A person can get bed ridden due to various health issues; however elderly generation is more vulnerable for getting bed ridden as they experience various health issues as the age advances. Old age is a very beautiful stage of life cycle but it comes with many challenges. One of them is staying physically active and mobile. If you have a loved one at your home who is aging and you see the age related issues deteriorating his/her health. Primary mode action is to find a way out to stop him/her from getting bed ridden. This can be done by taking care of their physical as well as mental health. Family, friends and medical professionals such as Geriatric Physicians, Geriatric Physiotherapists, Psychologists, counselors etc play a very important role in preventing a patient from being bed ridden. At this stage it is very important to maintain proper health checkups, physical examinations, dietary intake and proper mobility of our elderly person. Encouraging them regularly for maintaining their physical activities helps improve physical as well as mental functions. Regular exercises can also reverse some of the effects of chronic diseases.
Sedentary lifestyle often seen to be predominant in older people is one of the main reasons for premature onset of old age health issues. Normal Physical activity and a proper exercise regime set by your physiotherapist is very important to maintain a good metabolism and thereby contribute to healthy cardiovascular, musculoskeletal, neurological and psychological well being. Some of the commonly seen health issues in elderly which need proper attention at the right time, so as to prevent further complications are as follows:
- Cardiovascular diseases.
- Respiratory diseases.
- Alzheimer’s diseases/dementia.
- Parkinsonism’s.
- Motor Neuron diseases.
- Multiple sclerosis.
Another most commonly seen problem in elderly is Loss of balance, which leads to fear of fall or even fall leading to fractures. These all medical conditions can be prevented to deteriorate ones health condition to the extent of getting bed ridden by proper physical activities, exercises and healthy diet. Proper medical intervention with your team of Geriatric physician, Physiotherapist, Dietitian and a counselor is needed at the stage. However, in some cases the deterioration may have already affected the persons health and lead him/her bed bound. At this stage we need to prevent further complications and try to comfort the patient as much as we can.
Medical complications of bed ridden patients
Prolonged time spent in bed can cause many complications. Even though the period for remaining bed ridden may vary from person to person depending upon the severity of their condition. It is highly recommended to consult your physiotherapist at this stage. If your therapist finds it ideal for the patient to perform exercises (actively, active assisted or passively depending on the condition of the patient) he/she will prescribe an exercise program for the patient which will help the patient to perform activities of daily living, such as going to toilet, washing face, brushing, eating independently and also maintain a good strength of muscles. However, if the deterioration is severe and patient cannot move at all then we also need to be watchful about many other complications which come with prolonged bed rest. Some of the complications for elderly patients being in bed for long due to various health issues are:-
Malnourishment: Low metabolism due to lack of movement lead to malnourishment. This is a serious problem as it can lead to weak immune system. Prior diet plan for such patients is recommended from a dietitian.
Deep vein Thrombosis: Blood clot formation is commonly seen when blood flow slows down in bed ridden patients due to lack of movement. To prevent these Your Physiotherapist will prescribe passive exercises. These are performed by physiotherapist passively on patient. This means physiotherapist moves each part of the patients body by him/herself. This not only improves blood circulation but also maintains the joint range of motion and prevents muscle contracture or prevents muscles from getting tight and stopping the movement further.
Contractures /Weak muscles/Decreases Range of motion in joints: These are prevented by passive exercises as well as proper position of the body with the help of pillows. It is advisable to turn the patient every 2 hourly in the bed from side to side.
Respiratory Complications such as pneumonia: Pneumonia can be prevented by chest physiotherapy. Breathing exercises in case of patients who are able to perform exercises actively can prevent respiratory complications. In case of patients who are not able to perform active exercises, postural drainage and other manual techniques to clear the air ways can prevent further respiratory complications.
Urinary tract infection: This might require catheterization, monitoring the symptoms, watching the output and color of the urine. Keeping the area clean can prevent further aggravation of the infection.
Constipation: After consulting your doctor and dietitian it is advisable to give laxatives or food rich in high fiber. Encourage patient to increase water intake. In case of critical patients more medications to clean the gut maybe required and needs medical supervision.
Pressure sores or commonly known as bed sores: Repositioning and turning patient every 2 hours can help relieve pressure points. Also the use water/air mattress or water glove at critical pressure points is helpful .The common bed soreness points in human body are buttocks, shoulder blades, back of elbow, back of heel, back of skull, hip , inner knees etc.
Depression: Being bed bound is a very stressful stage for patients as well as care givers. It is very important to show love, care and support to such patients. Apart from exercises, encourage them to read a book (if they can) or a family member can read a book for them. Ask them to watch television especially something they have always liked. If visitors are allowed to meet such patients, invite their friends to meet and talk to them. Keeping their room well ventilated, well lit and making sure their bed is closer to the window may also help. Nature is a natural healer and sitting closer to window will not only help them breathe fresh air but also watch nature. Soothing massage to help relax muscles and mind may calm down the anxiety.
(Author is a Physiotherapist. She has done BPT (Bangalore India), PGDMS (London), MBA (USA), MIAP, Fellowship in Geriatric Rehabilitation, Fellowship in Pediatric Rehabilitation. She is also a certified women’s health exercise expert)
