If you are a caregiver for a family member or other loved one, you know what kind of commitment it can be. When someone’s mobility is affected by complications of conditions such as stroke or Parkinson’s disease and they become bedbound, caregiving tasks can be enormously complex and time-consuming.
This can be difficult for both the caregiver and the person that is bedbound. There are some common challenges people face in this situation. There are also special considerations when caring for a bedbound person. Without proper management of these challenges, there is a risk of many poor outcomes.
Common problems linked with being bedbound
The human body requires regular movement to stay healthy. Immobility means that a person does not have the benefit of changing positions, increasing circulation, taking deep breaths, and tending to personal care. Without these activities, a person can have several common complications:
- Respiratory infections such as pneumonia
- Pressure ulcers, also called bedsores, due to poor skin care and staying in the same position too long
- Isolation and depression
- Pain due to inability to change positions (especially back pain)
- Blood clots (also called a deep vein thrombosis or DVT), due to blood pooling in the lower extremities
- Sleep problems due to pain, lack of exercise, or trouble keeping a regular sleep schedule
- Decreased appetite due to lack of activity and/or depression
- Constipation caused by a lack of movement, which helps digestion
- Risk of injury or death in a home emergency such as a fire
With the right care, all of these problems can be prevented. Let’s take a closer look at six care tips for someone who is bedbound.
1. Hygiene is essential
A bedbound person must completely depend on others for their care, and personal hygiene is no exception. The inability to tend to personal hygiene can affect people physically and mentally. Routines should be started to manage the following hygiene concerns:
- Bathing- this often means a bed bath, using a tub of warm soapy water to wash the entire body and then rinsing and drying. Apply lotion as needed to moisturize dry skin and prevent irritation.
- Washing hair- there are dry shampoo options, but washing over a basin of water with shampoo at least weekly helps keep hair and scalp healthy.
- Brushing teeth- oral hygiene affects a person’s ability to eat and must be performed daily, ideally twice per day.
- Trimming nails- keeping nails clean and trimmed short reduces the risk of dirt and disease-causing bacteria building up under the nails.
- Changing bedding- bath time is a perfect opportunity to make sure all bedding is fresh and clean– or change anytime it is soiled.
- Peri-care- this involves keeping the genital area clean and dry. It must be tended to regularly, especially in the case of incontinent people.
2. Avoid skin damage
Along with keeping skin clean, avoiding damage due to prolonged moisture or pressure is a major concern for those who are bedbound. A pressure ulcer or bedsore can develop in as little as 2-6 hours.1 Here are some steps to take to avoid pressure injuries:
- Keep a regular turning schedule- help the person change position every 2 hours.2
- Use padding on bony/high-risk areas- the buttocks, tailbone, hips, heels, ankles, shoulder blades, knees, and back of the head are especially prone to developing pressure sores. Pillows, heel protectors, wheelchair and chair cushions, and specialty mattresses designed to relieve pressure can all reduce this risk.
- Maintain clean and dry skin- moisture and irritation are leading causes of skin breakdown.
- Ensure good nutrition- a healthy, balanced diet helps any skin damage to heal properly.
3. Provide regular stimulation and entertainment
Imagine being unable to leave your bed or room without help, and how quickly you would feel listless and bored staring at the same four walls. Just because someone’s body is unable to be active doesn’t mean their mind is the same. Lack of stimulation and entertainment can contribute to the development of depression. There are many ways you can be sure someone has interesting ways to keep their mind occupied:
- Reading materials- books, magazines, and newspapers can help pass the time. Electronic readers can allow larger print and better lighting for people with visual difficulty.
- Television and movies- everyone has favorite TV shows! Watching movies can be a shared activity, too.
- Puzzles and games- crossword puzzles, solitaire, and shared games offer mental stimulation.
- Exercise in bed- even if a person can’t move very well themselves, helping them pedal their legs and stretch other muscles helps reduce the risk of blood clots and muscle contractures (where the muscles become so stiff they can’t move).
- Items to keep hands busy- for people with dementia, offering items that keep their hands busy can reduce restless behavior. Folding washcloths, playing with dolls, or using special blankets that are designed for people with dementia and have buttons, zippers, and other fasteners to interact with can help.
4. Offer companionship
Hours spent alone confined to bed are lonely and also contribute to depression. Routine personal care and hygiene allow for some interaction but may be less comforting than intentional, meaningful shared experiences. Consider these ways to offer companionship:
- Set aside time to join activities- is there a show the person enjoys watching? Do they enjoy a certain card game? Would they like to participate in shopping online for food and personal care items? Can you choose a book to read together daily?
- Facilitate visits- are there family and friends who would enjoy stopping by? If they are far away, you can set up virtual video visits to chat. This is a great way to bring church services to someone who misses them, too.
- Adopt a pet- a cat or dog can be great companionship for someone who is restricted to bed.
- Involve a home care service- a professional caregiver can not only help with hygiene, feeding, and personal care, but also offer regular companionship during times you can’t be available.
5. Involve your healthcare providers
Many health concerns caused by immobility can be helped with suggestions from doctors, nutritionists, and physical therapists. Talk to your regular physician about the following:
- Ways to reduce blood clots- a doctor may prescribe blood-thinning medication or recommend prescription compression stockings.
- Good nutrition- a person who has special dietary needs might benefit from a consultation with a nutritionist or from supplementation.
- How to avoid muscle, joint, and respiratory problems- talking with a physical therapist may offer tips for in-bed exercises to maintain flexibility. And breathing exercises or a device called an incentive spirometer can help reduce the risk of pneumonia.
- Any ongoing health concerns- pain, constipation, symptoms of depression, and sleep issues should all be reported to your doctor.
6. Have a safety plan
Being alone and trapped in an emergency is a scary idea for someone who is bedbound. It’s important to develop a safety plan and that anyone involved in the person’s care is aware of the plan. These are some things to consider:
- Establish emergency exits- what is the fastest and easiest way out of the home? It is helpful to move a bedbound individual to the first floor of a home whenever possible.
- Regularly test smoke and carbon monoxide detectors- the US Consumer Product Safety Commission recommends every home have working smoke detectors on every level of the house outside bedrooms and inside each bedroom. Carbon monoxide detectors should be on every level of the home (excluding attics and basements) and outside sleeping areas. 3
- Decide on a safe meetup zone outside the home- anyone who leaves the house should know where to meet everyone else in the home, so there is no confusion about who might be left behind.
- Know what transfer devices are available- someone who is bedbound must be transferred to a wheelchair or a device such as an inflatable or portable stretcher. Where is it kept?
- Plan an evacuation location- especially in areas that experience weather events like flooding and hurricanes, knowing where to evacuate ahead of time is important. This can be a hospital, the home of a family member, or other locations that allow the person to stay comfortable.
Total care doesn’t have to be overwhelming
Remember that a person’s needs can change, especially as their condition changes. They may have reduced mobility temporarily due to an illness they are recovering from. They may also have a progressive condition that increases their needs. It’s important to be flexible and to involve your loved one in decisions about their own care as much as possible.
Although a person with restricted mobility can require total care, managing the steps we’ve discussed doesn’t have to be overwhelming. Coordinating multiple caregivers means the responsibilities aren’t resting on one family member. Sometimes this can mean involving in-home care services, even just for respite care. If you’re caring for a bedbound family member at home and would benefit from extra helping hands, Caresify’s team can meet your needs. You can read more here or call 888-799-5007 for more information.
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