Vladimir Yashin, a general practitioner, teacher at Moscow Medical School No. 13, and author of the textbook “ Healthy image life."
Often, chronic patients do not need active treatment and daily medical supervision. Let's say that during a long stay in the hospital (for example, after a stroke), a person received the necessary qualified assistance. And, of course, he wants to go home, to close people, in a familiar environment.
Indeed, in practice I can say: houses and walls help. Good care and care can work wonders. An old saying goes: “The doctor heals, the caregiver cures.” It is still quite relevant today. What is important for a caregiver to know?
Hygiene comes first
All manuals unanimously recommend regularly ventilating the room where the patient is lying and carrying out wet cleaning daily. For many people, the second point is difficult to achieve. But try to wipe the dust on the shelves and floor at least once a week - cleanliness and comfort improve the patient’s mood, and this is a direct path to recovery.
Bed linen should be changed weekly - and this is a vital issue. The more the laundry is caked, the more crumbs spilled on it, the more the risk of bedsores increases.
To change linen and straighten the bed, it is necessary, if possible, to transfer the patient to another bed. Overweight people need to be carried by two people: one puts his hands under the head and shoulder blades, the other - under the lower back and hips and lifts them up at the same time.
If it is not possible to move the patient, there is another way. The patient is moved to the edge of the bed, the dirty sheet is rolled up lengthwise in the form of a bandage, and a clean one is straightened in its place. The patient is rolled onto the clean side, the dirty sheet is removed from the other side and a clean one is straightened.
Changing clothes
To change underwear, you need to place your hands under the patient’s sacrum, then grab the edge of the shirt/T-shirt and carefully push it towards the head. Raising both the patient’s arms, remove the shirt over the head and then free his hands.
Dress the patient in the reverse order: first the sleeves of the shirt, then the neckline over the head. By the way, in stores and pharmacies you can buy undershirts for seriously ill patients, for example with myocardial infarction, which are easy to put on and take off.
Skin care
If the condition allows, the patient is seated in bed, and he independently washes his hands, face, neck and ears with soap and water at room temperature. A bedridden patient is wiped using tampons or sponges moistened with water with the addition of vodka or cologne. Seriously ill patients need to wipe the entire body with camphor alcohol, especially the folds in the groin, armpits and areas of skin under the mammary glands in women. If the skin is dry, you need to lubricate it with baby cream every 2-3 days.
Among modern means for skin care, which are sold in pharmacies, we can, in particular, recommend the following: alcohol-free body lotion (has a softening and soothing effect), foam for washing and body care (provides nutrition and care for irritated skin, relieves bad smell urine), wet wipes for sensitive skin (they have cleansing and disinfecting properties).
After each meal it is necessary to clean the oral cavity. To do this, you need a cotton swab, a 2% soda solution and a kidney-shaped basin (sold at the pharmacy). The patient should be seated in bed, take a cotton swab with tweezers, soak it in a soda solution and wipe the tongue, teeth and oral surface of the cheeks. After this, the patient should rinse his mouth warm water, and the caregiver holds a kidney-shaped basin under his chin.
Bathing
A moderately ill patient is washed once a week in a bath or shower, following the doctor’s recommendations. The bath is half filled with water (not lower than 35-37° C). The patient is helped to wash his head, back and legs. When washing in the shower, sit him in the bathtub on a bench and use a flexible hose.
Severe and weakened patients are washed in bed, placing an oilcloth over the sheet. Using a sponge moistened with warm water and soap, wash the upper half of the body, then the stomach, thighs and legs.
For washing (as well as for emptying Bladder and intestines) use a bedpan and warm water (or a solution of furatsilin at a dilution of 1:5000). The procedure must be carried out several times a day. You need: oilcloth (place it under the vessel), a water jug, sterile cotton swabs and a holder. The patient lies on his back with his knees bent. The caregiver pours warm water or a disinfectant solution over the external genitalia in women or the perineal area in men, and then wipes the skin with cotton swabs.
Prevention of bedsores
Bedsores are skin ulcers of varying sizes and depths. Most often they appear in seriously ill patients in the sacral area, less often in the area of the shoulder blades, the back of the head, buttocks, heels and other places where soft tissues are compressed between the bone and the bed. The first sign is pale skin, then redness, swelling and peeling of the epidermis. In the future - blisters and necrosis of the skin. IN severe cases Not only soft tissues, but also cartilage and even bone can undergo necrosis. The following manipulations can help prevent bedsores:
- if the patient’s condition allows, it is necessary to change his position in bed several times a day;
- Wash areas of possible formation of bedsores with warm water and soap, and then wipe with camphor alcohol;
- do a simple massage of areas of the body where bedsores may form;
- make sure there are no wrinkles or food crumbs on the sheet;
- for seriously ill patients who have been in bed on their back for a long time, place an inflatable rubber circle placed in a pillowcase so that the sacrum is above its opening;
- in case of hyperemia (redness), rub the skin with a dry towel, and to improve local blood circulation, irradiate the affected area with a quartz lamp;
- wash the skin with soap and water at room temperature, and then wipe it with alcohol and powder with talcum powder.
Enemas
Bedridden patients suffering from constipation need it (once every 2-3 days). To do this, use an Esmarch mug (a rubber tank with a capacity of up to 2 liters). The patient is placed on his left side with his legs bent to his stomach. An oilcloth is placed under the buttocks, the free edge of which is lowered into a bucket. Pour boiled water into Esmarch's mug (the tap on the rubber tube is closed) to 2/3 of the volume, lubricate the tip with Vaseline. Then open the tap to let out some water and air, and close it again. After this, spreading the buttocks, insert the tip into the rectum with rotational movements and open the tap. At the same time, Esmarch's mug is raised higher than the bed. Sometimes, instead of cleansing ones, microenemas are given with the same frequency vegetable oil- using a rubber bulb. Microclysters are easier for patients to tolerate; the procedure is carried out before bedtime so that the patient has stool in the morning.
Innovation for health
IN Lately A lot of inventions have appeared that make it easier: these are various pads (for those suffering from mild forms of incontinence), and absorbent panties, and disposable sheets that can replace the usual oilcloth. Remember, in the use of these means, the main law is expediency. If the degree of incontinence is mild, then there is no need to “steam” in absorbent panties around the clock. The more body contact natural fabrics, the less the danger of bedsores and diaper rash. However, if incontinence has become normal, then absorbent panties and sheets can save you from the same bedsores - after all, not all caregivers have the opportunity to regularly change their underwear.
Caring for your eyes, ears and nose
If patients develop discharge from the eyes, they should wipe their eyes daily with a sterile gauze swab moistened with a 3% solution. boric acid. It is also necessary to clean the ears from the accumulation of wax in the ear canal. For this purpose, a few drops of a 3% solution of hydrogen peroxide are instilled into the ear, and then injected with light rotational movements. cotton swab to the very beginning of the ear canal and carefully, so as not to damage the eardrum, clean it. Weakened patients cannot clean their nose on their own, so the caregiver performs this procedure daily. What is it? The patient should be seated with his head slightly thrown back, placing a pillow under his back. Then a cotton swab is moistened with petroleum jelly or glycerin and inserted into the nasal passage. After holding it for 2-3 minutes, it is pulled out of the nose along with the crusts using rotational movements.
Weather in the house
Naturally, a long stay in bed and the associated discomfort depress a person and traumatize his psyche. He often becomes very irritable and moody. This is fine. I urge you not to break down under any circumstances. After all, your emotional reaction can worsen the patient’s condition - do you need subsequent remorse?
The best way to get rid of irritation is a change of environment. If your ward cannot go outside or at least onto the balcony, do not be afraid to invite guests - friends and relatives. Many are afraid of injuring relatives or tiring the patient. But remember: strangers force the patient to get ready, mobilize, and forget about irritation. New faces practically guarantee an improvement in mood and a feeling of returning to a normal, active life.
Stroke- acute cerebrovascular accident, developing most often as a complication of hypertension, atherosclerosis of cerebral vessels, coronary heart disease, abnormalities of cerebral vessels, aneurysms, diabetes mellitus.
If your ward has one of the diseases listed above, there is a risk of stroke. We will analyze the symptoms of the disease in order to provide first aid in a timely manner during an attack.
There are hemorrhagic and ischemic strokes (cerebral infarction), as well as subarachnoid hemorrhage.
Hemorrhagic stroke |
Ischemic stroke |
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The development of a stroke may be accompanied by emotional distress or physical stress. |
Provoking moments are emotional stress, fatigue, infectious diseases. |
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This is a cerebral hemorrhage. Occurs as a result of rupture of an artery due to fluctuations in blood pressure or the functional state of blood vessels. |
Occurs in old age as a result of blockage (thrombus or eboma) or sharp narrowing of atherosclerotic cerebral vessels. |
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There is also a subarachnoid hemorrhage, which occurs when a cerebral aneurysm ruptures. Characteristic
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Emergency care for stroke
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Try to protect the person from falling, lay him down. |
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Give the head an elevated position, but do not bend the patient’s neck (place a pillow under the patient’s shoulders and head). |
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Call an ambulance. |
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Loosen tight clothing. |
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Open the window to provide fresh air. |
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If an oxygen tank or oxygen bag is available, use it to normalize the patient's breathing. |
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If a patient loses consciousness, ensure the airway is clear: approach the patient from the side of his head, clasp the corners of the patient’s lower jaw on both sides with both hands and pull him towards you and up. |
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When vomiting: |
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If you suspect a swallowing disorder, you should not give liquid, much less tablets. |
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You can give your client several glycine tablets (2-4 pcs) at intervals of 30 minutes under the tongue. |
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Try to measure the patient's blood pressure: |
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Upon arrival of the ambulance, hospitalize the patient |
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You cannot hospitalize a patient in a coma in a regular ambulance (this can be life-threatening). Call a resuscitation vehicle. |
Home care for patients after a stroke
No matter how severe the stroke may be, with proper treatment and active participation of the patient in rehabilitation procedures most of body functions are restored.
The patient needs a full range of procedures for rehabilitation, including therapeutic exercises and massage.
Turn a bedridden patient every two hours to prevent the formation of bedsores. Properly position the patient's paralyzed arm and leg:
In the supine position:
1. To prevent the development of stiffness in the shoulder joint and the appearance of pain in it:
Place a stool next to the bed, on the paralyzed side, and place a large pillow on it so that the corner of the pillow is under the patient’s shoulder joint.
Extend your client's arm at the elbow. Place it palm up, straighten your fingers, apply a splint and bandage it to your arm. The longueta should reach the middle of the forearm.
Move the patient's arm to the side 90° (maintaining a palm-up position) and place it on a pillow so that the shoulder joint and the entire arm are at the same level horizontally.
Place a roller between your arm and chest so as to fix your arm in the correct position; if necessary, place a 0.5 kg bag of sand on the roller.
2. Bend the patient’s paralyzed leg at the knee 15-20°. Place a cushion under your knee.
3. Place your foot in the middle position between flexion and extension and secure it with a stand.
In the “healthy side” position:
Bend the patient’s paralyzed arm at the shoulder and elbow joints and place a pillow under it;
bend the paralyzed leg at the hip, knee and ankle joints and place a pillow under it.
In the “lying on the paralyzed side” position:
tilt the patient's head down slightly;
Stretch the patient’s paralyzed arm forward at a right angle to the body and turn it palm up;
place the patient’s healthy arm to one side or move it back (but not forward!);
slightly bend the patient’s paralyzed leg at the knee joint, but straighten it at the hip;
Bend your healthy leg at the hip and knee joints and place a pillow under it.
To maintain mobility of the joints in the paralyzed arm and leg, perform “passive exercises” with the patient: first take the patient’s hand and carefully make certain movements, and then make movements with the patient’s paralyzed leg.
Perform a set of therapeutic exercises with your ward every 4 hours.
Make sure that the movements are smooth and do not cause pain.
Make sure that the patient does breathing exercises. Breathing affects muscle tone.
Keep in mind that the behavior of patients with right-sided paralysis differs from the behavior of patients with left-sided paralysis.
Right-sided violation - paralysis of the left side of the body |
Left-sided violation |
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Underestimating the scale of movement disorders, the patient is indifferent to his situation. |
Lethargy, passivity, |
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Characteristic:
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Characteristic:
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Restoring motor activity after a stroke.
Exiting bed rest should be done gradually and only in consultation with a doctor.
First, the patient is taught to sit down, then to do exercises for the legs, then to stand up and only then to walk.
If the person in your care cannot sit up independently:
- First, help him sit up.
- Then he needs to learn to sit in bed.
- Provide the bed with special devices so that the patient can sit up without your help.
- Teach the patient to lower his legs from the bed and move to a nearby chair or wheelchair.
- Gradually teach the patient:
- stand;
- transfer the weight of the body from one side of the body to the other;
- take steps on the spot;
- To learn to walk, purchase a walker.
When teaching walking, stay close to the patient on the affected side.
Care after a stroke involves a range of activities and exercises, which may vary depending on what part of the brain is affected. Proper provision of assistance will help speed up the patient’s recovery and return to normal life in a large number of cases.
Features of patient care after a stroke
Care after a stroke may vary. Some patients are able to independently support their life activities, and their relatives need to properly organize assistance for a short time in order to speed up recovery. Others remain permanently bedridden. It is more difficult to care for such patients: they are not able to move on their own, their survival depends entirely on the care of loved ones.
How to prevent a patient from developing pneumonia
Inflammation of the lungs more often appears in patients who have not retained the ability to move. Pathology occurs due to impaired blood circulation and difficulty breathing. In 10-15% of cases, it leads to the death of a person who has suffered a cerebral hemorrhage.
To avoid the occurrence of pneumonia, it is necessary to create conditions in which the pathogenic microflora in the upper respiratory tract is reduced. It is recommended to do this in a hospital setting. The patient needs daily physiological procedures and sanitation.
Maintaining good hygiene is important. Neglecting them can cause death.
The breathing tube can also cause inflammation. Modern analogues should be used: they are safer.
Antibiotics should not be used for prevention: they are used only to treat the disease.
What are the dangers of thromboembolic complications?
The formation of blood clots can be fatal. The thrombus enters the pulmonary artery through the venous vessels, clogs it, and disrupts blood flow. If this happens, the patient will require immediate resuscitation.
Prevent dangerous consequence possible by performing special movements. If a person is unable to move independently, help from loved ones is needed. Special gymnastics should be performed regularly and a person should not be allowed to lie still, since lack of movement is the main cause of thromboembolic complications.
Deep vein thrombosis may also occur. This complication occurs often in cases of paralysis of the lower extremities and in elderly patients. The disease can be prevented by wearing special stockings on the patient’s legs. Your doctor may also prescribe medications, but they may not be suitable for everyone. For people with moderate lesions, early discharge from the hospital is also suitable: physical activity will be a good measure to prevent pathology.
How to restore a patient’s motor function after a stroke
Movement dysfunctions are observed in all survivors of cerebral hemorrhage. They may have varying degrees expressiveness. There may be a partial or complete inability to move one or more limbs. The legs recover more easily: the movements they make are not so small. If the lower extremities are affected, there is no need to restore fine motor skills.
To help the patient quickly regain control of his arms and legs, doctors prescribe a set of exercises. At the beginning of the rehabilitation period, patients are often unable to perform exercises on their own; they require the help of a doctor or relatives.
The person's legs and arms are bent and they perform movements selected by the doctor. When the patient's condition improves, he is taught to sit down, stand up, and move around. A cane, walker, or support may be needed.
The most difficult thing is to restore fine motor skills, motor activity of the fingers. It is important from the first days of rehabilitation to perform special exercises that will allow you to restore function over time.
Electrical muscle stimulation is also used. A special device sends small impulses, causing the muscles to contract. This method is especially useful for bedridden patients who are not able to independently engage in physical therapy.
Fighting psycho-emotional disorders
Stroke survivors often suffer from depression, become irritable, and withdraw into themselves. This occurs due to the inability to lead the same way of life and the constant need for help from relatives. Bedridden patients are especially susceptible to psycho-emotional disorders.
Relatives need to create a favorable environment at home in which a person can relax. The victim must be treated kindly. You cannot put pressure on him, blame him for anything, or get angry. This will make the situation worse.
Make the person feel needed. Communicate with him, support him. It is impossible to isolate the patient from society. Communication with friendly people is useful. If necessary, suggest words: after a stroke, memory is impaired, so a person may forget phrases.
If motor activity is preserved, assign simple tasks to the victim. If something doesn’t work out, treat it with understanding, don’t focus your attention, and show confidence that next time everything will be fine. This will help the patient realize his need.
Diet and food
After a stroke, you will have to stop drinking alcohol in any quantity. Violation of this prohibition may lead to relapse.
Since excess body weight is a risk factor, patients with large weight will have to reduce the daily amount of calories.
The diet is selected taking into account the causes of the stroke. If hemorrhage occurs due to arterial hypertension, reduce the amount of salt in the diet and exclude tea and coffee from the menu. After ischemic stroke You will have to give up fatty foods and simple carbohydrates.
The diet should increase the amount of fruit and vegetable salads, lean meats, and cereals. Avoid foods that are too sour, spicy or salty.
Restoration of speech and memory
To restore speech functions, you should contact a speech therapist-aphasiologist. This specialist will select special exercises and give recommendations to the patient’s relatives. In order for therapy to bring the desired effect, you need to start as early as possible. Classes must be regular.
Your memory should also be trained. Suitable for this Board games, special techniques. It is useful to repeat phrases and learn poems.
Caring for a bedridden patient after a stroke
Rehabilitation begins in a hospital. When the patient's condition stabilizes, he will be allowed to take him home. Caring for the victim at home should be carried out following the doctor’s recommendations: this will make the person’s life more comfortable.
Positioning
A person should not be in one position all the time. You should turn it over every 2-3 hours.
The posture on your back is helpful. Limbs should not hang from the bed. You can put the patient on the healthy side. In this case, pillows should be placed under the injured limbs and placed in front of the body.
Lying on the affected side is also acceptable. At the same time, move your healthy limbs to the side or back: this will prevent you from falling onto your stomach.
Feeding
After a cerebral hemorrhage, swallowing functions may be impaired. To make it easier for the victim to swallow food, you should feed him soft foods. Solid food should be finely chopped. Avoid foods that are too cold or hot.
A person needs to be fed 6 times a day in small portions. Don't force him to eat if he doesn't want to. If you have a long-term lack of appetite, you should work with a psychologist. Often this phenomenon occurs for psychological reasons.
Stool control
Due to lack of movement, intestinal motility disturbances are possible. To avoid constipation and bloating, regularly turn the patient over and perform passive exercises. The victim should drink a large number of water to soften the stool. If necessary, use enemas and medications.
Change of bed linen
You need to change your underwear every day. If the product gets dirty and wet, you should immediately replace it with a clean one. The procedure must be carried out carefully so as not to injure the patient. Be sure to straighten out all wrinkles, as they can cause bedsores.
the washing up
The patient is washed at least once a day. It is recommended to carry out the procedure twice: in the morning and in the evening. You should wipe your skin with a damp sponge and brush your teeth. It is also important to treat mucous membranes.
Hair washing is done once a week. It is important to dry the patient's hair to prevent colds from occurring. Ears are cleaned every 3-7 days.
Prevention of bedsores
To prevent the formation of bedsores, regularly give the patient a special massage. Important and proper care behind the skin. You should thoroughly rub the problem areas using a special solution, which can be purchased at the pharmacy. In addition, it is advisable to buy special rugs and mattresses that prevent the occurrence of a pathological condition.
Prevention of recurrent stroke
To prevent recurrent cerebral hemorrhage, the patient will have to refuse bad habits: smoking, alcoholism. Fatty foods that increase the level of “bad” cholesterol are prohibited.
Proper care of patients is important, especially if they are paralyzed. Rehabilitation after a stroke should be carried out according to the rules. To prevent a second blow, you should regularly perform exercises, use passive gymnastics for people who have not retained the ability to move, and maintain hygiene. If necessary, procedures and medications are indicated.
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A stroke often leaves a patient incapacitated. The consequence of the disease can be partial paralysis, in which a person loses the ability to self-care. Caring for patients after a stroke requires some skills, so relatives receive the necessary information from medical personnel or study special literature.
Basic principles of care
The consequences after a stroke are individual for each patient. Some patients may develop only speech disorders and minor neurological pathologies. Loss of motor activity is a more common consequence of a history of hemorrhagic stroke. After discharge from the hospital, the patient undergoes a rehabilitation period at home or in specialized institutions, if he does not have relatives and friends.
In order to eliminate the risk of relapse and speed up the process of restoring body functions, when caring for a patient after a stroke at home, you must adhere to the following program:
- ensuring hygienic care;
- good nutrition;
- prevention of bedsores;
- performing special exercises to restore motor activity.
These are the basic principles of rehabilitation care, violation of which can lead to undesirable consequences. If you do not provide the patient with proper hygiene, this will cause diaper rash and infection. At poor nutrition Digestive problems with the development of constipation or diarrhea are possible. Insufficient stimulation of blood circulation in the sacral area within a short time will lead to the appearance of bedsores.
How often do you get your blood tested?
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Only as prescribed by the attending physician 31%, 1825 votes
Once a year and I think that's enough 17%, 1013 votes
At least twice a year 15%, 892 vote
More than twice a year but less than six times 11%, 671 voice
I take care of my health and rent once a month 6%, 362 vote
I'm afraid of this procedure and try not to pass 4%, 242 vote
21.10.2019
Caring for a bedridden patient at home requires an integrated approach. Special technical devices can make the rehabilitation period less painful for both the patient and his loved ones. For bedridden patients, it is recommended to purchase a special multifunctional bed with the ability to adjust the head and foot parts. This design will allow you to give the patient’s body a comfortable position at any time. In addition, the ability to change the height of the bed will facilitate hygiene procedures and exercises.
An important point is the presence of built-in side rails at the bed, which prevent the patient from accidentally falling and help the patient turn over independently.
If it is not possible to purchase such a bed, then you can independently change the height of the patient’s sleeping place using additional mattresses. Chairs with wooden backs can be used as handrails and fall protection. For stability, the chair legs are placed in special iron frames, which can be made to order.
When the patient begins to walk, the safest conditions possible should be created for him at home. It is necessary to make special handrails in the bathroom and toilet, the floors in the apartment should not be slippery, it is better to keep the doors to the rooms open so that the patient does not exert unnecessary effort. All this must be done taking into account the fact that in patients after a stroke, coordination of movements is often impaired and there is a high risk of falling.
What should the room be like?
It would be good if the patient was given a separate room. The room should be bright and as spacious as possible. If it is on the sunny side, then blinds should be hung on the windows. During the hot season, it is advisable to equip the room with air conditioning, but as far away from the patient’s bed as possible. If it is not possible to install such equipment, then you can use a floor fan.
In cold weather, the room should be well heated. One of the consequences of a stroke is poor circulation, which can cause the patient to feel cold.
Rehabilitation of bedridden patients after a stroke is a long and difficult process. The physical aspect of caring for an incapacitated person is complicated by his negative emotional state, which often turns into prolonged depression. A bedridden patient perceives a stroke as a collapse of his usual life, when suddenly, from a full-fledged person, he suddenly turns into a helpless burden for his relatives. In order to overcome all difficulties and restore lost body functions, you need to know the basic rules for proper care for this category of patients.
Medical principles of care
Restoring a bedridden patient at home includes a set of care measures aimed at preventing the threat of a recurrent stroke and the occurrence of serious complications associated with the patient’s constant stay in bed.
Bedsores
First of all, this is the prevention of bedsores that affect soft tissue and can lead to tragic consequences.
To ensure normal blood flow in problem areas of the body that are forced to experience constant pressure, the following care measures are intended:
- periodically changing the patient’s body position (every 2-3 hours);
- daily examination and hygiene of the skin;
- regular change of bed linen;
- sanitary treatment of the skin with antiseptics, anti-inflammatory ointments;
- providing qualified massage.
In the fight against the disease, technical means for the rehabilitation of bedridden patients after a stroke have proven effective: functional beds, orthopedic pillows, absorbent linen, absorbent sheets. Special medical products facilitate not only physical and psychological condition for a bedridden person after a stroke, but also for caring for him.
Pneumonia and venous thrombosis
The result of insufficient blood circulation in bedridden patients after a stroke can be such serious pathologies as hypostatic (congestive) pneumonia and thromboembolism. With pneumonia, thick and viscous sputum accumulates in the bronchi, the lungs swell and become inflamed, disrupting the patient’s respiratory functions. Prevent disease and improve ventilation of the lungs with simple breathing exercises(inflating balloons, blowing air bubbles out of water using a straw), vibration and drainage massage of the chest.
Stagnation of venous blood in the lower extremities creates the risk of blockage of the pulmonary artery by a detached thrombus, which often ends in instant death. Caring for a bedridden patient after a stroke at home requires the use of compression knitted stockings or elastic bandages, which normalize blood flow in the legs, to prevent thrombosis. Reception medicines that reduce blood viscosity, is carried out only as prescribed by the attending physician.
The danger of congestive pneumonia lies in its sluggish nature and mild symptoms in the initial stages of the disease. The pathology is difficult to diagnose and difficult to treat, in 70% of cases it leads to the death of the patient.
Nutrition
- this is the most important aspect of the process of rehabilitation measures aimed at the patient’s recovery. The limited physical activity of a bedridden patient disrupts and complicates the digestion process. Many paralyzed people have impaired swallowing, chewing, and ability to feed themselves after a stroke. Therapeutic diet and care consists of feeding the patient at the onset of the disease with soft, semi-liquid food enriched with fiber. Such food, in combination with choleretic drugs, is good for activating and helping to avoid constipation. Fiber is found not only in natural products, but is also sold in pharmacies in powder form, which can be mixed with any liquid to the desired consistency.
A bedridden patient after a stroke should receive daily diet calorie content not exceeding 2000 kcal. The emphasis is on boiled vegetables, lean meats and fish, and dairy products. It is advisable to exclude fatty, salty, spicy foods, sweets, and baked goods from the menu.
Restoration activities
Turning a bedridden patient after a stroke is necessary for feeding and massage. It is important that the patient’s position on the bed is not static and does not cause him discomfort or pain. All paralyzed parts of the body should take a natural position, and the process of bending the limbs should alternate with periods of relaxation. Such “passive” exercises will help maintain joint mobility in immobilized limbs. To create a gap between the body and limbs, dense cushions and small pillows are used, which not only fix the patient’s position, but also improve blood flow, preventing the appearance of prickly heat.
Physiotherapy
All recommendations on how to care for a bedridden patient after a stroke at home are given by the attending physician based on the severity of the patient’s condition and the type of impairment. He also coordinates the procedure and set of exercises of therapeutic gymnastics, the purpose of which is:
- improve muscle tone;
- normalize the blood circulation process;
- improve the functioning of internal organs;
- prevent limb contracture.
Simple movements of flexion, extension, rotation of the arms and legs, warming up the fingers, hands, and feet are performed after the acute phase of the disease, when the patient tries to sit or stand independently. Exercise therapy must be supplemented breathing exercises and revitalizing massage.
The main condition for therapeutic exercises is regularity and a gradual increase in load. Exercises started in the first 2-3 months after a stroke help achieve good results.
Household organization
General requirements for the room in which the patient is located are: cleanliness, Fresh air, the absence of unnecessary objects that block the approach to the bed and make it difficult to care for a stroke patient. The remaining factors of how to care for bedridden patients at home after a stroke are determined by which hemisphere of the brain the blood supply was disrupted.
| Violation | Damage area | Action |
| Left-sided paralysis | The right side of the brain is affected: impaired motor functions, perception, coordination of movements, partial paralysis of the left side of the body. | All items in the room necessary for the patient and his care are located to the right of the bed. The patient must be re-taught to speak, explain letters, and show how they are written. |
| Right-sided paralysis | The left hemisphere is affected: impaired speech, memory, perception of information, emotional passivity. | Used in conversation simple words, tactile touches, facial expressions and gestures. It is advisable to touch upon pleasant, familiar topics and use written communication. |
Psychological component
The effectiveness of all rehabilitation measures directly depends on the emotional state of the bedridden patient. Round-the-clock care should include active communication with the bedridden family member and a patient attitude towards his fears, grievances and irritability.
It is useful for a person weakened by illness to know that he is needed and loved. Showing care and confidence in a speedy recovery, attentive care help overcome depression, give strength and the desire to regain lost health.
The favorable outcome of rehabilitation at home depends on how knowledgeable a loved one is about how to care for a bedridden patient after a stroke. Quality care is half the success and a high chance of full recovery in the struggle for a full, active life.
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