot be overlooked. On the other hand, the emotional background also changes: mood, mental and psychological balance.

Some lose interest in life, others completely close in on themselves, others may fall into a state of psychosis. Sooner or later, the condition worsens, the person feels that he is losing his own dignity, more often he thinks about a quick and easy death, asks for euthanasia. These changes are hard to observe, remaining indifferent. But you will have to come to terms with this or try to alleviate the situation with drugs.

With the approach of death, the patient sleeps more and more, showing apathy towards the outside world. In the last moments, a sharp improvement in the condition may occur, reaching the point that the patient who has been lying for a long time is eager to get out of bed. This phase is replaced by the subsequent relaxation of the body with an irreversible decrease in the activity of all body systems and the attenuation of its vital functions.

Bedridden patient: ten signs that death is near

At the end of the life cycle, an elderly person or a bedridden patient feels more and more weak and tired due to a lack of energy. As a result, he is increasingly in a state of sleep. It can be deep or drowsy, through which voices are heard and the surrounding reality is perceived.

A dying person can see, hear, feel and perceive things that do not actually exist, sounds. In order not to upset the patient, this should not be denied. It is also possible to lose orientation and the Patient is more and more immersed in himself and loses interest in the reality around him.

Urine due to kidney failure darkens to almost brown with a reddish tint. As a result, edema appears. The patient's breathing quickens, it becomes intermittent and unstable.

Under pale skin, as a result of a violation of blood circulation, dark “walking” venous spots appear, which change their location. They usually first appear on the feet. In the last moments, the limbs of a dying person become cold due to the fact that the blood, draining from them, is redirected to more important parts of the body.

Failure of life support systems

There are primary signs that appear at the initial stage in the body of a dying person, and secondary ones, indicating the development of irreversible processes. Symptoms may be external or hidden.

Disorders of the gastrointestinal tract

How does the bedridden patient react to this? Signs before death, associated with loss of appetite and a change in the nature and volume of food consumed, are manifested by problems with the stool. Most often, constipation develops against this background. A patient without a laxative or an enema finds it increasingly difficult to empty the bowels.

Patients spend the last days of their lives refusing food and water altogether. You shouldn't worry too much about this. It is believed that dehydration in the body increases the synthesis of endorphins and anesthetics, which to some extent improve overall well-being.

Functional disorders

How does the condition of patients change and how does the bed patient react to this? Signs before death, associated with the weakening of the sphincters, in the last few hours of a person's life are manifested by fecal and urinary incontinence. In such cases, you must be prepared to provide him with hygienic conditions, using absorbent underwear, diapers or diapers.

Even in the presence of appetite, there are situations when the patient loses the ability to swallow food, and soon water and saliva. This may lead to aspiration.

With severe exhaustion, when the eyeballs are very sunken, the patient is not able to completely close the eyelids. This has a depressing effect on those around you. If the eyes are constantly open, the conjunctiva must be moistened with special ointments or saline.

and thermoregulation

What are the symptoms of these changes if the patient is bedridden? Signs before death in a weakened person in an unconscious state are manifested by terminal tachypnea - against the background of frequent respiratory movements, death rattles are heard. This is due to the movement of the mucous secretion in the large bronchi, trachea and pharynx. This condition is quite normal for a dying person and does not cause him suffering. If it is possible to lay the patient on his side, wheezing will be less pronounced.

The beginning of the death of the part of the brain responsible for thermoregulation is manifested by jumps in the patient's body temperature in a critical range. He can feel hot flashes and sudden cold. The extremities are cold, the perspiring skin changes color.

Road to death

Most patients die quietly: gradually losing consciousness, in a dream, falling into a coma. Sometimes it is said about such situations that the patient died on the “usual road”. It is generally accepted that in this case, irreversible neurological processes occur without significant deviations.

Another picture is observed in agonal delirium. The movement of the patient to death in this case will take place along the “difficult road”. Signs before death in a bedridden patient who embarked on this path: psychosis with excessive excitement, anxiety, disorientation in space and time against the background of confusion. If at the same time there is a clear inversion of the wakefulness and sleep cycles, then for the patient's family and relatives such a condition can be extremely difficult.

Delirium with agitation is complicated by a feeling of anxiety, fear, often turning into a need to go somewhere, to run. Sometimes this is speech anxiety, manifested by an unconscious flow of words. The patient in this state can perform only simple actions, not fully understanding what he is doing, how and why. The ability to reason logically is impossible for him. These phenomena are reversible if the cause of such changes is identified in time and stopped by medical intervention.

Pain

Before death, what symptoms and signs in a bedridden patient indicate physical suffering?

As a rule, uncontrolled pain in the last hours of a dying person's life rarely increases. However, it is still possible. An unconscious patient will not be able to let you know about this. Nevertheless, it is believed that pain in such cases also causes excruciating suffering. A sign of this is usually a tense forehead and deep wrinkles appearing on it.

If, during examination of an unconscious patient, there are assumptions about the presence of a developing pain syndrome, the doctor usually prescribes opiates. You should be careful, as they can accumulate and, over time, aggravate an already serious condition due to the development of excessive overexcitation and convulsions.

Giving help

A bedridden patient before death may experience significant suffering. Relief of symptoms of physiological pain can be achieved with drug therapy. Mental suffering and psychological discomfort of the patient, as a rule, become a problem for relatives and close family members of the dying.

An experienced doctor at the stage of assessing the general condition of the patient can recognize the initial symptoms of irreversible pathological changes in cognitive processes. First of all, this is: absent-mindedness, perception and understanding of reality, the adequacy of thinking when making decisions. You can also notice violations of the affective function of consciousness: emotional and sensory perception, attitude to life, the relationship of the individual with society.

The choice of methods of alleviating suffering, the process of assessing the chances and possible outcomes in the presence of the patient, in individual cases, can itself serve as a therapeutic tool. This approach gives the patient a chance to really realize that they sympathize with him, but they are perceived as a capable person with the right to vote and choose possible ways to solve the situation.

In some cases, a day or two before the expected death, it makes sense to stop taking certain medications: diuretics, antibiotics, vitamins, laxatives, hormonal and hypertensive drugs. They will only exacerbate suffering, cause inconvenience to the patient. Painkillers, anticonvulsants and antiemetics, tranquilizers should be left.

Communication with a dying person

How to behave relatives, in whose family there is a bed patient?

Signs of approaching death can be obvious or conditional. If there are the slightest prerequisites for a negative forecast, it is worth preparing in advance for the worst. Listening, asking, trying to understand the non-verbal language of the patient, you can determine the moment when changes in his emotional and physiological state indicate the imminent approach of death.

Whether the dying person will know about it is not so important. If he realizes and perceives, it alleviates the situation. False promises and vain hopes for his recovery should not be made. It must be made clear that his last will will be fulfilled.

The patient should not remain isolated from active affairs. It is bad if there is a feeling that something is being hidden from him. If a person wants to talk about the last moments of his life, then it is better to do it calmly than to hush up the topic or blame stupid thoughts. A dying person wants to understand that he will not be alone, that he will be taken care of, that suffering will not touch him.

At the same time, relatives and friends need to be ready to show patience and provide all possible assistance. It is also important to listen, let them talk and say words of comfort.

Medical assessment

Is it necessary to tell the whole truth to relatives in whose family there is a bed patient before death? What are the signs of this condition?

There are situations when the family of a terminally ill patient, being in the dark about his condition, literally spends his last savings in the hope of changing the situation. But even the best and most optimistic treatment plan can fail. It will happen that the patient will never get back on his feet, will not return to active life. All efforts will be in vain, spending will be useless.

Relatives and friends of the patient, in order to provide care in the hope of a speedy recovery, quit their jobs and lose their source of income. In an attempt to alleviate suffering, they put the family in a difficult financial situation. Relationship problems arise, unresolved conflicts due to lack of funds, legal issues - all this only aggravates the situation.

Knowing the symptoms of imminent death, seeing irreversible signs of physiological changes, an experienced doctor is obliged to inform the patient's family about this. Informed, understanding the inevitability of the outcome, they will be able to focus on providing him with psychological and spiritual support.

Palliative care

Do relatives who have a bed patient need help before death? What symptoms and signs of the patient suggest that she should be treated?

Palliative care for the patient is not aimed at prolonging or shortening his life. Its principles affirm the concept of death as a natural and regular process of the life cycle of any person. However, for patients with an incurable disease, especially in its progressive stage, when all treatment options have been exhausted, the question of medical and social assistance is raised.

First of all, you need to apply for it when the patient no longer has the opportunity to lead an active lifestyle or the family does not have the conditions to ensure this. In this case, attention is paid to alleviating the suffering of the patient. At this stage, not only the medical component is important, but also social adaptation, psychological balance, peace of mind of the patient and his family.

A dying patient needs not only attention, care and normal living conditions. Psychological relief is also important for him, easing the experiences associated, on the one hand, with the inability to self-service, and on the other hand, with the realization of the fact of an imminent imminent death. Trained nurses also know the subtleties of the art of alleviating such suffering and can provide significant assistance to terminally ill people.

Predictors of death according to scientists

What to expect for relatives who have a bed patient in the family?

Symptoms of the approaching death of a person "eaten" by a cancerous tumor were documented by the staff of palliative care clinics. According to observations, not all patients showed obvious changes in the physiological state. A third of them did not show symptoms or their recognition was conditional.

But in the majority of terminally ill patients, three days before death, a marked decrease in the response to verbal stimulation could be noted. They did not respond to simple gestures and did not recognize the facial expressions of the personnel communicating with them. The “smile line” in such patients was omitted, an unusual sounding of the voice (grunting of the ligaments) was observed.

In some patients, in addition, there was hyperextension of the cervical muscles (increased relaxation and mobility of the vertebrae), non-reactive pupils were observed, patients could not close their eyelids tightly. Of the obvious functional disorders, bleeding in the gastrointestinal tract (in the upper sections) was diagnosed.

According to scientists, the presence of half or more of these signs may most likely indicate an unfavorable prognosis for the patient and his sudden death.

Signs and folk beliefs

In the old days, our ancestors paid attention to the behavior of a dying person before death. Symptoms (signs) in a bedridden patient could predict not only death, but also the future prosperity of his family. So, if the dying person asked for food (milk, honey, butter) in the last moments and relatives gave it, then this could affect the future of the family. There was a belief that the deceased could take wealth and good luck with him.

It was necessary to prepare for imminent death if the patient shuddered violently for no apparent reason. It was like looking into his eyes. Also a sign of close death was a cold and pointed nose. There was a belief that it was for him that death was holding the candidate in the last days before his death.

The ancestors were convinced that if a person turns away from the light and most of the time lies facing the wall, he is on the threshold of another world. If he suddenly felt relieved and asked to be transferred to his left side, then this is a sure sign of an imminent death. Such a person will die without pain if the windows and the door are opened in the room.

Bedridden patient: how to recognize the signs of impending death?

Relatives of a dying patient at home should be aware of what they may encounter in the last days, hours, moments of his life. It is impossible to accurately predict the moment of death and how everything will happen. Not all of the symptoms and symptoms described above may be present before the death of a bedridden patient.

The stages of dying, like the processes of the origin of life, are individual. No matter how hard it is for relatives, you need to remember that it is even more difficult for a dying person. Close people need to be patient and provide the dying person with the maximum possible conditions, moral support and attention and care. Death is an inevitable outcome of the life cycle and it cannot be changed.

Pneumonia in bedridden patients is not uncommon. The cause of its occurrence is often not bacteria, fungi or viruses, but small amounts of food that enter the respiratory tract during the feeding of the patient. This type of pneumonia is also called aspiration pneumonia. The risk group includes, as a rule, the following categories of people:

Bed patients.
Patients with neurological diseases (for example, after a stroke).
Patients after anesthesia.
Patients after significant injuries (fracture of the femoral neck, etc.).
Elderly people who have a weakening of the cough reflex.

In addition, the lungs must be well ventilated. The lack of fresh air and congestion in the lungs also provoke the development of pneumonia in bedridden patients.

Symptoms of pneumonia in bedridden patients

Typical symptoms of aspiration pneumonia include:

Severe unproductive cough.
Mostly nocturnal cough.
Strong salivation.
Prolapse of food from the mouth during chewing.
Dyspnea.

The temperature in pneumonia in bedridden patients either rises only slightly, or does not rise at all. When listening with a phonendoscope, it is possible to fix the presence of dry rales.

Treatment of pneumonia in bedridden patients

A bedridden patient and pneumonia is a rather dangerous combination. As a rule, such a person has a reduced immunity, his body is greatly weakened. In addition, many of them, due to long-term treatment of the underlying disease, develop resistance to antibiotics. However, broad-spectrum antibiotics are the only way to get rid of the inflammation that has arisen in the tissues of the lungs.

If the bacteria that caused the pneumonia can be found in the coughed up sputum, treatment can be more targeted. In addition, it is necessary to eliminate the cause that caused the onset of the disease. Breathing exercises will help to establish ventilation of the lungs. The room in which the patient is located must be ventilated at least once a day. If the patient is completely unable to move, it is necessary to turn over several times a day, if possible, bring him to a semi-sitting position, at least for the duration of feeding.

With timely treatment, the prognosis for recovery is usually favorable. But the one who cares for a bedridden patient must remember that the disease can return at any time, so the prevention of aspiration pneumonia should be one of the points of care for such a patient, otherwise the result can be more than sad.