The need to care for a sick person who cannot get out of bed and needs the care and care of family and friends always makes us think about the need to acquire some skills that help to cope with this difficult problem. How to organize proper care, using only your strength? How to alleviate the suffering and feelings of a loved one? How to care for the patient so that no bedsores form on the skin? What care products should be chosen so as not to harm?
Leading dermatologists recommend paying attention in such situations to such aspects of hygiene as:
- gentle skin cleansing,
- effective prevention of pressure sores and inflammatory reactions in the genital area, anus and in the natural folds of the skin,
- therapeutic measures that contribute to the restoration of the skin.
In our article, we will introduce you to these important aspects of bed care, and this information will help you avoid mistakes in this difficult and important matter.
Hygienic measures for patients who are forced to spend a long time in bed should be carried out in the morning and in the evening. Doctors recommend conducting them before breakfast and before bedtime, because it is these time intervals that are most favorable for performing such procedures.
To perform hygiene procedures, it is necessary to prepare such hygiene products:
- two basins for water,
- inflatable bath for washing your hair,
- stand for the pelvis,
- jug for heated water,
- special cosmetics and devices for caring for bed patients: gels, foams, lotions, creams, foaming mittens and sponges (for example, Tena Wash, Seni Care, Menalind, etc.),
- medical and cleaning gloves,
- fabric and paper towels and napkins,
- rubberized diapers and disposable oilcloths,
- absorbent diapers
- cotton wool
- gauze napkins,
- cotton buds,
- special toothbrushes (if the patient himself cannot brush his teeth),
- items for haircuts, manicures, pedicures and shaving,
- male or female urinals,
- circles, rollers or mattresses for the prevention of pressure sores.
If necessary, other hygiene products can be added to this list:
- Breastfeeding bibs
- urological and gynecological pads,
- dry closets,
- chairs for the shower or seat and handrails for taking a bath,
- toilet chairs
- devices for stoma care,
- disposable underwear and bed linen, etc.
A physician can help determine the need for certain care products for bedridden patients, because their range largely depends on the patient’s diagnosis.
Before starting skin cleansing procedures, it is necessary to eliminate all possible sources of drafts and make sure that the air temperature in the room is at least 20 degrees. Such caution when caring for bedridden patients is never unnecessary, because due to illness their immunity becomes weakened, and sharp fluctuations in temperature can lead to exacerbation of chronic diseases.
Stage 1 - care for the patient's oral cavity
If the patient's condition allows, then he can be seated on a chair or give his body a semi-sitting position. If the patient can not change the horizontal position of the body, then his head must be turned to the side and with the help of cotton buds (pagavit) to clear the cheek space from accumulated saliva and plaque. To facilitate the implementation of hygiene procedures for the oral cavity, you can use special disposable plastic spatulas, with which you can alternately and accurately move the left and right cheeks.
To clean the teeth of a sick person you can follow the same rules as for brushing your teeth in a healthy person, but the movements of the toothbrush in such situations should be more gentle and performed with extreme caution.
After completing the procedure, it is necessary to rinse the patient’s mouth with water or a hygienic solution (special solutions for rinsing the oral cavity, solutions of soda, hydrogen peroxide, borax, etc.). To do this, you can use a rubber syringe and a soft tip or special rubber cylinders to rinse the patient's oral cavity. When performing this procedure, the head must be slightly raised above the surface of the bed so that the liquid does not enter the esophagus and respiratory tract.
A special approach is also recommended for the selection of a toothbrush and toothpaste for bedridden care. In most cases, in such patients, the oral mucosa becomes vulnerable and sensitive to the effects of hard bristles, and toothpaste should be selected in accordance with the age-related needs and characteristics of the patient’s diagnosis.
For patients after a stroke, pastes are recommended that have astringent and hemostatic properties. Such oral hygiene products include:
- LACALUT aktiv,
- LACALUT fitoformula,
- Parodontax F et al.
For patients with increased sensitivity of tooth enamel, the following toothpastes are recommended:
- LACALUT Extra Sensitive,
- PRESIDENT Sensitive,
- SILCA Complete Sensitive,
- Oral-B Sensitiv.
For patients with diabetes, the following toothpastes are recommended:
- series of toothpastes DIADENT: DiaDent Regular, DiaDent Asset,
- PerioTherapy Healthy Gums Toothpaste.
For seriously ill children who are forced to stay supine for a long time, it is recommended to choose toothpastes that are able to match their age and have the necessary properties that are determined by the diagnosis.
The duration of the use of therapeutic toothpastes for seriously ill patients is determined individually, since some of their active components with prolonged use can have a negative effect on the health of the oral cavity. After their use, the use of hygienic toothpastes is recommended.
After completing this procedure, it is necessary to wet the patient's lips with an absorbent cloth and apply a hygienic lipstick or moisturizing balm on them, which prevents drying out and cracking of the lips. For this, such means can be used:
- EOS Balm,
- lip balm BABE Laboratorios SPF 20,
- fatty oils: shea butter (shea butter), jojoba, cocoa, soybeans,
- Hygienic lipstick "Frost".
When choosing such balms and hygienic balms, you must make sure that they are hypoallergenic.
Stage 2 - washing
To wash the patient's face, you can use the following solutions:
- Seni Care washing cream,
- washing cream TENA Wash Cream,
- washing lotion Menalind professional,
- Electric and others.
One of the above solutions is diluted in water and a sponge or hygroscopic glove is moistened in it. After that, the patient’s face is wiped, and then they begin hygienic processing of the eyes. For this procedure, it is recommended to use two wet discs made of cellulose (a separate disc should be used for each eye). The movements should be directed from the outer corner of the eye to the inner.
You can use cotton swabs to clean the inside of your auricles and ear canal. After that, using a damp sponge, it is necessary to clean the skin behind the ears, the neck, chest (including folds under the chest), the surface of the sides and stomach of the patient. In parallel with these actions, the cleansed skin areas are blotted with a moisture-absorbing cloth and covered with a towel (blanket) or clothing is put on the treated areas of the body.
After this, the patient is gently turned on its side and the back area is wiped with the same washing solution. The treated skin is dried with a towel and applied to them one of the means to protect the skin from pressure sores:
- Seni Care body gel
- protective cream Menalind professional with zinc,
- Seni Care protective body cream with arginine,
- protective body cream Seni Care zinc, etc.
In the absence of contraindications, after completion of skin cleansing and application of care products for it, percussion massage is recommended.
Sometimes, to wash irritated areas of the patient’s skin, one has to use special products that provide gentle cleansing of the skin. These include:
- foam TENA Wash Mousse,
- Seni Care foam, etc.
Stage 3 - Hand Wash
For washing hands, the same washing solution is used as for washing the body. Each patient’s hand is alternately immersed in a basin with a washing solution and washed with a sponge or gloves. Close attention is paid to clearing the areas of the interdigital space, since it is in it that a large number of pathogenic microorganisms often accumulate.
After washing, the hands are dried with a towel and a special care agent - Seni Care cream for dry and roughened skin - is applied to the area of the elbows (as a rule, roughness of the skin is often observed on them). After that, cut the patient's nails and file them with a special nail file. Further, nail care is carried out as they grow back.
Stage 4 - changing diapers and hygiene of intimate areas
Before starting to cleanse this area of the body, it is necessary to change gloves to new ones and prepare a new washing solution.
Further, the procedure is performed in the following sequence:
- to lay a waterproof diaper under the patient's pelvis (if the bed had not previously been covered with a waterproof oilcloth with an absorbent sheet or absorbent sheet),
- remove the diaper and wrap it in a bag,
- put on a hand a mitt for washing or take a special soft sponge to handle intimate areas,
- moisten a mitten or sponge in a washing solution and squeeze,
- to spread the patient’s legs and put them so that they bend at the knees, and the heels are as close as possible to the pelvis,
- treat the perineal area so that the movements of the sponge are directed from the pubis to the anus,
- dry the perineum with a soft towel (only a specially designated towel or disposable absorbent diaper can be used for this),
- turn the patient on his side, wipe the body and dry the skin with a towel (special attention should be observed when drying the natural folds),
- apply a protector to the skin (protective foam or cream),
- take a clean diaper, unfold, fold it along and gently straighten the protective cuffs and fasteners,
- put the diaper on the patient.
To treat the perineal area, you can use wet wipes for intimate hygiene or cleansing foams. To do this, you can purchase the following tools:
- Seni Care or TENA Wet Wipe wet wipes,
- Seni Care or TENA Wash Mousse.
Stage 5 - washing the feet
To wash your feet, prepare a new cleaning solution and change the sponge or washing mittens. Next, the procedure is performed in the following sequence:
- wipe the legs with a sponge or washing mitt up to the ankle joint,
- dry your feet with a towel
- the patient’s feet should be lowered into the pelvis and washed, paying close attention to the areas between the fingers,
- dry your feet with a towel
- turn the patient on his side and put on the back surface of the legs means to protect against pressure sores,
- lay the patient on his back,
- trim the toenails and treat their edges with a pedicure file.
After completing all stages of washing the patient on coarsened areas of the skin (for example, on the elbows, heels or knees), you can apply special products to effectively soften them - Seni Care cream for dry and rough skin. The completion of hygiene procedures should end with putting on a shirt, giving the body a comfortable position in bed and, if necessary, enclosing rollers or special rubber rings for the prevention of pressure sores. After this, cover the patient with a blanket. In some cases, after the completion of hygiene procedures, it is recommended that therapeutic measures be carried out (for example: treatment of trophic ulcers, treatment of pressure sores, prevention of thrombophlebitis, etc.).
All the above stages of hygienic procedures for the care of bed patients should be performed daily. Compliance with this rule always has a positive effect on the patient’s condition and has a positive effect on the condition of the skin, preventing the occurrence of pressure sores and the development of infectious complications.
Washing the patient’s head should be done as the hair gets dirty. To perform this procedure, you need to prepare the following accessories:
- wash basin (for this it is more convenient to use special inflatable bathtubs for washing the hair),
- stand for the pelvis,
- a jug of water at a comfortable temperature,
- a comb
- kerchief or hat.
The patient is laid on his back and a pillow is placed under the shoulders so that its upper edge is at shoulder level and the head is slightly thrown back. A roll is rolled out of the towel and placed under the neck. The head of the bed is covered with oilcloth, on which a basin of water is installed.
Next, the procedure for washing the hair is carried out in the following sequence:
- the head is gently supported by hand or laid on a special recess in an inflatable bath for washing the head,
- water from a jug is poured onto the patient’s head and all hair is moistened,
- apply shampoo, foam and wash the scalp and hair with gentle movements,
- rinse the hair until the residual foam is completely washed off,
- wrap the head with a towel and, supporting the patient’s head, carefully remove the basin and oilcloth from the head of the bed,
- the patient’s head is laid on the bed, wiped and gently combed,
- put a scarf or hat on the patient’s head until the hair is completely dry,
- the patient’s head is placed in a comfortable position on a pillow.
Hair cutting of the patient is carried out as necessary. For seriously ill patients, a short haircut is recommended, because such a hairstyle makes it easier to care for him.
Hygienic care for a seriously ill loved one or family member is always a troublesome and heavy burden for his friends and relatives. They have to put a lot of effort and time for this. However, the proper organization of hygiene measures for care, which was described in this article, will help you significantly alleviate all these problems and will have a beneficial effect on both the physical and emotional state of the patient.
Which doctor to contact
It should help organize patient care, give the appropriate instructions to the local therapist who observes the patient. If necessary, a local nurse or specialists from palliative care centers are connected. A dermatologist will recommend modern skin care products. Additional care advice can be provided by the specialist who treated the patient: neurologist, traumatologist, oncologist and others.
Features of hygienic care for seriously ill patients
The comfort of a sick person, fully or partially bedridden, depends not only on the timely reception of the medications prescribed by the treating doctor. Proper hygienic care for a seriously ill patient is among the list of necessary measures - a guarantee of vigor and a quicker recovery of the patient.
The skin of a patient adhering to bed rest should be looked after especially carefully. Human skin performs such functions: protective, analytical, regulatory, excretory.Water, uric acid, urea, potassium, and other substances are released through the sweat channels of the dermis. In a normal state, the body secretes about 1 liter of sweat per day. A patient who has a fever can produce 10 or more liters of sweat. After evaporation of sweat, metabolic products remain on the surface of the epidermis, adversely affecting the condition of the skin.
Sites of the epidermis contaminated with sweat and sebum, natural bowel movements, begin to itch, blush. This leads to skin infection. As a result, diaper rash, wounds, fungal diseases, bedsores appear. The problem areas on the human body are:
- areas between the fingers, toes,
- folds in the area of intimate organs,
- areas under the breast in women,
- intergluteal space.
Hygienic care for seriously ill patients includes a set of such measures:
You need to take care of the patient’s body starting with the organization of a comfortable berth. For bed, you need to choose soft linen, without rough seams. It is important to ensure that no wrinkles form on the bed, crumbs, other foreign objects that injure the epidermis do not collect. It must be ensured that no depressions form on the mattress. For the organization of a berth it is better to choose a special decubitus mattress. The blanket should be chosen moderately light and warm. Both overheating and hypothermia adversely affect the health of the bedridden patient.
Bed linen and underwear need to be changed as they become soiled. If the patient cannot control his physiological bowel movements, diapers should be used.
Wet body treatment is performed 1 time per day, genitalia - as needed. For washing you will need: a basin, warm water, a soft towel / sponge, liquid soap, camphor oil. After washing, the body must be wiped dry, treat the places prone to the formation of pressure sores with camphor oil, allow to dry in the fresh air. General hygienic care for seriously ill patients is performed several times a day.
You need to brush your teeth after waking up, before going to bed. After eating, it is recommended to rinse your mouth with a disinfectant solution. This is due to the fact that severe diseases associated with fever, cause a weakening of the body. As a result of this, microbes that cause diseases of the oral cavity begin to actively develop in a moist environment of the oral cavity. This causes additional discomfort to the lying patient.
Especially carefully you need to monitor dentures. They can cause the development of gingivitis, candidiasis in the mouth. Dentures must be washed thoroughly after eating. If dry mouth is observed, dentures should be removed at night and soaked in a weak solution of sodium hypochlorite. It is recommended that the prostheses be stored in a clean, dry, tight-fitting container at night. If the patient is not able to independently carry out oral hygiene, a nurse (caring person) should help brush his teeth, rinse his mouth. Toothbrushing with toothpaste can be replaced by treating the oral cavity with a swab moistened with a weak solution of potassium permanganate. Do not forget to cleanse your tongue, gums, lips.
Ears should be washed periodically with warm water and a cleaning agent of your choice. It is important to ensure that no water remains in the ear canal. It is convenient to remove sulfur with a swab using a moistened solution of hydrogen peroxide / vegetable oil. Any inflammatory processes must be treated in a timely manner.
- Nasal passage care
It is necessary to clean the nose according to the needs of the patient. In the case of observing the inflammatory process of the nasal passages daily. Liquid secretions are sucked off with a special enema, tubes, and other suitable devices. Dry crusts formed on the inner walls of the nose can be conveniently removed with a gauze swab moistened with petroleum jelly, a vegetable oil of your choice. Remember the discharge that collects in the nose will make it difficult to breathe, thereby worsening the well-being of a seriously ill patient.
A caregiver must pay due attention to eye care. Untimely removal of secretions from the corners of the eyes can cause an infection that can affect the eye and impair vision. Eyes and eyelids must be wiped with a gauze swab moistened with warm water or a distilled solution. For each eye, take a separate swab. After cleansing the eyeball of mucus, pus, the eyes can be instilled with special drops or lubricated with a suitable ointment.
A bedridden patient needs to be washed every 4 to 6 days. Untimely washing can cause dryness, brittle hair, dandruff. In order to make head hygiene simple and comfortable, the patient's hair must be cut short. In addition to washing your hair, seriously ill hair needs to be combed daily. The comb for combing can be moistened with a solution of vinegar, which removes dust and dandruff well. Remember, the patient should have his own scallop. It must be washed periodically in a solution of alcohol or vinegar. To wash the head of a patient bedridden, it is advisable to use a basin, oilcloth, towel, hair dryer.
A lying patient needs to shorten his nails. Short cropped nails make your hands attractive. In addition, accidental combing of the skin is excluded, which leads to the formation of long non-healing wounds. Nails and tools, before and after cutting, should be treated with a disinfectant. For this, medical alcohol, cologne, chloramint are suitable.
A regular component of men's toilet is shaving. Smoothly shaved skin, allows you to feel neat and well-groomed, creates a pleasant emotional background. For shaving, it is best to use an electric razor. The skin after the procedure must be treated with a suitable cosmetic product.
The list of necessary daily care actions
The choice of the complex, the frequency of hygiene procedures depends on the condition of the seriously ill. It is very important to understand what actions the patient is able to perform on his own, so as not to lose those skills that are still available. Every morning, a caregiver should:
- wake up the patient
- help relieve natural need
- wash the genitals, if necessary, change the diaper,
- carry out hygiene procedures - perform toilet eyes, nose, mouth, ears,
- wipe armpits, places under the breast in women,
- comb your hair
- straighten the bed, pajamas,
- perform pressure sore prevention
- measure physiological indicators,
- feed the patient
- help take medicine
- comply with individual doctor's recommendations.
Careful hygiene - comfort and well-being of a bed patient.
General Hygiene Products
Maintaining a clean body, mouth, eyes, ears, intimate areas of a lying patient should be an everyday procedure. The psychological comfort of a person bedridden largely depends on this. For this, it is not necessary to use expensive hygiene products for bedridden patients. In pharmacies, retail and online stores in a wide assortment of products for the care of different price categories, available to all those in need.
For oral care
To carry out the procedure for brushing your teeth, you will need the following hygiene products:
- sterile, disposable gloves,
- oilcloth or sheet
- water tank
- soft bristled toothbrush
- putty knife,
- hygienic cotton buds,
- sanitary napkins,
- petroleum jelly or any moisturizing lip cream.
The main subject of care for bedridden patients at home when brushing their teeth is a brush with soft bristles that will prevent damage to the gums (especially in older people). When caring for a bed patient, special attention should be paid to the choice of toothpaste. All pastes for oral hygiene are divided into 3 main categories:
|1.||Hygienic||Designed to remove soft dental deposits such as plaque and food debris. The use of these funds is indicated in the absence of an oral pathology: caries, periodontitis, stomatitis.|
|2.||Multicomponent treatment||Used for patients weighed down by dental pathology. Some antifungal compound toothpastes have been used successfully for bedridden patients with candidiasis of the oral cavity.|
|3.||Therapeutic||Such products contain in their list of components an increased content of trace elements (fluorine and calcium), which support the protective properties of enamel, and prevent the development of caries, which can often be found in a bedridden patient.|
A spatula will be required to fix the oral cavity in a static position, and plaque and food debris are removed with hygienic sticks. For these purposes, toothpicks are not recommended, as they can damage the gums, which will cause an inflammatory process.
Vaseline or nourishing cream - means for bedridden patients, necessary for moisturizing the lips after the procedure for brushing your teeth.
For washing hair
It is believed that one of the most difficult procedures for the care of a bedridden patient is washing his head. However, now there are many devices on sale that greatly facilitate this procedure. Special detergents are also sold, thanks to which the issue of cleanliness of the hair of a lying 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 bed patient. It is an inflatable tank with a headrest, in which the head is conveniently fixed without load on the shoulder girdle. A hose is necessarily included in the kit of such a bath, which, when connected to the drain hole, allows you to empty the bath without unnecessary trouble.
Proper hygiene for bedridden patients is carried out by choosing the appropriate detergent, i.e. shampoo. A quality shampoo should have excellent moisturizing and nourishing properties, be hypoallergenic and gentle to the scalp. For people of advanced age and with weakened immunity, shampoos containing urea, which regulate 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 settled dirt and fat from the hair and is easily removed with a comb. Such a hygienic care product for bedridden patients is convenient in everyday life if there is not enough time for a full wash of the head.
Also, with a limited amount of water, special caps for washing hair are used - very convenient individual hygienic care products for bedridden patients. They are also used in situations where the patient is opposed to having someone else touch his head. The cap contains a special gel, or conditioner shampoo, which cleanse the hair without water.
For the treatment of nails
Hygiene for bed patients in this case has no fundamental differences from the usual methods of treating fingers and toes. Nails should be carefully trimmed, filed, sanitized and treated with a moisturizer.
Instead of scissors, you can use large and large manicure and pedicure nippers. They are stronger and sharper due to the massiveness, which greatly simplifies the process of cutting.
The choice of the nail 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. To care for a bed patient, a file with a range from 180 - 240 grit is suitable.
Important! All devices for processing nails should be individual. After each procedure, they must be disinfected.
Since the nails of bedridden patients are often affected by a fungus, they become quite stiff. In this case, it is necessary to treat them with hygienic antifungal creams such as Bifosin or Nogtivit, which quickly relieve the fungus and soften the nail plate.
An alternative to pharmacy antifungal drugs is a bath with tar soap, which has a good softening effect for nails. This can be a good hygienic tool for caring for the nails of a bed patient.
For eye care
A bedridden patient often cannot control the purity of his own eyes, so one of the tasks of loved ones is to pay attention to these parts of the body. To wash eyes from hygiene products for bedridden patients at home, you will need:
- cotton pad,
- saline solution
- antiseptic solutions
- decoctions of herbs.
Instead of ordinary water, it is better to purchase saline in the nearest pharmacy, as it is softer than running water. With the appearance of discharge from the eyes, solutions with chlorhexidine, boric acid or furacilin will be quite effective.
The mote in the eye can cause a fair amount of discomfort to the bedridden patient, and a simple napkin dipped in tea leaves or in a soft saline solution may be a good remedy. Supporters of herbal medicine will respect hygiene products such as chamomile broth, dill juice, rose hip infusion, bay leaf lotions, drops of propolis water or honey.
Important! Using decoctions of herbs and bee products for the treatment of mucous membranes, make sure that the patient is not allergic to these funds.
For ear treatment
When caring for a bed patient, do not forget about the hygienic treatment of the ears. Most often, cotton swabs are used to clean the ear canals. For healthy and sick people, this tool is unproductive, since sulfur can settle in the back of the ear, forming sulfur plugs. Therefore, from means of hygienic cleaning of the ears, aqueous solutions in the form of drops are used. Bed care products such as hydrogen peroxide and urea peroxide are low-cost and popular methods for cleaning the ear canals. To carry out the entire procedure, it is enough to introduce 10 drops of the drug into the ear.
In elderly bedridden patients, deafness is a fairly common occurrence. When using hearing aids, earwax is formed at an accelerated pace. For such patients, there is a drug Remo-Vax in the form of ear drops. It qualitatively removes sulfur deposits and prevents the formation of sulfur plugs. To solve this problem, hygiene products with a surfactant, A-cerumen and Vaxol, have proven themselves well.
Intimate hygiene products
Maintaining the purity of the intimate areas of the 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 him experience a minimum of physical and psychological discomfort during the implementation of the delicate procedure for caring for the perineal area of the lying patient.
Diaper is a special hygiene product for bedridden patients, consisting of tissue, which has great ability to absorb 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 a comparison is made between these products, then the advantage of disposable diapers over conventional ones is obvious. Due to the porous structure of the material of disposable diapers, the bed patient is protected from maceration of the skin, the formation of pressure sores and diaper rash, the appearance of sharp smells of urine.This is due to the fact that the composition of such a diaper includes multilayer pressed cellulose. In addition, they more reliably protect the bed and bedding from pollution.
Simple diapers made of linen fibers or cotton fabric are curled and easily crumpled, irritating the skin, which leads to the formation of pressure sores and diaper rash. In addition, if disposable diapers are disposed of as they become soiled, ordinary fabric diapers must be washed and ironed daily with a hot iron, which takes a lot of time.
Important! Handling reusable diapers with a hot iron is essential to prevent secondary infections.
These are special hygiene products, which are disposable bags that are used for stomas (postoperative intestinal openings) that communicate with the external environment. When natural defecation is not possible, such a sac is fixed in the hole and collects the outgoing feces. This hygiene product for the care of bedridden patients is used very often, and it is important to know what it is.
Kalopriemniki differ in components:
- One component. These are ordinary bags for collecting discharge.
- Two-component. They consist of a special adhesive plate, which is attached to the stoma, and then a bag for the detachable is attached to this plate. The advantage of this device is that it creates the effect of a "second skin". The hygiene of replacing such a kalopriemnik for bedridden patients is much more comfortable than usual.
|Name of funds||Dosage and effects|
|Sealants||They are used to heal and reduce skin irritation, as well as the formation of a waterproof barrier that improves fixation of the air bag.|
|Sprays||Designed to facilitate replacement, removal of the air bag. The composition of the spray painlessly disconnects the adhesive base of the bag.|
|Cleaners||Hygienic product for quick and effective cleaning of the skin, residues of feces, mucus and pus.|
|Protective film "second skin"||A hygienic fluid is applied to the skin, which evaporates easily, leaving behind a thin elastic film that protects the skin from maceration. Due to the specific basis, the skin “breathes” and does not cause severe irritation.|
|Absorbent Powders||Powders are used to prevent maceration of the skin. Such a powder is able to collect the discharge, forming a layer of gel that protects the skin and improves fixation of the receiver.|
|Odor neutralizers||Special hygienic chemicals that convert the contents of the fecal sac into gel, removing unpleasant odors.|
For urine collection use special hygienic devices - urinals, better known as the "duck". They are widely used due to their ease of use. As a rule, reusable means for bed patients are used to collect urine, since they are easily amenable to sterilization.
Disposable urinals may differ in components:
If a single-component urinal has only one bag for collecting the discharge, then its “brothers” add a base with a removable bag and a drainage tube. Through such drainage, hygiene for bedridden patients is easier and more comfortable.
Important! The change of urine and colostomy 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 defecation, as well as a kind of protection against embarrassing situations. It is worth noting that in the absence of carers, such hygiene products for bed care significantly simplify care.
An alternative to using diapers can be urological pads for women and men. Such bed care products 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 in the speed and volume of absorption of urine. Since these pads instantly absorb moisture and provide a more reliable fixation, the risk of urine flow 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 pressure sores
Pressure ulcers are a specific complication of the patient’s lying lifestyle, in which blood and lymph circulation in the tissues and muscles is disturbed. Pressure ulcers remain one of the most serious problems of patient care, therefore, along with special anti-decubitus devices (mattresses, pillows, circles), it is necessary to use hygiene products.
To minimize the risk of pressure sores, the skin of a bed patient should be moderately dry and clean. In the hygiene market, Menalind, Seni and Convin have established themselves, producing hygiene products for treating the skin of bedridden patients:
- Hygienic wet wipes for bedridden patients gently cleanse the skin and do not injure it.
- Massage oils and moisturizing care products for bedridden patients intensely nourish the skin when it is excessively dry, and additionally stimulate blood circulation.
- Hygienic cleansing foams replace soap with water, acting more gently on the skin. They cleanse it, remove odors, do not irritate, providing quality care.
- Creams with zinc have proved to be excellent in protecting against diaper rash and have 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 also is a preventive measure to prevent infectious processes.
What to cook
For washing an elderly patient, it is better to choose mild shampoo and soap, hypoallergenic, without perfumes and dyes. This is due to the fact that grandparents have dry and vulnerable skin, you need to handle it carefully. Aggressive effects can lead to wounds, peeling, pain.
For intimate hygiene, you need a mild soap or a special tool designed to care for the intimate area. The usual good brush and toothpaste are useful for oral care.
There are special care products for bedridden patients - indelible lotions and foams. They are true paralyzed care assistants. Using them is easy and convenient, you do not need to rinse. They are able to maintain a clean body of a person who is difficult or impossible to move.
If a sick person is able to take a bath or shower with the help of another, this must be done, because indelible means will not replace water. Such helpers are an excellent way out for complex and one-time situations.
After washing, it’s useful to grease the skin of an elderly person with a suitable light cream.
Sponges and terry cloths wipe the body.
Absorbent or protective sheets or oilcloths will be required - they are needed to put them under the patient in bed.
- an inflatable bathtub, which is placed under the patient and then inflated,
- folding bathtub that can be placed directly in the room and then carefully transferred to the patient.
If you plan to wipe, just one or two basins with water.
Towels need a few. In a bedridden patient, parts of the body are washed separately and immediately washed areas are covered with towels so that the person does not catch a cold. After washing, the ward is covered with a warm blanket or blanket.
If necessary, prepare wet wipes, cotton pads, balls, etc. - a set of additional tools is individual.
What is needed for hygiene of a bed patient:
- Bath: regular, inflatable or folding. Protective sheets, oilcloths and basins with warm water for washing in bed,
- Towels, napkins, cotton pads,
- Sponges and terry cloths,
- Soft and hypoallergenic shampoo and soap, means for intimate hygiene, toothpaste and brush, indelible foams and products, shaving and razor,
- Cream for moisturizing and protecting the skin,
- Plaid or blanket.
General hygiene issues for bedridden patients
Experts advise in the field of hygienic care for bed patients to pay special attention to several factors:
- skin cleansing,
- preventing the formation of pressure sores and inflammatory elements in the area of the anus, genitals and folds of the dermis on the body,
- timely treatment of damaged skin.
These manipulations for bedridden patients should be carried out twice a day. The most suitable period for this is the time after waking up before taking breakfast, as well as shortly before a night's sleep.
In order for bedridden patient care and hygiene not to become problematic for the person serving such a patient, the following things must be purchased in advance:
- inflatable bath to wash your hair,
- a container to water warm water,
- two basins and a stand for them,
- cosmetics and washing supplies - shampoo, soap, washcloth,
- diapers that absorb moisture
- gauze napkins,
- medical and rubber gloves for cleaning,
- ear sticks
- fabric and paper towels,
- a toothbrush, toothpaste (if a sick person is not able to brush his teeth himself, a special brush will be required),
- rubberized diapers, oilcloth for single use,
- cotton wool
- kalo and urinals,
- accessories for manicure, haircuts, shaving,
- medical equipment to prevent pressure sores in the patient: mattresses, rollers, circles.
This list of hygiene products for the care of bedridden patients is compiled individually, depending on the severity of their condition. Additionally, you may need:
- urological and gynecological pads,
- disposable underwear
- foot care products
- shower chairs or handrails for washing in the bathroom,
- dry closet
- armchair with toilet function.
How often do you need hygiene?
- Body and head hygiene - once a week.
- Intimate Care - everyday. In case of incontinence as necessary.
- Foot hygiene - daily.
- Oral hygiene - twice a day daily.
Not everyone is able to carry out hygiene of a bed patient. It is highly desirable that this be a close relative whom the patient trusts, who has enough strength and endurance to move him. If the patient is larger and more severe, several people will need help. This is necessary if the ward is going to be washed in the shower.
Before starting hygiene, you need to evaluate the patient's condition: is he ready for the procedures, is he conscious, can he hear and understand speech. If everything is normal, you can start. If at least one of the factors is not met, washing will become difficult for the patient and caregiver. It is necessary to postpone hygiene procedures to a more appropriate moment.
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The assistant needs to wear comfortable clothes that do not constrain movements, while she should not be too loose. The best option would be sports items, shoes with non-slip safe soles and backs.
Women with long hair should collect it in a ponytail or braid. Remove all jewelry, watches from yourself.
Before starting the hygiene procedures, prepare all the things and means that are required. Make sure that the room itself is suitable for manipulation. Near the bed of a bedridden patient, do not place dishes that may break, wires or other unnecessary things.
If the bed has special functions, position it at a convenient height when the edge is on par with the upper third of the assistant's thigh. If this is not possible, then you need a chair or a stool so as not to tear your back.
Control your own posture during hygiene. The back should be in a straight position and not bend.
1. In bed.
If it is impossible to transfer a person to the bathroom or shower, there is a way to wash and perform hygiene of the bed patient directly in bed. This is done by several methods: with and without water. Each of the methods has its pros and cons.
Positive aspects of hygiene of a lying patient in bed:
|Washing with water (traditional method)||Wash without using water|
|· The feeling of the presence of water on the surface of the skin positively affects the well-being and condition of the patient.|
· A long-lasting feeling of freshness and purity.
· Washing with water is an inexpensive option for money
|· Do not get wet bed, water does not wet the floor.|
· Such personal hygiene of a bed patient is less time consuming and easier than with water.
· This method is suitable for daily washing.
· No need to carry the patient to the bathroom, you can wash immediately in bed
Washing without water is carried out using special means, for example, foam. Their components dissolve the dirt on the surface of the skin, and the structure helps to clean the dermis even in hard to reach places. The formulation of such funds was developed taking into account the condition of the skin of bedridden patients, therefore they have a moisturizing and protective effect. These compounds are of two types: one does not need water, while others require a minimum amount (for foam). After the detergent is distributed over the surface of the skin, use a soft cloth to gently remove it, while removing all dirt.
Hygiene for a bed patient at home using water will be a more difficult task. If possible, it is advisable to buy an inflatable bath or a bath-sheet. Such designs have a drain for water, which ensures hygiene with minimal effort, therefore, the necessary manipulations can be done by one person without assistance.
The sequence of steps when applying a bath sheet:
- turn the patient on his side,
- put a bath on the free part of the bed,
- place the person lying on it (the procedure is similar to replacing bedding),
- raise the sides of the bath,
- put a metal frame,
- change the patient’s position to a comfortable one (the head should be on a special headrest),
- pour the right amount of water, wash the person,
- upon completion of the procedure, remove the plug and remove water with a hose,
- treat the inside of the bath with a dry cloth
- wipe the patient with a towel,
- remove the racks that hold the patient
- flip it on its side,
- remove the remaining parts of the bath.
The inflatable product is used in a similar way. The difference is that there is no frame, and the bath needs to be inflated. There are options that have a compression pump, with which preparation for water procedures will take two minutes.
In the absence of special means, hygiene of bedridden patients at home is carried out by the usual method using oilcloth (to protect the bed from getting wet), washcloths, and a basin. It is important to adhere to the following rules:
- The washing of a lying person is carried out in parts. It is necessary to process one area, dry it with a towel, cover and move on to the next. Thanks to this, the patient will not remain naked for a long time, that is, the risk of freezing will decrease. The sequence of zones for hygiene is the head, arms, torso, legs.
- The movement as you wash goes from clean to dirty areas.
- The skin can not be rubbed with a washcloth. You need to be careful enough to make light blotting movements.
- Squeeze the washcloth slightly before use to prevent excess fluid from entering the bed.. Water should be changed for the face, body and groin area and have separate sponges for them.
If a lying person is not able to sit, then special pillows and devices are needed, using which you can hold him in a sitting position.
2. In the bath.
Hygiene of a lying person in a bath without suitable appliances and means is very difficult.
Even the small weight of the patient does not relieve the caregiver from two serious difficulties:
- how to move a person to the bathroom,
- how to return him to bed after the completion of hygiene.
To solve the first problem, you need a gurney and a device that can lift a person if necessary (if the bed patient has a lot of weight).
In the second situation, it is important how mobile the patient is. You should not think that if the patient has a small weight, and you could easily put him in the bath, then removing it will be just as easy. A wet body is very slippery, which creates additional difficulties. There is a risk of injuries and injuries to both the patient and himself.
While maintaining some physical activity in the patient, you most likely will have enough established handrails. It is also recommended that you purchase specialized bath seats in advance. They help to conduct human hygiene in a sitting position, while not completely immersing him in water. There are rotary devices that greatly facilitate the landing and lifting of a bed patient during care.
Today, the market offers options for electric lifts. They are able to lower and raise a person from the water with an electric drive. This mechanism is hidden and completely safe. One of the useful functions of such an invention is the possibility of independent washing.
Devices that are still necessary to maintain personal hygiene of a bed patient in the bathroom:
- a small ladder or step (for patients with partial mobility),
- a chair for a helping person,
- various handrails
- anti-slip mats.
Intimate hygiene of bed patients
Intimate hygiene - A rather scrupulous procedure, requiring a manifestation of tact. It is advisable that there is only an assistant in the room whom the patient trusts.
To perform the manipulation, you must have an intimate gel and tissue wipes. If a person wants to empty himself, a vessel should be placed. Then you can start washing.
The patient is placed on his back, the legs are bent at the knees, the bedding is spread out below.
Hygiene products for bedridden women - This is a cloth soaked in water, and a little intimate remedy applied to it. Wipe the intimate area with a tissue strictly from front to back so that bacteria from the anus do not enter the vagina.
For handling men need a cotton swab. Wash in the direction from the penis to the anus. The penis is cleaned, moving in a circle, while do not forget to process the head and foreskin.
It is important to regularly check the integrity of the mucous membranes. At the end of the procedure, the delicate area is gently wiped dry with a towel and a moisturizer is applied. For incontinence, a diaper should be worn.
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Hygiene of the oral cavity of a bed patient
Brushing your teeth should be done twice a day, best in the morning and before bedtime. To do this, the head of the bed rises, a person is planted. He should put a towel on his chest. It is advisable to choose a toothbrush with soft bristles. Useful and dental floss. We completely brush all the teeth and the spaces between them and help the patient rinse his mouth from the remnants of the paste. Rinse aid is allowed for a fresh smell.
If the patient has prostheses, they should be regularly treated. To do this, remove the products from the oral cavity, treat them with dirt with a brush intended for this, and rinse thoroughly under running water. Keep dentures in a closed container in boiled water.
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Care for the ears and nose of a bed patient
Accumulation of sulfur in the ears can cause hearing loss. Passages need to be cleaned regularly. For this bed patient, position him so that he sits sideways, then slightly tilt his head to the other side of you. Gently pull the lobe down and insert a couple drops of 3% hydrogen peroxide into the ear. Next, clean the sink with cotton buds.
To clean the nose of the patient, you need to sit down and throw his head back. Lubricate the cotton swab, turunda with vaseline or any cosmetic oil and carefully remove the accumulated crusts with circular movements.
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Round-the-clock care of elderly people by professional carers (all personnel are citizens of the Russian Federation).
5 meals a day and diet.
1-2-3-seater placement (for bedridden specialized comfortable beds).
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Individual work of psychologists: art therapy, music classes, modeling.
Weekly examination of specialized doctors.
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1. Accept the situation
The first days when it becomes necessary to care for a seriously ill patient is difficult, first of all, morally.
A heavy burden suddenly falls on an unprepared person living his usual measured life. The first week is becoming critical.
At this time, it may seem that life has turned into a series of insurmountable obstacles. But despair, anger, rejection of already coming and future changes will certainly be replaced by humility and breaking the deadlock.
It is also important to understand that your loved one, of course, is even harder, and he also needs moral support. Perhaps the patient himself, and those who have to look after him, will be useful to consult a competent psychologist.
2. Organize a “support group”
It is difficult for one person to cope with the care of a seriously ill patient. In order not to test your strengths, you should organize a “support group” from the very first days.
Relatives, friends, acquaintances, neighbors can enter it.
It is better to make a list of those who can potentially support you in a crisis situation, and decide what tasks they can perform.
It is optimal to ask different "helpers" for a little specific help. So you at least slightly unload yourself and do not burden loved ones. On the contrary, give them the opportunity to do what is feasible.
3. Create a clear daily routine
Understanding how to distribute your and other people's time will help the regime of the day of your ward, to which you will now be subordinate. It should include:
· Hygiene procedures.
· Help with natural shipments.
· Procedures for the prevention (or treatment) of pressure sores.
· Help with medication.
· Cleaning the patient's room.
Record as much as possible every hour, starting from the ascent and ending with going to bed. This will help to systematize tasks, facilitate their perception and complete them on time.
4. Provide patient care items
It is better that this stage was completed, even when the patient is in the hospital.
To care for a bedridden patient you will need:
· Anti-decubitus mattress. You can not minimize its significance. Even if the patient can change the position of the body, with constant bed rest, bedsores are a matter of time, and the nearest one. They can form in the first days of immobilization.
A modern anti-decubitus mattress, which has many chambers that periodically inflate and deflate, helps to avoid their appearance. This allows you to provide air access even to those parts of the body that are in contact with bedding all the time, and prevent the formation of pressure sores.
· A bedpan. When buying this patient care item, take a closer look - ducks can be different.
Ideally, the vessel should have a lid and an additional hole through which it is convenient to pour its contents.
· Disposable diapers necessary if the patient is so immobilized that it is impossible to use the vessel, or does not control the physiological administration.
· Disposable diapers. Doctors do not recommend using them constantly to minimize the risk of pressure sores. Diapers are best used if necessary, for example, during hygiene procedures, feeding and so on. The one-time alternative is reusable oilcloth.
· Wet wipes without fragrances and fragrancesbetter adapted for sensitive skin or for patient care.
· Cotton pads or cotton swabs.
· Cosmetics for patient care - gel for washing, intimate hygiene, soap, delicate sponge.
· Means for preventing the formation of pressure sores. It can be both medicines in the form of ointments, creams, and banal camphor alcohol. By the way, many doctors prefer it. Rub them with body parts that are constantly in contact with bedding, as well as folds - armpits, areas under the breasts of women, inguinal folds - should be in the morning and evening.
· Paper and fabric towels.
· A drinking bowl (if the patient cannot sit), a breastplate for feeding.
· Exercise Equipmentinterfering with congestive processes in the lungs. Prolonged immobility can lead to impaired respiratory function and contribute to the development of pneumonia. Regular and simple exercises, such as ... inflating balloons, help prevent it. It is especially important for older people to perform them.
5. Organize the space
Before the patient arrives, try to equip his room so that it is convenient for both the "patient" and you.
It is better if there is an approach to the bed from both sides. The headboard should be positioned so that the patient sees who enters the room.
Remove from the room carpets, soft toys and other items that are not amenable to wet cleaning, leaving only what can be easily wiped with a damp cloth. At the same time, do not turn the room into a semblance of a hospital ward - it should remain cozy and “warm”.
Place a bedside table at arm's length from the patient, on which he can store personal belongings, water and easily reach them. Be sure to provide the patient with access to a light source - a floor lamp, a sconce, and also to a power outlet. If she’s not nearby, arrange for carrying. It is convenient to use the baby monitor: it simplifies care and makes life easier for the patient.
Choose seamless linens made from 100% cotton. You will need a minimum of 2 sets: linen needs to be changed every day, and if necessary, more often.
Well, and most probably the most important thing, be sure to be patient. In combination with love, it has a truly healing effect.
The opinion of the author may not coincide with the opinion of the publisher
How to prepare yourself
Hygiene for a bed patient is not always possible and not for everyone. This should be a close person whom the patient trusts, and a suitable physique, since the recumbent needs to be moved. If a bed patient is larger and heavier than his assistant, several people will be required. This is especially important if the person will be washed in the bathroom. Also, the assistants themselves need to be in good health, so it is best to help a bedridden patient in a boarding house for the elderly, you can find out the prices directly on the site.
Before carrying out the procedures, it is necessary to evaluate the patient's adequacy: whether he is ready to wash, in a conscious state, whether he can understand and obey. If everything is in order, you can start washing. If not, then hygiene will be difficult for both the patient and the assistant. In this case, it is better to postpone hygiene until a more appropriate time.
- It is necessary to dress comfortably. Clothing should not constrain movements and should not be excessively loose. Best sportswear, shoes with non-slip soles and backs - it is safe.
- Long hair - put in a ponytail or bun. Remove all jewelry and watches.
- Prepare everything you need. Make sure that the room is comfortably ready to start procedures. There should not be breaking dishes, objects, wires, etc., near the bed.
- If possible, set the bed to a suitable height. Height is appropriate if the edge of the bed rests on the upper third of the thigh. If this is not the case, a chair or stool will come in handy for the assistant not to tear.
- Watch your postures during the procedure. The back should always be straight and not twist.
How to wash a person in bed
- If the patient wants to use the toilet, he needs to urinate and empty before bathing.
- The room where they will wash the person should be warm. Temperature + 22-23 degrees. There should be no drafts - the windows must be closed.
- Moisten a sponge for the body and arms. Wipe your face and neck, remove excess moisture with a towel immediately.
- Separately, wash each part of the body by wiping with a sponge with detergent and then with a clean, damp sponge. Each washed body part needs to be gently wet and covered with a towel. After washing and covering one part of the body, go to another.
- After the whole body is washed, it can be treated with cream.
If a person is washed in an inflatable or folding bath, you can use a shower head, which will greatly facilitate body washing. Used water is then easily removed through a special hole.
According to specialists from a nursing home for bedridden patients, it is important to remember:
- Do not wipe the entire body immediately, wash in parts.
- Immediately pat the washed area with a towel and cover with a towel so as not to catch the ward's cold and cause pressure surges.
- Skin cannot be rubbed. Do not use coarse washcloths. All movements should be neat, washcloths and sponges should be soft.
- In order not to spread dirt over the body, wash your skin from clean to dirty. For example, if a person has dirty hands, start washing from your shoulders.
- Especially carefully you need to handle the folds on the body - there are often diaper rash.
A bed patient is brushed twice a day: in the morning and before bedtime. If possible, you need to raise the head of the bed or put a person. A towel is placed on the chest. Brush your teeth with a soft brush and a suitable paste, thoroughly cleaning the gaps and spaces between the teeth. Then you need to help the person in rinsing the mouth. If there are dentures, they must be removed and processed separately. For storage of prostheses at night, use closed containers with clean water. At the end of the procedure, you can use mouthwashes.
It is necessary to prepare for the fact that washing lying down is a long and accurate process. The main difficulties are associated with creating a comfortable environment, as well as the movement of the ward. Modern facilities and accessories, as well as an individual approach will help create maximum comfort. Hygiene lying should be a person whom he trusts. If necessary, there must be assistants. Be sure to get dressed correctly - this is part of the safety precautions. Any caring person needs to be careful and tactful: remember that the bedridder does not move well, that he has sensitive skin and, possibly, psychological discomfort. Better help can be provided in a boarding house for the care of the elderly and disabled.
In any case, you can find the best hygiene option for each ward and maintain it.