Dr. Ayşe Köse from the Home Health Unit of Private Izmir Gazi Hospital provided information about the points to be considered in the care of bedridden patients.
Stating that people can become temporarily or permanently bedridden for various reasons at some period of their lives, Dr. Ayşe Köse said, "In this case, if the person's age is also advanced, their health balances deteriorate faster. One-third of the elderly who apply to the hospital may become in need of help with daily activities such as bathing or dressing upon discharge from the hospital, even if they stay in the hospital for only three days. The main reason for this is that muscles, which function healthily under normal conditions, quickly change their structure when one becomes bedridden."
Muscle Wasting May Occur
Stating that being bedridden or stopping muscle use means a loss of 10-15 percent of muscle mass in a week, Dr. Ayşe Köse said, "Half of the muscle strength is lost in the first 3-5 weeks. In this case, the functionality of the body can deteriorate to such an extent that even sitting, breathing, and swallowing become difficult, and the risk of bedsores increases. To reduce muscle wasting and not to further deteriorate the patient's quality of life, physiotherapy exercises that will force the muscles to work should be applied even if the person is in bed or in a sitting position."
Watch Out for Bedsores
"Skin compressed between the bed and body bones, especially if there is little fat tissue underneath, becomes irritated quickly and difficult-to-treat wounds can open," said Dr. Ayşe Köse. "These wounds are called decubitus ulcers or bedsores. They are most commonly observed over the shoulder blades, tailbone, heels, and over the hip joint in patients lying on their side. In these areas, bones are prominent, the subcutaneous tissue is thin, and these are the most compressed areas when lying down. As a result of this compression, vessels reaching these areas are also compressed, blood flow decreases, and the tissue has difficulty reaching the proteins it needs for repair. In 70 percent of patients over 70 years of age, wounds start to form within the first 2 weeks of being bedridden."
Nutrition Should Not Be Neglected
Expressing that in most bedridden patients, appetite may have decreased or the ability to eat on their own may have been lost, Dr. Ayşe Köse said, "The deterioration of cognitive functions also interrupts healthy nutrition. Generally, even in healthy individuals in advanced age, protein loss from the kidneys occurs. However, it is important that protein is not lacking for the reduction of muscle wasting and wound healing. In addition to protein, it is also important to be able to get sufficient energy content. A food consumption that seems adequate for the patient may actually not be enough to protect the patient's general health status and heal their wounds. In this case, nutritional support should be given."
Formation of Clots Can Be Prevented
"It should be ensured that clots do not form in the leg veins, even if the bedridden condition is for a temporary period," said Dr. Ayşe Köse. "This clot, while disrupting circulation in the leg, can also break off and be dragged to the lungs, leading to a dangerous picture manifesting with findings such as shortness of breath and fainting. Your doctor will give appropriate treatment to be used for a certain period to control the formation of clots in the leg and will make suggestions. In the Home Health Unit of Private Izmir Gazi Hospital, all these applications are carried out with a holistic approach by our expert physicians."