Caring for clients who are confined to bed takes extra time and patience. Do your CNAs have all the information they need to provide quality care to their bed bound clients? Consider sharing the following practical hints and tips with the nursing assistants at your workplace.
Caring for Bed Bound Clients
PRESSURE SORES STAGES
Can you imagine being confined to your bed, day after day, unable to care for your most basic needs? While a sudden accident or injury can cause someone to become bed bound overnight, most people end up that way after a period of immobility.
For example, you may work with clients who are bed bound due to a short term immobility related to stroke, injury, fracture of the spine or hip or surgery. For them, rehabilitation is usually possible.
You may have other clients who are bed bound due to a long term immobility. This may be related to paralysis, severe stroke, certain disease processes, end stage Alzheimer's, end stage Parkinson's, multiple sclerosis, severe obesity-or they may be nearing the end of their lives.
Sixty years ago, it was common for doctors to put their patients on bed rest. After childbirth, new mothers stayed in bed for two weeks. And, patients were on bed rest for four weeks after a heart attack! Today, we know that bed rest and immobility can lead to a variety of serious complications.
Here are some of the problems that can develop from immobility-regardless of the client's age:
Loss of muscle mass, strength and endurance Pressure Sores Muscle pain Osteoporosis Pneumonia Constipation Incontinence and urinary tract infections Blood clots in the legs Contractures Depression Confusion Anxiety Mood swings Social isolation Loss of independence
10 Client Care Tips
Only give a complete bed bath once or twice a week, or as needed, to avoid over drying. Moisturize the skin with dye-free, fragrance-free lotions if available. Learn to recognize early signs of pressure sores. Prevention is much easier than treatment. If you accidentally cause a cut or tear, apply pressure to stop the bleeding. Tell a nurse or supervisor right away so treatment can be started. Accidents happen and it's better to deal with them immediately! Always follow the care plan and re-position the bed bound client as ordered. If no order is in place, re-position every two hours. If ordered, use heel protectors, bed cradles, special mattresses or other special equipment as instructed. If you are unsure how to use special equipment, ask your supervisor for a demonstration. Keep at least 3-4 pillows available. Use pillows creatively to position the client and to pad bony areas. For example, place a pillow between the knees for the side-lying position. Recognize the signs of both dehydration and edema. Notify the nurse right away if you notice any symptoms. If your clients need help with feeding, place them in an upright, seated position for comfort and safety. Offer small bites at a relaxed pace. Assess the client's ability to chew and swallow safely at every meal. If chewing or swallowing becomes difficult, stop the feeding and inform the nurse. Just like everyone else, your bed bound clients need their teeth cleaned, hair brushed, and hands, face and perineal area washed every day. Routine cleaning of the teeth, hair and skin has been proven to prevent infection! Unconscious clients may need mouth care as often as every two hours. REMEMBER! When someone's health is declining, hearing is the last sense to go. So, even if a bed bound client seems unresponsive, assume that he or she can hear you-and any noises in the room and surrounding area.
Nursing assistants provide up to 80% of the hands-on client care. This puts you in the best position to have a real impact on your clients' lives. If you care for clients who are confined to bed--whether it is temporary or permanent--your daily efforts will go a long way toward improving their quality of life.
Are Your Nursing Assistants in the Know About Caring For Bed Bound Clients? PRESSURE SORES STAGES
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