Knowing and identifying the signs of an infection is the best way to avert them before they worsen.
1. Daily examination
Daily examination of pressure points on the body will help them prevent bed sores. Pressure points are the regions on which the weight of the body centers in a position like sitting, sleeping, etc. Common sites to look out for pressure ulcers are shoulder blades, buttocks, and back of the thighs if the patient is resting on a bed for maximum hours each day. Once bed sores are formed, it is difficult to treat them, as the patient will not be mobile for most part of the day.
2. Water/air beds
Water/air beds are commonly used in to avoid formation of bed sores. The constant pressure reduces the circulation to the skin of pressure points. A water bed offers minimal resistance as compared to a regular mattress and better aeration to the skin thus averting pressure ulcers. The water also helps keep the skin cool, making the patient more comfortable. Make the patient lie down on either sides or the back every few hours, to reduce chances of pressure ulcers.
Keeping the body clean will help prevent infections. Add a tablespoon of an antiseptic agent like Dettol/ Savlon/Betadene to a bucket of water while sponging the patient. If an ulcer has already set in, one must clean the wound daily using clean cotton swabs soaked in an antiseptic liquid like Savlon or Betadene (not Dettol, as it will produce a severe burning sensation) to keep the area aseptic and hasten recovery.
Massage improves blood circulation in the body. It is a good idea to perform gentle but firm massages for 30 minutes each day. Use of plain coconut oil or a moisturizer during a massage is advisable. This will also help keep the skin soft, supple and prevent infections.
Keep the body dry and clean. Avoid friction as it can lead to other skin infections like intertrigo and fungal infections. Gently sprinkle and spread talcum powder on the entire back, behind the arms and thighs, to reduce contact and friction between skin and bed sheet.
6. Bowel movements
Bowel movements often reduce in frequency and constipation might be a common complaint as the person is bedridden and has little mobility. Increased fluid intake, about 10-12 glasses of fluids in the form of juices, coconut water, plain water, beverages, should be taken care of.
7. Respiratory system
The respiratory system is affected, as muscle strength tends to flag. The oxygen supply to the body tissues thereby reduces. Easy breathing exercises and changing sides every few hours helps expansion of lungs. This is very vital as lung secretions may remain stagnant in the lung, leading to chest infection. Respiratory physiotherapy is of tremendous importance in such cases.
The worst impact is seen on the bones. Under normal circumstances, our bones undergo constant breakdown as well as building up. However, in bedridden patients, the rate of building up remains the same, but the rate of breakdown increases giving rise to weak bones. The fragile bones have a low calcium content and are prone to easy fractures.
9. Muscular changes
Muscular changes are difficult to reverse easily. Due to lack of use, muscles tend to contract and set firmly as contractures or breakdown due to disuse. Once contractures set in, there are increased chances of the patient assuming abnormal postures. The joints tend to become stiff due to increased contraction of the tendons. Passive movements like physiotherapy must be continued each day to prevent these. Exercises though difficult, must be continued and the patient must be motivated to do them for a set time each day.
10. Psychological concerns
Psychological concerns like depression tend to surface as complete immobilization leads to dependency and reduced social interaction. Constant reassurance, family get together, and conversations with the patient even if they can’t add much to the dialogue, ensure optimal mental health and happiness.