Caring for bedridden patients at home after a stroke. Caring for a bedridden patient at home. Rules for medical and hygienic care for bedridden patients after a stroke For his care

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

It is important for them to know how to correctly perform all procedures for caring for a bedridden patient.

Medical care for bedridden patients in medical institutions is provided by staff. When patients are discharged home, care responsibilities are transferred to the patient's relatives. Creating a comfortable environment for such patients can improve their quality of life. Caring for bedridden patients at home is difficult work that requires organization, patience and a lot of time. First, let's talk about what requirements a room for bedridden patients must meet.

What should a bedridden patient's room be like?

For a bedridden patient at home, it is advisable to allocate a separate room. It should be quite spacious and bright. If it is south facing, then in summer on hot days it needs to be shaded. It's good if there are blinds on the windows. They protect from the sun when necessary and are easy to clean.

It’s good if the room is protected from extraneous loud sounds, but the patient should not feel isolated from society.

The room in which the patient is located should not be cluttered, but everything necessary must be placed at hand. The room should contain the following furniture: a table, a closet or chest of drawers with linen, a chair, and, if necessary, a TV or portable radio (the patient should be aware of all the latest events and not feel like an outcast). Unnecessary items must be removed from the room, as they make cleaning difficult.

Means for caring for bedridden patients should be right there, nearby.

The bed mat should not slide. You can use a bathroom rug; they are usually made with a rubberized bottom, which prevents them from sliding on the floor.

The room should be ventilated in any weather at least twice a day for 15-20 minutes. Wet cleaning is done daily. Bedridden patients are very sensitive to dust and various infections, because they usually have reduced immunity.

Bed for a bedridden patient

If a patient spends a lot of time in bed, it is advisable that his bed be special and functional. Its height is easy to adjust; the head and foot parts can be raised and lowered if necessary. This bed has special side posts that prevent the patient from falling out of it. A functional bed will make caring for bedridden patients easier. Bedsores are best prevented, but they are difficult to treat. The possibility of bedsores forming with such a bed is much less.

But if you cannot purchase such a bed, then the usual one can be somewhat transformed. The desired height can be achieved by placing several mattresses on top of each other. Chairs inserted into the bed frame will prevent the patient from accidentally falling.

The bed should be wide enough, since bedridden patients spend most of their time in it. They should be comfortable. The approach must be ensured from all sides. It is so easy to change bedding and underwear and turn the patient into a different position.

Items needed by the patient

Items for caring for bedridden patients should be nearby. On the bedside table there should always be fresh drinking water and a glass (mug or sippy cup), a TV remote control, the patient’s glasses (if he reads in them), a table lamp (floor lamp or wall sconce). It is convenient if the patient has a bell on his table or bedside table, with which, if necessary, he can call a nurse or relative caring for a bedridden patient to him. All these items must be placed in such a way that the patient can easily reach them on his own.

The drawer of the bedside table should contain a tonometer, a thermometer, cotton pads and swabs, as well as special cosmetics, talc, cream and anti-bedsore products and necessary medications. The lower drawer can accommodate disposable nappies, nappies and trash bags. Items for caring for bedridden patients must be arranged in such a way that, if necessary, the patient himself can reach them. The toilet chair, if used by the patient, should also be located next to the bed.

Basic rules of care

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

• patients who have had a heart attack or stroke need to measure their blood pressure every morning and evening, record it, and show these records to the attending physician;
• body temperature is measured daily;
• it is necessary to monitor the nature and quantity of bowel movements, and if they become pathological (loose stools, streaks of blood, little urine, dark or red urine, etc.), inform the doctor;
• the condition of the skin should be assessed daily (the appearance of bedsores, rashes or redness);
• All necessary medications must be given to the patient on a schedule or make sure that he does not forget to take them himself.

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

If a patient is incontinent of urine or feces, it is necessary to stock up on disposable diapers and diapers.

Underwear for a patient should be soft and only made of natural fabric; preferably, it should be seamless, but if it has fasteners or ties, they should only be on the front.

It is always necessary to ask the patient what he wants and, if possible, fulfill his requests. There is no point in arguing; the patient understands better what exactly he needs at the moment.

Ask who he would like to see and invite only these people, but the visits should not be boring.

If the patient gets worse, he should not be left alone, especially at night. Keep the lights dim in the room. If you cannot constantly be present in the room with the patient if his health worsens, then you can hire a caregiver or a nurse. Nurses with medical education provide better care for bedridden patients. You can hire them through an agency or look for them in medical institutions.

Hygienic care for bedridden patients

For seriously ill patients, hygiene is especially important. The immunity of such people is weakened, so any infection can worsen the condition or provoke a concomitant disease, for example, congestive pneumonia.

Hygienic care includes daily washing, hand washing, brushing teeth and hygiene of intimate places. To do this, it is better to use neutral liquid shampoos and detergents for the care of bedridden patients with a pH of 5.5. The body also needs regular washing. Special treatment should be carried out where there are skin folds - these are the back and buttocks (places where bedsores most often form).

To wash the body, you need to use a sponge and a hard towel, which is used to rub and massage the patient’s skin after washing. After the hygiene procedure, the body must be thoroughly dried. On a wet body, bacterial infection grows, which can lead to inflammatory processes. After hygiene procedures, skin folds and places of contact with the bed (where bedsores can form) must be treated with talcum powder or baby cream.

After changing the diaper, the genital area must be washed using gentle detergents, wiped dry and treated with a protective cream (there are special creams for diapers).

When changing bed linen and diapers, they should not be pulled from under the patient, as this can damage the skin and cause the formation of bedsores.

Caring for bedridden patients. Bedsores and their prevention

Bedsores are areas of necrosis (death) of the soft tissues of the body. They can form in bedridden patients as a result of compression of the tissue of protruding areas, these are places above bone protrusions. Typically, bedsores appear in immobilized patients. Typical places of their manifestation are the buttocks, heels, back of the head, elbows, and less often the back and hips. Skin care for bedridden patients, in addition to normal hygiene procedures, includes the prevention of bedsores.

It is needed by both bedridden patients and patients who use a wheelchair for mobility, who are partially immobilized (for example, an arm or leg does not function after a stroke), as well as those suffering from obesity, severe diabetes mellitus, or urinary or fecal incontinence.

Caring for a bedridden patient involves preventing bedsores. It would be a good idea to lightly massage your back area after each body wash. This will increase blood circulation and thereby help improve tissue trophism, which will serve as the prevention of bedsores.

To prevent the formation of bedsores, you must:

• eliminate risk factors for the formation of bedsores;
• use the necessary devices for the prevention of bedsores (rollers, soft pillows, rubber circle);
• careful hygiene of the patient’s skin;
• performing physical exercises if the patient is immobilized, but these should be passive exercises (i.e., the person caring for the patient independently flexes and straightens his limbs);
• massage, it can be done on your own, it can be a non-professional massage, the main task is to increase blood flow to the places that experience the greatest compression (perform the most common movements - stroking, light patting);
• complete nutrition.

How to eliminate risk factors for the formation of bedsores?

1. Carefully examine the patient’s body every day for redness and changes in the skin, paying special attention to areas of bony protrusions.
2. Every 2 hours it is necessary to change the position of the patient's body. So, for example, to turn him onto his left side, you need to cross the patient's arms over his chest and put his right leg on his left. Then approach him on the right and put your one hand under his thigh and put the other on his shoulder, and then turn the lying patient in one motion. Patients should be turned from side to side as carefully as possible to avoid excessive tension or friction of the skin. You can put a soft pillow between your legs, especially for emaciated patients (for obese patients this measure will be unnecessary).
3. The temperature in the room must be maintained optimal (19-20 degrees) so as not to provoke excessive sweating of the patient and the formation of diaper rash.
4. Bed linen should always be clean and changed promptly. Use soft underwear and only made from natural fabrics. It is best to place a disposable absorbent diaper on top of it; this will prevent the formation of diaper rash and make it easier to care for a bedridden patient.

Nutrition for bedridden patients

Since a bedridden person moves little, his diet should be moderate, because such an organism does not experience large energy costs. The calorie content of the food is reduced, but the diet is well balanced. The amount of protein and minerals should be sufficient. Protein is a building material for cells; if it is lacking, tissue restoration and wound healing will be poor.

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

Treatment of bedsores

If, nevertheless, preventive measures were not enough or they did not help and bedsores appeared, then their treatment should be started immediately. It consists of three main areas:

1. Improve blood supply to the places where bedsores form (do not lie on the wound, use a rubber circle, anti-bedsore mattress, turn the patient often).
2. Clean the wound of pus, dirt and necrotic tissue and treat it with chlorhexidine. Do not touch the wound with your hands, carry out all manipulations with gloves and use auxiliary means (sterile wipes, tweezers), apply the medicine directly from the bottle (do not use hydrogen peroxide, iodine, brilliant green - they dry the skin and interfere with healing).
3. Take measures to heal the wound as quickly as possible (completely clean the wound of necrotic tissue, since they are a breeding ground for the development of infection), change the dressing once a day.

Features of patient care after a stroke

Often, after a stroke, the patient is cared for by his relatives. Regardless of the severity of the disease, the patient should remain in bed for the first time. An ischemic stroke often leads to partial immobilization of a person. Care for a bedridden patient after discharge from the hospital is carried out by his relatives. In such patients, the right or left side of the body is paralyzed, and when caring for them, certain rules should be followed.

Such patients need to change body position every 2 hours, undergo a complex of physical therapy and massage. These measures are necessary to restore nerve impulses and restore mobility of paralyzed limbs. The more often exercise therapy and massage are performed, the better the dynamics of recovery will be. Ideally, these complexes should be repeated every 3-4 hours. Patients can perform some basic exercises on their own.

When caring for such a patient, it is very important to ensure that the paralyzed limbs are not suspended. To do this, bolsters, pillows or garters should be used, and mobility in the shoulder joint should be maintained, and some distance should be maintained between the arm and the body.

If the patient is turned on his paralyzed side, then the affected arm is placed 90 degrees relative to the body, placing a small pillow under it, and the healthy arm is pulled back.

Sometimes the recovery period lasts a long time, during this time you need to be patient and consistently follow all the doctor’s recommendations. The patient will have to learn to hold objects and move independently again.

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

Mom Early in the morning, through a dream, I hear my mother’s voice - she is calling me. “I’m running, running,” my message-thought flies to her and freezes halfway and returns to me... Mom is not there, she is far away and she no longer needs my care. Her soul was freed from her helpless body and, perhaps, had already met our dad, for whom she had missed so much in recent years. And with her son Volodya, who passed away so early, he was her only son and she loved him immensely. Yesterday it was nine days since her heart stopped and my mother’s thin hand grew cold in my palms, I wanted to warm it; and the body was still giving off its last warmth, but it was quiet in the place where the heart used to beat. I was in a hurry to say as many kind words as possible, to convey to her the last greetings from all my relatives, and I was sure that she heard me - her face became so calm and bright. My fingers were still flexible and, perhaps, my tears warmed them a little, and my nails, which, having rested in recent years from hard peasant work, were now beautiful, but they had now turned blue. For the first time, I saw Death coming so close and it seemed to me as mysterious, incomprehensible and beautiful as Life... I want to tell you about our mother. After all, it was they, our parents, who laid the foundation for the outline of our life on this earth. Many hardships and trials befell their generation. She was born in one thousand nine hundred and twenty-seven in the family of Vasily and Alexandra Agapov, in the small Siberian village of Sharagun; many names of the villages have been preserved in our places, where they lived in ancient times near Lake Baikal. Behind was the First World War, the Great October Revolution and the bloody civil war. As if in a terrible storm, battered and impoverished villages barely survived from shock and hunger. After the civil war there was a slight lull - the land was cultivated, livestock multiplied and children were born into peasant families. In the neighboring village, on the old farm, at that time my grandfather - my father's father and his brothers built good houses for four families, hauling mountains of flagstone for foundations and thick logs from the taiga, dragged along a sled road. My mother’s grandmother, Avdotya Likandrovna, was an extraordinary creature; having been widowed at an early age, she became an Ottoman not only in her family but also in the village! By some miracle, this dashing courage and a reverent, pious and affectionate Soul coexisted in her. It was she, during the food requisition, when detachments of food procurers raked even sowing grain from the peasants, dooming their families to hunger, who persuaded the women to hide the seeds in the forest; and at night, putting their little bags in a cart, hiding from everyone, they themselves quietly rolled it away and hid the grain in the forest guardhouse. And the case when they herded them into a commune and grandmother Avdotya stood on the porch of her house with an ax in one hand and an icon in the other, in order to prevent the villains from entering the house. I described him in the story “From Genetic Memory,” in chapter four, my mother was then five years old, my older sister, Glana, was nine, and my little sister Vera was a newborn. The thought still haunts me about who Mammoth was, why they showed him to me, and how my great-grandmother ran like a red thread through his life? Mom was talking about some uncle Orsya, Arseny, which means that his grandparents raised him as an adopted son and he came when they were already living on the old farm and brought a doll; my mother was then seven years old. The grandmother, seeing him, clasped her hands and ran up the hill, to meet him like a young woman, the older granddaughters ran after her with all their might and caught up with her when she, stepping on her long skirt, fell face down, and Uncle Orsya, who ran up, picked her up and pressed her to him. like a little girl. Near the house, frightened that everyone had run away from her, their two-year-old sister was rolling on the ground and roaring loudly, only when her uncle handed her a doll, her roar suddenly stopped, her eyes widened and she grabbed this miracle with her dusty hands! The uncle was dressed in city clothes and after staying for several days, he left. She never saw him again, her grandmother was sad, but did not say anything about him. Maybe he is the same Mammoth? After all, our relatives used to hide everything that happened during Stalin’s times in order to protect the young from complexes and consequences. As an adult, I learned about the double dispossession of our ancestors on my father’s side, that his two uncles were repressed, and about ten years ago my great aunt was able to obtain copies of documents from the district archive about this dispossession. And my father’s beloved aunt Anna had her husband shot in Irkutsk, and she and her daughter Galya were exiled to Central Asia and later lived in Tashkent. I will insert here this chapter about the distant Easter Sunday of my great-grandmother and mother, they lived through it together - old and little. “That April Sunday was the first day of Easter. For his grandmother - the holiest and brightest holiday, which nothing could overshadow! A fine sunny morning foreshadowed the joy of the Soul - a freshly whitewashed hut, winter frames are exposed and the windows are shining clean, there are woven rugs on the floor smelling of freshness, festive curtains and tablecloths and a burning lamp near the icons. On the table are delicate green wheat shoots and eggs painted with onion feathers on a large dish. The cake smells sweet. Quiet, well-dressed children are sitting on a bench by the window, in the sunlight, waiting for a festive breakfast. Suddenly, in the yard, disturbing this state of joyful peace, a dog barked angrily, the clatter of boots and rude swearing were heard. It turns out that at the last meeting the organization of a commune was announced, and since the father of the family signed up for the commune, he now had to leave his home and move to another village with all the household and household, and it was necessary to hand over all the living creatures to the common yard, including chickens and excluding cats and dogs. And those who did not want to join the commune had to move to this village. Not only was this done cruelly, contrary to all logic and common sense, but such a day was also chosen to hit harder, humiliate and show that neither you, nor your faith, nor your values ​​are worth anything! Then his little grandmother, dry and hunched over from constant hard work, rushed to defend her nest like a desperate bird! She stood on the porch like crazy, with an icon in one hand and an ax in the other. - Throw the ax, grandma, if you don’t want to go to the madhouse! - a young man in a military uniform yelled at her and at the same time sharply pulled out and threw the ax to the side. The grandmother, having lost her balance, fell face down, dropping the icon at her feet. And they, stepping over it, went up into the house, while a big man with a red muzzle, who was walking last, stepped on the icon with a heavy dirty boot - it cracked and split along the bright face of the Virgin Mary. With trembling hands, picking up and kissing and pressing these two halves to her chest, she began to pray earnestly, asking forgiveness from the Lord for being so embittered on Easter Sunday. She prayed for these people who, having despised everything holy, walk the earth like blind people. She mourned them and felt sorry for them, as they mourn and feel sorry for their children who died early, who did not know love and happiness in her... He slowly knelt down and, picking up the crumpled photograph, carefully pressed it to his lips. Having lowered his head, and indeed now very similar to a mortally wounded mammoth, he froze like that, silently moving his lips. And how then, the furious and confident detachment, herding people like livestock into one herd, fell silent, ashamed in front of the old mother praying for them and, trying not to make noise, left the yard. So it is now - the room became quiet and although none of them looked at him or heard his silent prayer, it was as if the Holy Spirit, albeit for a moment, descended on them, opening their eyes and awakening the Soul. How shocked he was, he, who did not remember a single prayer, who had matured on the field of Soviet atheism, by that power, that energy of love felt by all cells, which now covered him, protecting him from the malice of others and his own. The bright image of his grandmother often came to life in his memory and then, as if the divine Light illuminated his Soul in its deepest recesses. This image warmed him, inspired him to rejoice and believe in life. Then, on Easter morning, she did not enter her house again. The son carefully lifted her and, sitting her on the prepared cart, said: “Mama, look after the guys.” She stroked their heads, pressing her lips first to one or the other of the fluffy tops, still smelling of birch leaves and Bogorodsk grass from yesterday’s bath. A wooden village was placed nearby, in which a baby was sleeping serenely on a pillow. The bright spring sun blinded him and he squinted in his sleep, moving his lips funny and spreading his little pink fingers that had gotten out of the diapers. Icons wrapped in embroidered towels were also placed here. A hot samovar, wrapped in a blanket, was placed in a kneading bowl and a cast iron pot with homemade noodles, and a basket with bread and colored eggs prepared for breaking the fast after Lent. At the back of the cart there was a large ficus in a skating rink - it had recently released tender leaves that were still twisted into shiny tubes. And, finally, a basket woven from birch bark, from which a cat who still had blind newborn kittens looked at everyone with amber eyes, trustingly and gratefully. So the cart, loaded with the most expensive thing they had, surrounded by adults and teenagers, set off on the road to a new unknown life. On this path between the past and the future, the last happy Easter breakfast of their large friendly family took place in a forest clearing. Still transparent, the forest was filled with pink light and the sweet-tart smell of blooming rosemary. White-trunked birches, illuminated by the sun, illuminated the entire forest like huge candles! And the birds, on their honeymoon not yet preoccupied with feeding their offspring, sang in every possible way. Golden bees, after a long winter, circled in a joyful swarm above the pink clouds of wild rosemary; and the warmed earth soared, filling the air with the heady aroma of life. - God's grace! - the grandmother repeated endlessly, approaching first one, then the other. And her face glowed and her eyes filled with moisture, which, like birch sap from an overflowing hole, flowed down her wrinkled cheeks. What were those tears? Did she mourn everything lost today - the house that she and her husband built, where she gave birth and raised her children, the well-groomed land that fed and protected them, the farm acquired by hard work... No! She cried with joy, realizing that having lost their acquired earthly goods by someone’s cruel will, they did not lose God’s grace - the clear sun was shining, the birds were singing, the children were laughing, rejoicing in the fullness of life! And the earth was already bearing new fruits in its womb so that life on it would extend. He shuddered when her small, warm palm stroked his bowed head, ruffling his coarse, unruly hair. - Don’t be afraid, child, the Lord will protect you! I will give you my Guardian Angel. - What about you, little woman, who will protect you? - he laughed, hugging her fragile shoulders. “I still have a spare,” she laughed loudly, like a girl. Now, completing his earthly journey, he was sure that then, in her enlightened joy, she was able to see his future, already almost an adult, with a head weighed down with thoughts. And the Angel that she gave then, indeed, was next to him all his life - guarding and saving him. Here, in captivity, free from the hustle and bustle that often prevents us from focusing on our goal, realizing the truth, or accepting the test as a lesson, he realized a lot and understood how important it is to be able to enjoy even the smallest thing that gives you life. Perhaps, thanks to this divine gift, his grandmother lived for almost one hundred and two years in joy, despite all the hardships of life.” Her granddaughters constantly ran after her, like chickens after a hen, holding on to her skirt. She also took them into the forest, carrying the youngest on a hump, and over the summer she picked berries, mushrooms, and medicinal herbs for the whole winter. One day a wolf came out to them and she, hiding the girls under her skirt, pointed a stick at him, “bang” so loudly as if from a gun that he ran away with his tail between his legs! - “It’s good that the wolf was old and it was summer!” - she rejoiced while telling this story. In her seventies, she, having ordered her granddaughters to play quietly at home, fled to the neighboring village, where she worked part-time - mowing hay or reaping rye and wheat, deftly tying it into sheaves. She always returned with gifts, receiving for her work either a piece of cloth or calico, or money, which she used in the shop to buy matches, salt, sugar and some sweets for her granddaughters; Having tied it all up in an apron, I hurried home, tired and happy! If someone does something bad, she will shake her head and say: “Oh, you Lichomaniac.” As a child, I couldn’t understand what this meant, only later did I appreciate this weighty definition - if you do it badly, it means you’re inviting misfortune! And when they came running to her to complain about broken knees or torn clothes, she clasped her hands and said: “What a disaster!” and laughed loudly with her toothless mouth, and everyone immediately understood that there could be worse troubles! I talk so much about my mother’s grandmother - this is because my mother often remembered her lately, talked to her, and sometimes shouted: “Granny, go, look at your Manya - I’m lying there like a cut down willow, I can’t do anything. ..” And she felt sorry for her mother, Alexandra Leontyevna - she was quiet and timid, after the war she gave birth to two more sons, the last one, Vitya, was quite late, the eldest daughters already had children. I was very worried that they wouldn’t have time to get him back on his feet, but that’s what happened, first his father died, and soon she died too; the youngest was ten years old. I really want to tell one more story about little woman Avdotya, it happened in the mid-thirties, when trouble reached the Siberian villages - the destruction of churches. In the large village of Buret, on a sunny hill above the Angara, there was a beautiful white-stone church; people from all the surrounding villages and villages were baptized, got married and had funeral services here. Before blowing it up, they took out large icons and loaded them onto a cart; apparently, the order was to preserve them as material value. The old women and women, realizing that it was useless to shout and fight, silently crossed themselves, and then the unexpected happened! Outside the village, the old women, led by our Likandrovna, met this cart and, dragging down the commissioner who was supposed to deliver the icons to the area, they took them to the old farm, leaving him sitting tied up by the road, promising that the horse would be returned. For some time they looked for those icons, they tortured people in the villages, but everyone was silent, and what can you take from old women!? That is why our settlement was so unusual, although once its name was changed and instead of Staraya - Bernatovskaya, it was officially called Voroshilovo. Its space was a place of prayer, especially during the war people came here to pray for their soldiers and Victory. And what a miracle it was when years later, during perestroika, a church was opened in Buret in an old kindergarten, where a dome with a cross was erected on the roof and the priest, who came from the city to consecrate it, was amazed by the icons that the local residents brought to it. And my mother’s character was similar to her grandmother’s - she was a fighter, she was like fire at work, she was always one of the leading workers, she had two medals for valiant work and a stack of certificates of honor, she even went to the collective farmers’ congress in Moscow! But even on holidays she knew how to have fun, she wouldn’t leave the circle and go dancing, singing along to herself with ditties. And we had her as a singer, she always started playing and remembered a lot of songs, dad was proud of it! Of her daughters, Lida, our middle sister, has the strongest voice; Natasha, the youngest, sings quietly, but tenderly, and even with a guitar. And I just sing along, but with great joy and rapture! Already when my mother was lying down, I would sit down next to her and we would sing together three songs from her youth, she would get tired, but she would be glad that she remembered all the words, her cheeks would turn red. .. For nine days, the girls and I quietly sang her favorite songs, I think she was happy listening to us. I still haven’t told you a lot about my mother! As a girl, she loved to mount a horse, race with the boys, and, on occasion, fight with them if she needed to stand up for someone! When our future dad left for the army, she was only twelve years old, then the war began and he fought through it to the end at the front. And she completed a tractor driver’s course at fourteen and received a heavy caterpillar tractor and worked on it throughout the war. She proudly told how she begged the old master blacksmith Stanislav Novakovsky to make her wrenches for the tractor and took care of them like the apple of her eye so that the men in the repair shops would not steal them, and after the war she gave them to her dad when he moved to her tractor! The worst thing that stuck in her memory from that time was the fear that tramps would come out of the forest at night and attack them. They worked around the clock, in shifts, so that the tractor would not be idle, in the fields and slept, very young girls and boys, and they were asked questions from them as if they were adults. They also wanted to run around in the meadows, unwind their souls in songs, and play - their childhood was cut short early. The war ended, the whole village cried with joy, then they sang and danced and cried again! The girls were waiting for the grooms from the front, but only a few of them returned, and even then, many were crippled. Glasha, my mother’s older sister, was wooed and taken to another village - a handsome, healthy and cheerful guy was Uncle Pasha, but he was missing one leg, a piece of wood was fastened above the knee. And her fiancé died in '44. What happened to this piece of wood in the village - no mowing, no carrying water, no sawing firewood... He felt sorry for Glasha and loved him with all his heart. I remember this picture: two front-line soldiers, dad and Uncle Pasha, are sitting, and on a stool my little sister Natasha, she’s six years old, sings to them a long and sad song “The enemies burned down my native hut...”, and Uncle Pasha let go of his head and cried, he couldn’t stop Maybe dad is reassuring him, saying that you have a whole house, and he, “I’m sorry…” and let his head go even lower. After the war, he completed an accounting course and worked at the state farm for a long time, they respected him. When dad returned from the eastern front in the spring of '46, so brave, tall and curly, the girls held their breath - whoever they looked at. Marusya, our mother, showed all her courage and dexterity here, however, he stuttered strongly after a concussion and limped due to a deep wound on his thigh. Her mother tried to persuade her that where you stick your head, to the rich family, you can’t handle it. .. She still remembered how they were dispossessed, what a large farm the brothers had - a herd of cattle, and all sorts of seeders and winnowers! So they began to live and live, the house was empty at first, but it was large, beautiful and warm - one of those that my father’s father and his brothers built; They filled the mattress with hay, mom gave one pillow for two, and covered ourselves with dad’s overcoat. The bride didn’t have time to prepare the dowry, there was no time for that! But the main thing was that there was grandmother, father’s mother, Marya Nikolaevna, we fell into her arms one after another, my parents worked without a break. My father’s extended family, I think, received Marusya Agapova warily at first, but soon they fell in love with her for her dexterity in any task, her hard work and cheerful disposition. She always had something to put on the table - she would treat her, greet her, sing songs together, back then it was still customary for a large family to gather around the table on holidays. Our grandmother loved her, took pity on her and helped with the housework and with her grandchildren. Some kind of amazing thrift and generosity coexisted in her at the same time; It used to be that he would come from the market, where he would earn money from the products sold, put some of it in a handkerchief-piggy bank and, tying it in a knot, would smile slyly. The first valuable thing that the young couple bought for the house was a sewing machine - mother’s pride! It stood in our front corner, on a small bench, specially ordered from Grandfather Misha the Golden Hands, under a case and covered with an embroidered napkin. On the collective farm, in the post-war years, they often gave out various materials for workdays, mostly Chinese - chintz, staple, baize, calico, and for good work they were rewarded with an expensive piece of clothing. Mom, having taken a course in cutting and sewing from Grandma Zosya, our village dressmaker, began to sew all of us; For Easter, he will sew dresses with wings for us girls, family shirts and panties for dad and brother, and smart aprons with frills for himself and grandma. Sometimes we'll all dress up in the same color - it's even fun! When she left for me, she gave this car to her neighbor, her friend, I think she was sad to part with it. Mom was always proud that she and her grandfather had nine grandchildren and now six great-grandchildren! During the summer holidays, a horde of grandchildren came to their village, it was fun, but what a responsibility it is to feed everyone, to make sure that everything is fine, only over the years do you realize all this. They kept the farm constantly in order to help the children as well. And she was wise, she never interfered in our family affairs and never said a bad word about her sons-in-law or daughter-in-law, at least I didn’t hear them! My mother and I lived together for more than ten years, the most difficult years of her aging and extreme old age. Back in Switzerland, we celebrated her eighty years and for this anniversary we took her and her husband to Spain, where she saw the sea for the first time and was very surprised that there was so much salt water and that tangerines were hanging on the trees right in the city and no one was picking them! It’s good that at that time there was already a Skype connection and we could contact our relatives and see them, this was a great joy for her, and her friend, also Marusya, received a call on her cell phone and they chatted for a long time, laughed and sang songs. Here, in the Czech Republic, she was given a residence permit without any problems, got medical insurance, she was glad that we had a vegetable garden, growing apples and grapes, which she herself had never picked from a tree before. I just often thought about the mushrooms that grow in abundance in Siberian forests, I just dreamed about them! We have a small forest right behind the house and she loved to walk along the forest path with a cane, it’s beautiful there, the birds are singing.. One day a miracle happened - our mother comes, tired, sweaty, her hands are all in the ground, but so happy, tucked on her stomach the apron puffs up and puts dry white milk mushrooms on the table - so strong, only all the caps are in the ground, as if they had just emerged from the ground and the rain had not had time to wash them. I was surprised, since I had been exploring our forest for a long time and even toadstools were rarely seen here, but you won’t see milk mushrooms, even in Czech books about mushrooms! Mom then tenderly soaked the mushrooms, cleaned them, and we added salt to them in a jar, and she wrote down in her calendar when we could eat them. The next day, early in the morning, she drove me into the forest, told me to take the basket, she was already about eighty-six years old, her legs were difficult to lift; She and I reached the place where we had to go into a hollow and then climb up a small slope - there were dry leaves and pine needles under our feet, I barely climbed there, clinging to the bushes. She shouts to me from below: “Look there, bend over, take the stick...”, and I tell her: “Why did you climb here, if you didn’t kill yourself!” In short, I didn’t find any mushrooms, it was dry and didn’t smell like mushrooms, I just saw the place where my mother raked the leaves with her hands and collected her milk mushrooms. I realized that this was a gift to her from God for her faith, I think this was not the first time she was looking for them here and believed that she would find them! Yes, and some higher forces lifted her up this slope and brought her down from it! Seeing my empty basket, she sighed: “Unlucky”, picking her up by the arm, we hobbled home, sat on a bench behind the garden, I told her: “Mom, let’s pray, thank God, we’ll say, he gave you the mushrooms, like those here.” they don’t even grow, just don’t climb there again, otherwise he’ll think you’re greedy and fall out of there.” She agreed. Well, I’m sure I had a special gift from God - to go through the tests that He had prepared for me through my mother! Three years before leaving, something suddenly changed in her, maybe this often happens to old people when they become helpless. I have heard from many that old parents become capricious and angry and some negative thoughts creep into their heads, preventing them from living in peace. She looked at me coldly and her gaze seemed to say: “It’s easy to love a good, flexible and kind person, but love me as I am!” Unexpectedly, she screamed not in her own voice, scaring me, but seeing my fear, she laughed: “Well, I was scared, scarecrow!” At first I was confused, I didn’t know what to do - I was angry, offended, until I realized that I had to perceive her as my beloved sick child. Perhaps some dark energy essence moved into her when she became weak, and dark ones feed on negative emotions - fear, resentment, irritation... When all I had left was unconditional love for her, and my mother no longer had enough energy of her own, she left her. And again everything got better - my mother felt sorry for me, caught my hand, pressed it to her lips and said: “I have completely tortured you, daughter,” or after lunch: “lie down, my dear, rest a little.” - “Oh, how cold your hands are, how can you stay here without me, poor thing...” I’m not quite used to living without her yet. Sometimes I really want her to talk to me! I pray that my mother’s Soul will continue on the bright path, and that I will consciously continue my earthly path. Lyudmila Pavlasek

Vladimir Yashin, a general practitioner, teacher at Moscow Medical School No. 13, and author of the textbook “Healthy Lifestyle,” talks about how to provide professional care for a bedridden patient.

Often, chronic patients do not need active treatment and daily medical supervision. Let's say that during a long stay in the hospital (for example, after a stroke), a person received the necessary qualified assistance. And, of course, he wants to go home, to close people, in a familiar environment.

Indeed, in practice I can say: houses and walls help. Good care and attention can work wonders. An old saying goes: “The doctor heals, the caregiver cures.” It is still quite relevant today. What is important for a caregiver to know?

Hygiene comes first

All manuals unanimously recommend regularly ventilating the room where the patient is lying and carrying out wet cleaning daily. For many people, the second point is difficult to achieve. But try to wipe the dust on the shelves and floor at least once a week - cleanliness and comfort improve the patient’s mood, and this is a direct path to recovery.

Bed linen should be changed weekly - and this is a vital issue. The more the laundry is caked, the more crumbs spilled on it, the more the risk of bedsores increases.

To change linen and straighten the bed, it is necessary, if possible, to transfer the patient to another bed. Overweight people need to be carried by two people: one puts his hands under the head and shoulder blades, the other - under the lower back and hips and lifts them up at the same time.

If it is not possible to move the patient, there is another way. The patient is moved to the edge of the bed, the dirty sheet is rolled up lengthwise in the form of a bandage, and a clean one is straightened in its place. The patient is rolled onto the clean side, the dirty sheet is removed from the other side and a clean one is straightened.

Changing clothes

To change underwear, you need to place your hands under the patient’s sacrum, then grab the edge of the shirt/T-shirt and carefully push it towards the head. Raising both the patient’s arms, remove the shirt over the head and then free his hands.

Dress the patient in the reverse order: first the sleeves of the shirt, then the neckline over the head. By the way, in stores and pharmacies you can buy undershirts for seriously ill patients, for example with myocardial infarction, which are easy to put on and take off.

Skin care

If the condition allows, the patient is seated in bed, and he independently washes his hands, face, neck and ears with soap and water at room temperature. A bedridden patient is wiped using tampons or sponges moistened with water with the addition of vodka or cologne. Seriously ill patients need to wipe the entire body with camphor alcohol, especially the folds in the groin, armpits and areas of skin under the mammary glands in women. If the skin is dry, you need to lubricate it with baby cream every 2-3 days.

Among modern skin care products that are sold in pharmacies, we can, in particular, recommend the following: alcohol-free body lotion (has a softening and soothing effect), foam for washing and body care (provides nutrition and care for irritated skin , removes the unpleasant odor of urine), wet wipes for sensitive skin (they have cleansing and disinfecting properties).

After each meal it is necessary to clean the oral cavity. To do this, you need a cotton swab, a 2% soda solution and a kidney-shaped basin (sold at the pharmacy). The patient should be seated in bed, take a cotton swab with tweezers, soak it in a soda solution and wipe the tongue, teeth and oral surface of the cheeks. After this, the patient should rinse his mouth with warm water, and the caregiver holds a kidney-shaped basin under his chin.

Bathing

A moderately ill patient is washed once a week in a bath or shower, following the doctor’s recommendations. The bath is half filled with water (not lower than 35-37° C). The patient is helped to wash his head, back and legs. When washing in the shower, sit him in the bathtub on a bench and use a flexible hose.

Severe and weakened patients are washed in bed, placing an oilcloth over the sheet. Using a sponge moistened with warm water and soap, wash the upper half of the body, then the stomach, thighs and legs.

For washing (as well as for emptying the bladder and intestines), use a bedpan and warm water (or a solution of furatsilin at a dilution of 1:5000). The procedure must be carried out several times a day. You need: oilcloth (place it under the vessel), a water jug, sterile cotton swabs and a holder. The patient lies on his back with his knees bent. The caregiver pours warm water or a disinfectant solution over the external genitalia in women or the perineal area in men, and then wipes the skin with cotton swabs.

Prevention of bedsores

Bedsores are skin ulcers of varying sizes and depths. Most often they appear in seriously ill patients in the sacral area, less often in the area of ​​the shoulder blades, the back of the head, buttocks, heels and other places where soft tissues are compressed between the bone and the bed. The first sign is pale skin, then redness, swelling and peeling of the epidermis. In the future - blisters and necrosis of the skin. In severe cases, necrosis can affect not only soft tissue, but also cartilage and even bone. The following manipulations can help prevent bedsores:

• if the patient’s condition allows, it is necessary to change his position in bed several times a day;
• Wash areas of possible formation of bedsores with warm water and soap, and then wipe with camphor alcohol;
• do a simple massage of areas of the body where bedsores may form;
• make sure there are no wrinkles or food crumbs on the sheet;
• for seriously ill patients who have been in bed on their back for a long time, place an inflatable rubber circle placed in a pillowcase so that the sacrum is above its opening;
• in case of hyperemia (redness), rub the skin with a dry towel, and to improve local blood circulation, irradiate the affected area with a quartz lamp;
• wash the skin with soap and water at room temperature, and then wipe it with alcohol and powder with talcum powder.

Enemas

Bedridden patients suffering from constipation need it (once every 2-3 days). To do this, use an Esmarch mug (a rubber tank with a capacity of up to 2 liters). The patient is placed on his left side with his legs bent to his stomach. An oilcloth is placed under the buttocks, the free edge of which is lowered into a bucket. Pour boiled water into Esmarch's mug (the tap on the rubber tube is closed) to 2/3 of the volume, lubricate the tip with Vaseline. Then open the tap to let out some water and air, and close it again. After this, spreading the buttocks, insert the tip into the rectum with rotational movements and open the tap. At the same time, Esmarch's mug is raised higher than the bed. Sometimes, instead of cleansing ones, microenemas with vegetable oil are given at the same frequency - using a rubber bulb. Microclysters are easier for patients to tolerate; the procedure is carried out before bedtime so that the patient has stool in the morning.

Innovation for health

Recently, a lot of inventions have appeared that make it easier: these are a variety of pads (for those suffering from mild forms of incontinence), and absorbent panties, and disposable sheets that can replace the usual oilcloth. Remember, in the use of these means, the main law is expediency. If the degree of incontinence is mild, then there is no need to “steam” in absorbent panties around the clock. The greater the contact of the body with natural tissues, the less the danger of bedsores and diaper rash. However, if incontinence has become normal, then absorbent panties and sheets can save you from the same bedsores - after all, not all caregivers have the opportunity to regularly change their underwear.

Caring for your eyes, ears and nose

If patients develop discharge from the eyes, they should wipe their eyes daily with a sterile gauze swab moistened with a 3% solution of boric acid. It is also necessary to clean the ears from the accumulation of wax in the ear canal. For this purpose, a few drops of a 3% solution of hydrogen peroxide are instilled into the ear, and then a cotton swab is inserted into the very beginning of the ear canal with light rotational movements and carefully, so as not to damage the eardrum, clean it. Weakened patients cannot clean their nose on their own, so the caregiver performs this procedure daily. What is it? The patient should be seated with his head slightly thrown back, placing a pillow under his back. Then a cotton swab is moistened with petroleum jelly or glycerin and inserted into the nasal passage. After holding it for 2-3 minutes, it is pulled out of the nose along with the crusts using rotational movements.

Weather in the house

Naturally, a long stay in bed and the associated discomfort depress a person and traumatize his psyche. He often becomes very irritable and moody. This is fine. I urge you not to break down under any circumstances. After all, your emotional reaction can worsen the patient’s condition - do you need subsequent remorse?

The best way to get rid of irritation is a change of environment. If your ward cannot go outside or at least onto the balcony, do not be afraid to invite guests - friends and relatives. Many are afraid of injuring relatives or tiring the patient. But remember: strangers force the patient to get ready, mobilize, and forget about irritation. New faces practically guarantee an improvement in mood and a feeling of returning to a normal, active life.

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

It is important for them to know how to correctly perform all procedures for caring for a bedridden patient.

Medical care for bedridden patients in medical institutions is provided by staff. When patients are discharged home, care responsibilities are transferred to the patient's relatives. Creating a comfortable environment for such patients can improve their quality of life. Caring for bedridden patients at home is difficult work that requires organization, patience and a lot of time. First, let's talk about what requirements a room for bedridden patients must meet.

What should a bedridden patient's room be like?

For a bedridden patient at home, it is advisable to allocate a separate room. It should be quite spacious and bright. If it is south facing, then in summer on hot days it needs to be shaded. It's good if there are blinds on the windows. They protect from the sun when necessary and are easy to clean.

It’s good if the room is protected from extraneous loud sounds, but the patient should not feel isolated from society.

The room in which the patient is located should not be cluttered, but everything necessary must be placed at hand. The room should contain the following furniture: a table, a closet or chest of drawers with linen, a chair, and, if necessary, a TV or portable radio (the patient should be aware of all the latest events and not feel like an outcast). Unnecessary items must be removed from the room, as they make cleaning difficult.

Means for caring for bedridden patients should be right there, nearby.

The bed mat should not slide. You can use a bathroom rug; they are usually made with a rubberized bottom, which prevents them from sliding on the floor.

The room should be ventilated in any weather at least twice a day for 15-20 minutes. Wet cleaning is done daily. Bedridden patients are very sensitive to dust and various infections, because they usually have reduced immunity.

Bed for a bedridden patient

If a patient spends a lot of time in bed, it is advisable that his bed be special and functional. Its height is easy to adjust; the head and foot parts can be raised and lowered if necessary. This bed has special side posts that prevent the patient from falling out of it. A functional bed will make caring for bedridden patients easier. Bedsores are best prevented, but they are difficult to treat. The possibility of bedsores forming with such a bed is much less.

But if you cannot purchase such a bed, then the usual one can be somewhat transformed. The desired height can be achieved by placing several mattresses on top of each other. Chairs inserted into the bed frame will prevent the patient from accidentally falling.

The bed should be wide enough, since bedridden patients spend most of their time in it. They should be comfortable. The approach must be ensured from all sides. It is so easy to change bedding and underwear and turn the patient into a different position.

Items needed by the patient

Items for caring for bedridden patients should be nearby. On the bedside table there should always be fresh drinking water and a glass (mug or sippy cup), a TV remote control, the patient’s glasses (if he reads in them), a table lamp (floor lamp or wall sconce). It is convenient if the patient has a bell on his table or bedside table, with which, if necessary, he can call a nurse or relative caring for a bedridden patient to him. All these items must be placed in such a way that the patient can easily reach them on his own.

The drawer of the bedside table should contain a tonometer, a thermometer, cotton pads and swabs, as well as special cosmetics, talc, cream and anti-bedsore products and necessary medications. The lower drawer can accommodate disposable nappies, nappies and trash bags. Items for caring for bedridden patients must be arranged in such a way that, if necessary, the patient himself can reach them. The toilet chair, if used by the patient, should also be located next to the bed.

Basic rules of care

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

• patients who have had a heart attack or stroke need to measure their blood pressure every morning and evening, record it, and show these records to the attending physician;
• body temperature is measured daily;
• it is necessary to monitor the nature and quantity of bowel movements, and if they become pathological (loose stools, streaks of blood, little urine, dark or red urine, etc.), inform the doctor;
• the condition of the skin should be assessed daily (the appearance of bedsores, rashes or redness);
• All necessary medications must be given to the patient on a schedule or make sure that he does not forget to take them himself.

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

If a patient is incontinent of urine or feces, it is necessary to stock up on disposable diapers and diapers.

Underwear for a patient should be soft and only made of natural fabric; preferably, it should be seamless, but if it has fasteners or ties, they should only be on the front.

It is always necessary to ask the patient what he wants and, if possible, fulfill his requests. There is no point in arguing; the patient understands better what exactly he needs at the moment.

Ask who he would like to see and invite only these people, but the visits should not be boring.

If the patient gets worse, he should not be left alone, especially at night. Keep the lights dim in the room. If you cannot constantly be present in the room with the patient if his health worsens, then you can hire a caregiver or a nurse. Nurses with medical education provide better care for bedridden patients. You can hire them through an agency or look for them in medical institutions.

Hygienic care for bedridden patients

For seriously ill patients, hygiene is especially important. The immunity of such people is weakened, so any infection can worsen the condition or provoke a concomitant disease, for example, congestive pneumonia.

Hygienic care includes daily washing, hand washing, brushing teeth and hygiene of intimate places. To do this, it is better to use neutral liquid shampoos and detergents for the care of bedridden patients with a pH of 5.5. The body also needs regular washing. Special treatment should be carried out where there are skin folds - these are the back and buttocks (places where bedsores most often form).

To wash the body, you need to use a sponge and a hard towel, which is used to rub and massage the patient’s skin after washing. After the hygiene procedure, the body must be thoroughly dried. On a wet body, bacterial infection grows, which can lead to inflammatory processes. After hygiene procedures, skin folds and places of contact with the bed (where bedsores can form) must be treated with talcum powder or baby cream.

After changing the diaper, the genital area must be washed using gentle detergents, wiped dry and treated with a protective cream (there are special creams for diapers).

When changing bed linen and diapers, they should not be pulled from under the patient, as this can damage the skin and cause the formation of bedsores.

Caring for bedridden patients. Bedsores and their prevention

Bedsores are areas of necrosis (death) of the soft tissues of the body. They can form in bedridden patients as a result of compression of the tissue of protruding areas, these are places above bone protrusions. Typically, bedsores appear in immobilized patients. Typical places of their manifestation are the buttocks, heels, back of the head, elbows, and less often the back and hips. Skin care for bedridden patients, in addition to normal hygiene procedures, includes the prevention of bedsores.

It is needed by both bedridden patients and patients who use a wheelchair for mobility, who are partially immobilized (for example, an arm or leg does not function after a stroke), as well as those suffering from obesity, severe diabetes mellitus, or urinary or fecal incontinence.

Caring for a bedridden patient involves preventing bedsores. It would be a good idea to lightly massage your back area after each body wash. This will increase blood circulation and thereby help improve tissue trophism, which will serve as the prevention of bedsores.

To prevent the formation of bedsores, you must:

• eliminate risk factors for the formation of bedsores;
• use the necessary devices for the prevention of bedsores (rollers, soft pillows, rubber circle);
• careful hygiene of the patient’s skin;
• performing physical exercises if the patient is immobilized, but these should be passive exercises (i.e., the person caring for the patient independently flexes and straightens his limbs);
• massage, it can be done on your own, it can be a non-professional massage, the main task is to increase blood flow to the places that experience the greatest compression (perform the most common movements - stroking, light patting);
• complete nutrition.

How to eliminate risk factors for the formation of bedsores?

1. Carefully examine the patient’s body every day for redness and changes in the skin, paying special attention to areas of bony protrusions.
2. Every 2 hours it is necessary to change the position of the patient's body. So, for example, to turn him onto his left side, you need to cross the patient's arms over his chest and put his right leg on his left. Then approach him on the right and put your one hand under his thigh and put the other on his shoulder, and then turn the lying patient in one motion. Patients should be turned from side to side as carefully as possible to avoid excessive tension or friction of the skin. You can put a soft pillow between your legs, especially for emaciated patients (for obese patients this measure will be unnecessary).
3. The temperature in the room must be maintained optimal (19-20 degrees) so as not to provoke excessive sweating of the patient and the formation of diaper rash.
4. Bed linen should always be clean and changed promptly. Use soft underwear and only made from natural fabrics. It is best to place a disposable absorbent diaper on top of it; this will prevent the formation of diaper rash and make it easier to care for a bedridden patient.

Nutrition for bedridden patients

Since a bedridden person moves little, his diet should be moderate, because such an organism does not experience large energy costs. The calorie content of the food is reduced, but the diet is well balanced. The amount of protein and minerals should be sufficient. Protein is a building material for cells; if it is lacking, tissue restoration and wound healing will be poor.

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

Treatment of bedsores

If, nevertheless, preventive measures were not enough or they did not help and bedsores appeared, then their treatment should be started immediately. It consists of three main areas:

1. Improve blood supply to the places where bedsores form (do not lie on the wound, use a rubber circle, anti-bedsore mattress, turn the patient often).
2. Clean the wound of pus, dirt and necrotic tissue and treat it with chlorhexidine. Do not touch the wound with your hands, carry out all manipulations with gloves and use auxiliary means (sterile wipes, tweezers), apply the medicine directly from the bottle (do not use hydrogen peroxide, iodine, brilliant green - they dry the skin and interfere with healing).
3. Take measures to heal the wound as quickly as possible (completely clean the wound of necrotic tissue, since they are a breeding ground for the development of infection), change the dressing once a day.

Features of patient care after a stroke

Often, after a stroke, the patient is cared for by his relatives. Regardless of the severity of the disease, the patient should remain in bed for the first time. An ischemic stroke often leads to partial immobilization of a person. Care for a bedridden patient after discharge from the hospital is carried out by his relatives. In such patients, the right or left side of the body is paralyzed, and when caring for them, certain rules should be followed.

Such patients need to change body position every 2 hours, undergo a complex of physical therapy and massage. These measures are necessary to restore nerve impulses and restore mobility of paralyzed limbs. The more often exercise therapy and massage are performed, the better the dynamics of recovery will be. Ideally, these complexes should be repeated every 3-4 hours. Patients can perform some basic exercises on their own.

When caring for such a patient, it is very important to ensure that the paralyzed limbs are not suspended. To do this, bolsters, pillows or garters should be used, and mobility in the shoulder joint should be maintained, and some distance should be maintained between the arm and the body.

If the patient is turned on his paralyzed side, then the affected arm is placed 90 degrees relative to the body, placing a small pillow under it, and the healthy arm is pulled back.

Sometimes the recovery period lasts a long time, during this time you need to be patient and consistently follow all the doctor’s recommendations. The patient will have to learn to hold objects and move independently again.

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

One of the most important and labor-intensive processes of caring for patients who are unable to move and care for themselves is maintaining their cleanliness. Not every caregiver is able to easily cope with the current situation, not fully understanding how to organize competent hygienic care for their family member.

In order to prevent complications from a bedridden lifestyle (such as bedsores, diaper rash, pustular skin lesions, eye diseases, etc.), you need to know what care products for bedridden patients at home prevent their formation.

General hygiene products

Keeping the body, mouth, eyes, ears, and intimate areas of a bedridden patient clean should become a daily procedure. The psychological comfort of a bedridden person largely depends on this. To do this, it is not at all necessary to use expensive hygiene products for bedridden patients. Pharmacies, retail and online stores offer a wide range of care products in different price categories, available to everyone in need.

For oral care

To carry out the teeth cleaning procedure, you will need the following hygiene products:

• sterile, disposable gloves;
• oilcloth fabric or sheet;
• water container;
• a toothbrush with soft bristles;
• toothpaste;
• putty knife;
• hygienic cotton swabs;
• sanitary napkins;
• Vaseline or any lip moisturizer.

The main item of care for bedridden patients at home when brushing their teeth is a brush with soft bristles, which will prevent damage to the gums (especially in older people). When caring for a bedridden patient, special attention should be paid to the choice of toothpaste. All oral hygiene pastes are divided into 3 main categories:

№	Paste categories	Purpose
1.	Actually hygienic	Designed to eliminate soft dental deposits such as plaque and food debris. The use of these products is indicated in the absence of oral pathology: caries, periodontitis, stomatitis.
2.	Multicomponent medicinal	Used for patients burdened with dental pathology. Some antifungal compound toothpastes have been successfully used for bedridden patients with oral candidiasis.
3.	Treatment and prevention	Such products contain in their list of components an increased content of microelements (fluorine and calcium), which support the protective characteristics of the enamel and prevent the development of caries, which can often be found in a bedridden patient.

A spatula is needed to fix the oral cavity in a static position, and hygiene sticks are used to remove plaque and food debris. It is not recommended to use toothpicks for these purposes, because... they can damage the gums, which will cause an inflammatory process.

Vaseline or nourishing cream are products for bedridden patients necessary to moisturize lips after brushing their teeth.

For washing hair

There is an opinion that one of the most difficult manipulations in caring for a bedridden patient is washing your hair. However, there are now products on sale that greatly facilitate this procedure. Special detergents are also sold, thanks to which the issue of cleanliness of the hair of a bedridden patient will no longer be a problem.

A bath for washing hair in bed is one of the most necessary hygiene products for caring for a bedridden patient. It is an inflatable container with a headrest, in which the head is comfortably fixed without putting strain on the shoulder girdle. The kit of such a bathtub necessarily includes a hose, which, when connected to the hole for draining the water, allows you to empty the bathtub without unnecessary hassle.

Proper hygiene for bedridden patients is carried out by choosing a suitable detergent, i.e. shampoo. A high-quality shampoo should have excellent moisturizing and nourishing properties, be hypoallergenic and gentle on the scalp. For elderly people and those with weakened immune systems, shampoos containing urea, which regulates the process of natural change of the epidermis, are suitable.

Patients with short hair can use special dry shampoos that do not require water when used. This is an aerosol bottle that, when sprayed onto the scalp, absorbs all the settled dirt and grease from the hair and is easily removed with a comb. This hygienic product for caring for a bedridden patient is convenient in everyday life if there is not enough time to thoroughly wash your hair.

Also, when there is a limited amount of water, special caps are used for washing hair - very convenient personal hygiene products for bedridden patients. They are also used in situations where the patient is against someone else touching his head. The cap contains a special gel or shampoo with conditioner that cleanses hair without water.

For nail treatment

Hygiene for bedridden patients in this case does not differ fundamentally from the usual methods of treating fingers and toes. Nails should be neatly trimmed, filed, disinfected and treated with moisturizer.

Instead of scissors, you can use large manicure and pedicure clippers. They are stronger and sharper due to their massiveness, which greatly simplifies the cutting process.

The choice of file depends on the thickness of the nails. Each file has its own grit index (degree of abrasiveness). The thicker the nails, the larger the number should be. For caring for a bedridden patient, a file with a range of 180 – 240 grit is suitable.

Important! All devices for treating nails must be individual. After each procedure they must be disinfected.

Since the nails of bedridden patients are often affected by fungus, they become quite hard. In this case, it is necessary to treat them with hygienic antifungal creams such as Bifosin or Nogtivit, which quickly get rid of the fungus and soften the nail plate.

An alternative to pharmaceutical antifungal drugs is a bath with tar soap, which has a good softening effect on nails. This can be a good hygienic means of caring for the nails of a bedridden patient.

For eye care

A bedridden patient often cannot control the cleanliness of his own eyes, so one of the tasks of loved ones is to pay attention to these areas of the body. To wash the eyes from hygiene products for caring for a bedridden patient at home, you will need:

• cotton pad;
• saline;
• antiseptic solutions;
• herbal decoctions.

Instead of ordinary water, it is better to purchase saline solution at the nearest pharmacy, because... it is softer than running water. If discharge from the eyes appears, solutions with chlorhexidine, boric acid or furatsilin will be quite effective.

A speck in the eye can cause considerable discomfort to a bedridden patient, and a simple napkin soaked in tea leaves or a mild saline solution can be a good remedy. Supporters of herbal medicine will respect such hygiene products as chamomile decoction, dill juice, rosehip infusion, bay leaf lotions, drops of propolis water or honey.

Important! Using herbal decoctions and bee products to treat mucous membranes, make sure that the patient is not allergic to these products.

For ear treatment

When caring for a bedridden patient, do not forget about hygienic treatment of the ears. Most often, cotton swabs are used to clean the ear canals. For both healthy and sick people, this remedy is unproductive, since sulfur can settle deep in the ear, forming cerumen plugs. Therefore, aqueous solutions in the form of drops are used as means of hygienic ear cleaning. Care products for bedridden patients such as hydrogen peroxide and urea peroxide are inexpensive and popular methods of cleaning the ear canals. To carry out the entire procedure, it is enough to inject 10 drops of the drug into the ear.

In elderly bedridden patients, deafness is a fairly common phenomenon. When using hearing aids, earwax builds up at an accelerated rate. For such patients, there is the drug Remo-Vax in the form of ear drops. It efficiently removes sulfur deposits and prevents the formation of sulfur plugs. To solve this problem, hygiene products with surfactant - A-cerumen and Vaxol - have proven themselves well.

Intimate hygiene products

Maintaining the cleanliness of the intimate areas of a bedridden patient is ensured by the use of various devices and hygiene products. Manufacturers are trying to produce such products so that the patient and the person caring for them experience a minimum of physical and psychological discomfort when carrying out a delicate procedure for caring for the perineal area of ​​a bedridden patient.

Diapers

A diaper is a special hygienic product for the care of bedridden patients, consisting of fabric that has a high absorption capacity and is used for high-quality and comfortable care for a person.

There are 2 types of diapers - disposable and for long-term use. If we compare these products, the advantage of disposable diapers over regular ones is obvious. Thanks to the porous structure of the material of disposable diapers, a bedridden patient is protected from skin maceration, the formation of bedsores and diaper rash, and the appearance of. This is due to the fact that this diaper contains multilayer pressed cellulose. In addition, they more reliably protect the bed from dirt.

Simple diapers made of linen fibers or cotton fabrics curl and wrinkle easily, irritate the skin, which leads to the formation of bedsores and diaper rash. In addition, if disposable diapers are disposed of when they become dirty, then regular fabric ones must be washed and ironed daily with a hot iron, which takes a lot of time.

Important! Treatment of reusable diapers with a hot iron is mandatory to prevent the occurrence of secondary infection.

These are special hygiene products, which are disposable bags that are used for stomas () communicating with the external environment. When natural is not possible, such a bag is fixed in the hole and collects the excreted feces. This hygienic product for caring for bedridden patients is used very often, and it is important to know what it is.

Colostomy bags differ in components:

1. One-component. These are ordinary bags for collecting discharge.
2. Two-component. They consist of a special adhesive plate that is attached to the stoma, and then a bag for the discharge is attached to this plate. The advantage of such a device is that it creates a “second skin” effect. The hygiene of replacing such a colostomy bag for bedridden patients is much more comfortable than usual.

Stoma care products

Ostomy care is an important aspect of care for patients who are unable to relieve themselves naturally. Keeping this area clean will prevent unpleasant odors and prevent infection. The table describes the main stoma care products, which are highly desirable to use for bedridden patients.

Name of the product	Method of application and effects
Pastes-sealants	They are used to heal and reduce skin irritation, as well as form a waterproof barrier that improves the fixation of the colostomy bag.
Sprays	Designed to facilitate replacement and removal of colostomy bag. The composition of the spray painlessly separates the adhesive base of the pouch.
Cleaners	Hygienic product for quick and effective cleaning of skin, feces, mucus and pus.
Protective film “second skin”	A hygienic liquid is applied to the skin, which easily evaporates, leaving behind a thin elastic film that protects the skin from maceration. Thanks to the specific base, the skin “breathes” and does not cause severe irritation.
Absorbent powders	Powders are used to prevent skin maceration. This powder is able to collect discharge, forming a layer of gel that protects the skin and improves the fixation of the colostomy bag.
Odor neutralizers	Special hygienic chemical reagents that transform the contents of the fecal sac into a gel, removing unpleasant odors.

Urinals

To collect urine, special hygienic devices are used - urinals, better known as “ducks”. They are widely used due to their ease of use. As a rule, reusable urine collection devices for bedridden patients are used, since they are easily sterilized.

Disposable urinals may differ in components:

• one-component;
• two-component;
• three-component.

If a one-component urinal has only one bag for collecting discharge, then its “brothers” add a base with a removable bag and a drainage tube. Through such a drainage, it is easier and more comfortable to carry out hygiene for bedridden patients.

Important! Changing urine and colostomy bags must be done 10-15 minutes after emptying.

Diapers for adults

For many bedridden patients, either at home or in the hospital, the use of disposable diapers is one of the best solutions to the problem of urination and bowel movements, as well as a kind of protection from awkward situations. It is worth noting that in the absence of caregivers, such hygiene products for caring for bedridden people significantly simplify care.

Diapers for adult bedridden patients are usually made of special soft fabrics. They do not have an aggressive effect on the skin, are non-traumatic, hygienic and hypoallergenic. The air conductivity of the fabric is also important, since the “breathable” material does not cause irritation and diaper rash in humans. The outer layer has sufficient protection against moisture accumulating inside. The cellulose content should be as high as possible, since this is the basis of the absorbency of the diaper.

Urological pads

An alternative to using diapers can be urological pads for women and men. Such care products for bedridden people can be a convenient way out of a delicate situation if the use of diapers causes severe emotional discomfort.

Their main difference from conventional sanitary pads is the speed and volume of urine absorption. Because these pads instantly absorb moisture and provide a more secure hold, the threat of urine leakage is minimized. It is also worth noting that all urological pads are made of hypoallergenic materials, so itching and skin irritation do not occur.

Hygiene products for the prevention of bedsores

Bedsores are a specific complication of a patient’s bedridden lifestyle, in which blood and lymph circulation in tissues and muscles is disrupted. Bedsores remain one of the most serious problems in patient care, therefore, along with special anti-bedsore devices (pillows, circles), it is necessary to use hygiene products.

To minimize the risk of bedsores, the skin of a bedridden patient should be moderately dry and clean. The companies Menalind, Seni and Convin have proven themselves in the hygiene market, producing hygiene products for treating the skin of bedridden patients:

• Hygienic wet wipes for bedridden patients delicately cleanse the skin and do not injure it.
• Massage oils and moisturizing care products for bedridden patients intensively nourish the skin when it is excessively dry, and additionally stimulate blood circulation.
• Hygienic cleansing foams replace soap and water, being more gentle on the skin. They clean it, remove odors, and do not irritate it, thus providing quality care.
• Creams with zinc have proven themselves to be excellent in protecting against diaper rash and have thus gained great popularity among hygiene products for bedridden patients.

Proper hygiene of a bedridden patient is extremely important in general care. It not only gives the patient psychological comfort, but is also a preventive measure to prevent infectious processes.

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