How to care for a bedridden elderly person

Hygiene measures

Following hygiene rules is an important stage in caring for bedridden patients, which includes a number of activities:

Washing. The washing procedure is carried out twice a day - morning and evening. This allows you to cleanse the skin of sebaceous gland products, keratinized particles, and avoid the proliferation of pathogenic bacteria. To cleanse the skin, use soft sponges and products with pH 5.5. Special lotions and wet wipes perfectly clean and moisturize the skin. The face is dried with light blotting movements, after which a moisturizer is applied.
Teeth cleaning. If the patient is unable to perform oral hygiene on his own, loved ones help him do this with the help of silicone brushes. The sequence of actions is similar to brushing your teeth with a regular brush, except that the silicone brush is placed on your finger. You can rinse your mouth with water and a decoction of medicinal herbs (chamomile, sage). If your gums are bleeding, you can use oak bark to rinse.
Washing your hair. You need to wash your hair at least once a week. To do this, you can use a small inflatable bath with a recess for the head or hang the patient's head from the bed. In this case, a basin is placed on the floor into which water is drained while washing the hair. For hair care, it is recommended to use gentle sulfate-free shampoos that gently cleanse the scalp. Dry your hair with a towel, a special microfiber cap, or, if there are no contraindications, with a hairdryer. In addition, bedridden patients are recommended to massage the scalp, the effect of which improves blood circulation in the blood vessels.
Cleaning the ears and nasal passages. The ears should be cleaned once a week with 3% hydrogen peroxide. To do this, you need to drop 2-3 drops of peroxide into each ear, wait a few minutes, and then use cotton swabs to free the ear canal from the accumulation of wax using gentle rotating movements. The procedure for cleansing the nasal passages is identical, except that glycerin is used to separate dry crusts.
Washing feet. This is done with a warm soapy solution, after which the legs are lubricated with a rich cream, for example “Children’s”, or sea buckthorn oil. This is necessary in order to avoid dry heels and the formation of cracks on them.
Shaving. The procedure is carried out standardly using a basin with warm water and stool. After hair removal, the face is thoroughly washed with a napkin, blotted, and a moisturizing gel or aftershave cream is applied.
Genital hygiene. For convenience, it is recommended to use a bedpan and a moisture-wicking diaper. To perform genital hygiene you need a soft sponge with a special product with pH 5.5. You need to wash not only the genitals, but also the groin and anus areas. After cleansing the genitals, a moisturizing cream is applied to the perineum and groin area.

In addition, a bedridden patient needs to change his diaper in a timely manner. To do this, you need to turn it on its side, remove the used diaper and feces, wash the genitals, dry them with a napkin and apply a clean diaper. All actions must be performed slowly and carefully. If it is not possible to turn the patient on his side, then an assistant is required to change the diaper, since a bedridden patient will have to lift his buttocks.

Temperature conditions, ventilation

Maintaining the temperature regime is an important condition for ensuring comfort for a bedridden patient. This is important because at elevated air temperatures there is a high risk of bedsores (due to excessive sweating). To prevent this from happening, the room temperature should not exceed 20 °C, humidity – 60%.

How does a dying person feel?

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

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

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

Wet cleaning, quartzing

Wet cleaning should be carried out daily, and it is not recommended to use chlorine-containing products. If this is necessary, then after such cleaning you need to ventilate the room for half an hour.

The room where the patient is located needs to be quartzed. This will help kill microorganisms that are dangerous to his weakened immune system and avoid the occurrence of various pathologies. As a rule, quartzing is carried out with a quartz lamp, but you can also purchase a special bactericidal emitter. During quartzing with a quartzizer, the patient’s eyes should be covered with cloth glasses or a diaper folded several times. When using a bactericidal emitter, this is not necessary, since the device is equipped with a fan that draws air inside. Such devices are often used at home, since they perfectly disinfect the room and do not harm the iris and cornea of the eyes.

Prevention of bedsores

Often, bedsores form at the sites of tissue death, which, when infected, can lead to serious consequences. To avoid their occurrence, you must follow the following rules:

Turn a bedridden patient from one side to the other at least 5–7 times a day.
Keep your skin clean.
Place bags of cereal under the bone protrusions.
Make sure there are no wrinkles on bed linen or underwear.
Eat foods rich in proteins, vitamins, and microelements.
Massage areas often prone to bedsores.
Maintain normal air temperature in the patient's room.

If necessary, you can contact a massage therapist who will do a special massage aimed at improving blood circulation.

Problems with the gastrointestinal tract

The lack of active movements when lying down leads to a decrease in the tone of the gastrointestinal tract, especially the colon, which in turn leads to constipation or difficult bowel movements. Bedridden patients are forced to defecate in an unusual and difficult position, often in the presence of strangers. This helps suppress the urge to defecate. Some patients arbitrarily delay defecation because they are embarrassed to seek help from strangers. Constipation and sluggishness of the gastrointestinal tract can lead to indigestion, which is usually expressed initially in a coated tongue, bad breath, lack of appetite, and mild nausea. Fecal intoxication develops. Often constipation is replaced by diarrhea. After a few months of lying down, the gastrointestinal tract becomes very susceptible to changes in diet and infection, i.e. Such people develop digestive disorders faster than a person leading an active lifestyle.

Prevention of complications consists of creating comfortable conditions for physiological functions, exercising the anterior abdominal wall, and following an appropriate diet.

Nutrition for bedridden elderly patients

People with limited physical activity require dietary nutrition, so the question of what to feed a bedridden elderly person is of interest to everyone who is faced with such a situation. A nutritionist can create a menu for bedridden people, and you can also get recommendations on proper nutrition from your doctor.

If an elderly person can be in a sitting position, then a special table should be used to feed him (sometimes it comes complete with functional beds for bedridden patients). You can also use a bowl with suction cups - in this case it will not fall if you move it carelessly. If a person cannot eat food on his own, you can purchase drinking bowls for drinking liquid food (drinks, broths).

All food should be of normal consistency, pureed or liquid. The menu should include dishes high in protein (fish, lean meats, vegetables, dairy products).

Basic rules of dietary nutrition:

Limit the consumption of salt, sugar, carbohydrates, legumes.
Avoid fried foods, smoked meats, fast food, marinades, canned food, carbonated drinks, strong tea, coffee, and alcohol.
Maintain a drinking regimen (drink at least 1.5 liters of water).
Drink linden and green tea, chamomile decoction.

Portions should be small, and meals should be divided, 4-5 times a day. This diet is a prevention of constipation and gastrointestinal diseases.

Signs of imminent death

The death of a person is a very sensitive topic for most people, but, unfortunately, each of us has to face it in one way or another. If there are elderly bedridden or cancer-stricken relatives in the family, it is necessary not only for the caregiver to mentally prepare for an imminent loss, but also to know how to help and make the last minutes of a loved one’s life easier.

A person who is bedridden for the rest of his life constantly experiences mental anguish. Being of sound mind, he understands what inconvenience he causes to others, and imagines what he will have to endure. Moreover, such people feel all the changes occurring in their body. How does a sick person die? To understand that a person has several months/days/hours left to live, you need to know the main signs of death in a bedridden patient. How to recognize the signs of impending death? Signs of death of a bedridden patient are divided into initial and investigative. At the same time, some are the cause of others. Note. Any of the following symptoms may be the result of a long-term fatal illness and there is a chance of reversing it.

Changing your daily routine

The daily routine of an immobile bedridden patient consists of sleep and wakefulness. The main sign that death is near is that a person is constantly immersed in a superficial sleep, as if dozing. During such a stay, a person feels less physical pain, but his psycho-emotional state seriously changes. The expression of feelings becomes scarce, the patient constantly withdraws into himself and remains silent. Swelling and discoloration of the skin The next reliable sign that death is imminent is swelling of the limbs and the appearance of various spots on the skin. Before death, these signs appear in the body of a dying bedridden patient due to disruption of the functioning of the circulatory system and metabolic processes. Spots occur due to uneven distribution of blood and fluids in the vessels.

Problems with the sensory organs Older people often have problems with vision, hearing and tactile sensations. In bedridden patients, all diseases become aggravated due to constant severe pain, damage to organs and the nervous system, as a result of circulatory disorders. Signs of death in a bedridden patient manifest themselves not only in psycho-emotional changes, but also the external image of the person certainly changes. You can often observe deformation of the pupils, the so-called “cat's eye”. This phenomenon is associated with a sharp drop in eye pressure.

Loss of appetite

As a result of the fact that a person practically does not move and spends most of the day sleeping, a secondary sign of approaching death appears - the need for food decreases significantly, and the swallowing reflex disappears.
In this case, in order to feed the patient, a syringe or probe is used, glucose is used, and a course of vitamins is prescribed. As a result of the fact that a bedridden patient does not eat or drink, the general condition of the body worsens, problems with breathing, the digestive system and “going to the toilet” appear. Violation of thermoregulation If a patient experiences a change in the color of the extremities, the appearance of cyanosis and venous spots, death is inevitable. The body uses up its entire energy supply to maintain the functioning of its main organs, reducing blood circulation, which in turn leads to paresis and paralysis. General weakness
In the last days of life, a bedridden patient does not eat, experiences severe weakness, he cannot move independently or even get up to relieve himself. His body weight decreases sharply. In most cases, the processes of bowel movements and bowel movements can occur randomly

Changes in consciousness and memory problems

If the patient develops: memory problems; sudden change in mood; attacks of aggression; Depression means damage and death of the areas of the brain responsible for thinking. A person does not react to the people around him and the events taking place, and carries out inappropriate actions.

Predagonia

Predagonia is a manifestation of the body’s defensive reaction in the form of stupor or coma. As a result, metabolism decreases, breathing problems appear, and necrosis of tissues and organs begins.

Agony

Agony is a dying state of the body, a temporary improvement in the physical and psycho-emotional state of the patient, caused by the destruction of all vital processes in the body. A bedridden patient before death may notice: improved hearing and vision; normalization of respiratory processes and heartbeat; clear consciousness; reduction of pain. This activation can be observed for a whole hour. Agony most often foreshadows clinical death; it means that the body no longer receives oxygen, but brain activity is not yet impaired.

Symptoms of clinical and biological death
Clinical death is a reversible process that appears suddenly or after a serious illness and requires urgent medical attention. Signs of clinical death that appear in the first minutes:

If a person is in a coma, attached to a ventilator, and the pupils are dilated due to the action of medications, then clinical death can only be determined by the results of an ECG. If timely assistance is provided, within the first 5 minutes, you can bring a person back to life. If you provide artificial support for blood circulation and breathing later, you can return the heart rate, but the person will never regain consciousness. This is due to the fact that brain cells die earlier than the neurons responsible for the vital functions of the body.

A dying bedridden patient may not show signs before death, but clinical death will be recorded. Biological or true death is the irreversible cessation of the functioning of the body. Biological death occurs after clinical death, so all primary symptoms are similar. Secondary symptoms appear within 24 hours: cooling and numbness of the body; drying of mucous membranes; the appearance of cadaveric spots; tissue decomposition. Behavior of a dying patient In the last days of life, dying people often remember what they have lived through, telling the most vivid moments of their lives in all the colors and details. Thus, a person wants to leave as much good things about himself as possible in the memory of his loved ones. Positive changes in consciousness lead to the fact that a bedridden person tries to do something, wants to go somewhere, while being indignant that he has very little time left.

Such positive changes in mood are rare; most often, dying people fall into deep depression and become aggressive. Doctors explain that mood changes may be associated with taking strong narcotic painkillers, the rapid development of the disease, the appearance of metastases and changes in body temperature. A bedridden patient before death, being bedridden for a long time, but in a healthy mind, ponders his life and actions, evaluates what he and his loved ones will have to endure. Such reflections lead to changes in the emotional background and mental balance. Some of these people lose interest in what is happening around them and in life in general, others become withdrawn, and still others lose their minds and ability to think sensibly. The constant deterioration of health leads to the fact that the patient constantly thinks about death and asks to alleviate his situation through euthanasia.

How to ease the suffering of a dying person

Bedridden patients, people after a stroke, injury or with cancer most often experience severe pain. To block these near-death sensations, the attending physician prescribes strong painkillers. Many painkillers can only be purchased with a prescription (for example, Morphine). To prevent dependence on these drugs, it is necessary to constantly monitor the patient’s condition and change the dosage or stop taking the drug if improvement occurs. A dying person who is of sound mind has a great need for communication. It is important to treat the patient’s requests with understanding, even if they seem ridiculous.

How long can a bedridden patient live?
No doctor will give an exact answer to this question. A relative or guardian caring for a bedridden patient needs to be with him around the clock. For better care and relief of the patient’s suffering, special means should be used - beds, mattresses, diapers. To distract the patient, you can place a TV, radio or laptop next to his bed; it is also worth getting a pet (cat, fish). Most often, relatives, having learned that their relative needs constant care, refuse it. Such bedridden patients end up in nursing homes and hospitals, where all care problems fall on the shoulders of the workers of these institutions. Such an attitude towards a dying person not only leads to his apathy, aggression and isolation, but also aggravates his health. In medical institutions and boarding houses, there are certain standards of care, for example, each patient is allocated a certain amount of disposable products (diapers, nappies), and bedridden patients are practically deprived of communication.

When caring for a bedridden relative, it is important to choose an effective method of alleviating suffering, provide him with everything he needs and constantly worry about his well-being. Only in this way can his mental and physical torment be reduced, as well as prepare for his inevitable death. You cannot decide everything for a person; it is important to ask his opinion about what is happening, to provide a choice in certain actions. In some cases, when there are only a few days left to live, it is possible to discontinue a number of heavy medications that cause inconvenience to a bedridden patient (antibiotics, diuretics, complex vitamin complexes, laxatives and hormonal agents). It is necessary to leave only those medications and tranquilizers that relieve pain and prevent the occurrence of convulsions and vomiting. Brain reaction before death In the last hours of a person’s life, his brain activity is disrupted, numerous irreversible changes appear as a result of oxygen starvation, hypoxia and the death of neurons. The person may hallucinate, hear something, or feel as if someone is touching them. Brain processes take a matter of minutes, so the patient often falls into a stupor or loses consciousness in the last hours of life. The so-called “visions” of people before death are often associated with a past life, religion, or unfulfilled dreams. To date, there is no exact scientific answer about the nature of the appearance of such hallucinations.

What are the predictors of death?

according to scientists How does a sick person die? Based on numerous observations of dying patients, scientists have made a number of conclusions: Not all patients experience physiological changes. One in three people who die have no obvious symptoms of death. 60 - 72 hours before death, most patients lose their reaction to verbal stimuli. They do not respond to a smile, do not respond to the guardian’s gestures and facial expressions. There is a change in voice. Two days before death, there is increased relaxation of the neck muscles, i.e., it is difficult for the patient to keep his head in an elevated position. Slow movement of the pupils; the patient also cannot close his eyelids tightly or squint his eyes. You can also observe obvious disturbances in the functioning of the gastrointestinal tract, bleeding in its upper sections. Signs of imminent death in a bedridden patient manifest themselves in different ways. According to the observations of doctors, it is possible to notice obvious manifestations of symptoms in a certain period of time, and at the same time determine the approximate date of death of a person.

Boarding house for elderly people and bedridden patients

If it is not possible to care for a bedridden person at home, you can go to a boarding house, where people with limited physical activity receive qualified assistance. Such institutions have all the conditions for a comfortable stay and special rehabilitation programs. The boarding house is equipped with anti-decubitus mattresses, multifunctional beds and everything necessary for bedridden patients.

At home, it is quite difficult to provide proper care to a bedridden patient. By turning to a boarding house, an elderly person will receive attention, care, help from a psychologist and the opportunity to be in society