How to Change a Bedridden Person

This is how it is done in the hospital setting, by professional care givers.

Instructions

Difficulty: Easy

Things You’ll Need:

• An extra cover sheet(non-fitted) in addition to the regular bed clothes.
• (optional) a trapeze bar mounted over the bed.

1. Assess the persons functional ability. Do they have any upper body strength? How much will they be able to assist with the roll, transfer, or move? Can they hold themselves over during a roll to allow you to clean, change linens, etc...? For this article we will assume total lift without assist from the bed ridden person.
2. Take an extra non-fitted cover sheet, and half it twice. In other words fold the length over twice so it is 1/4 it's original length, but the same width. Place it under the patient's hips. Try to get it under the lower back(lumbar area) at the top, and about mid thigh at the bottom. This will be our "draw sheet".
3. For a pull up in bed, have the patient bend their knees up if they can, if they cannot, bend their knees up for them. If the bed is adjustable like a hospital style bed use the trendelenburg function on the bed to put the head lower than the foot, so gravity works with you. If it is a regular bed, and the person is heavy use 2 people or more to assist. Take the two sides of the extra sheet folded to be our draw sheet and pull up, and toward the head of the bed. It is really recommended to use at least 2 people for a pull up with a draw sheet with a person unable to assist. You can also pull to the left or right side of the bed as you go up to position for the next move, the roll.
4. After pulling the patient to one side of the bed or the other, use the side of the draw sheet opposite you to roll the patient into you. Side rails are recommended so that you both don't end up in the floor if the patient is heavier than you or very flaccid. Always roll in spinal alignment, keep shoulders parallel with hips, don't twist the torso during a roll. If you need to clean a soiled bed, after rolling with the draw sheet you can now use the persons hip, and shoulder to hold them over, tuck the draw sheet, and fitted sheets under them on that side, place the new sheets on that side of the bed, tuck them under the patient, and roll them the other way using the same technique as before to change an occupied bed without getting the person out of bed. Of course if the patient is completely flaccid you will have to have 2 people.
5. To dress a person who is bed ridden use the roll technique like you would for a bed change, but instead of tucking and changing sheets, remove and replace clothing, first one side then the other. Unfortunately, if the patient is completely unable to help, this can be a difficulty procedure, and is seldom quick or graceful, and you may have to consider multiple individual needs, such as limbs with limited movement, or sore, and swollen limbs. Turn pants, and socks inside out to make pulling them over easier. Button up shirts are typically easier to get on and off, and T-shirts , and pull overs can be problematic.

Tips & Warnings

• Clean, moisturized skin is easier to slide clothing over.
• Always turn a bed ridden person at least every 2 hours if their condition permits
• Use pillows to hold someone in a rolled position.
• You can use a bent knee for leverage in a difficult roll, as long as you keep the hips, and shoulders in alignment.
• If the bed is adjustable like a hospital bed familiarize yourself with the controls, and use them to your advantage. Nurses have more back injuries than any other profession from the constant necessity of moving bed ridden patients. SAVE YOUR BACK!!! Lift the bed to an appropriate height to facilitate rolling, and pulling the patient up.
• Don't get in a hurry, think the maneuver through, and execute it with the least energy expenditure. After finding the best way to do a certain maneuver in your particular circumstance, repetition will build speed.
• If the level of care your loved one requires is more than you are able to maintain, consider long term placement in an appropriate facility. Do what is best for your loved one, and yourself.
• Do not leave someone in a fully rolled position for extended periods of time, especially if they are very sick. This can decrease cardiac output by pressing organ weight on the vena cava, and aorta.
• Do not attempt a roll without side rails if the patient is flaccid, and you are alone.