How to Change Bedridden Alzheimer's Patients
Bedridden patients depend on caregivers to perform daily activities, such as changing clothes, and must be treated with special care to preserve their health, comfort and dignity. Patients with Alzheimer's disease, a type of dementia, require this same level of care and respect.
When dressing a bedridden Alzheimer's patient, an attitude of patience and reassurance is necessary from caregivers because the patient may be confused, frightened, or resistant. If a patient is unable to participate in dressing, the assistance of a second caregiver may be needed to prevent injury to the patient or caregivers.
Gather all necessary undergarments and clothing and place in an easily accessible location before undressing patient. Arrange items in the order they will be put on. For example, underwear/incontinence briefs will go on first, so they should be at the top of the stack, followed by trousers, undershirt/bra, shirt and socks.
Ensure patient's privacy by closing curtains and/or doors.
Put on disposable gloves, if needed.
Adjust height of bed to your waist level to prevent bending forward unnecessarily. This will reduce back strain and improve balance.
Lower bed rail on your side, making sure to leave opposite rail up for patient safety.
Raise head of bed to place patient in a sitting position, if not contraindicated by patient's condition.
Remove bottom half of patient's clothing, including trousers and undergarments. Unfasten front buttons, snaps or zips. Assist patient in raising hips (second caregiver may be needed for this). If patient is able, instruct her to bend knees and push with her heels to raise hips. Second caregiver can help patient support her hips. Remove trousers and undergarments by pulling on waistband and sliding fabric down to patient's knees. Assist patient in lowering hips. Bend patient's knees and slide trousers or undergarments over the legs. Remove patient's feet from trousers one at a time. If patient has a weak side, for example from stroke, always undress that side last.
Unfasten adhesive tabs on incontinence briefs. Assist patient in rolling to one side. Standing at the centre of patient's bedside, place hands under patient's back and guide her in rolling over. Do not lift patient. Stand with your back straight and knees bent while assisting patient. If patient is unable to roll over, a "draw sheet" (sheet folded to a quarter of its length) should be placed beneath patient's back. Pull up on your side of the "draw sheet" to gently roll patient onto her side (second caregiver should be positioned on opposite side to support patient). Encourage patient to hold onto bed rail, if able. Remove used brief from under patient and dispose of it. Place new brief under patient's back. Assist patient in rolling onto back. Help patient to bend knees and spread legs. Pull front half of brief between patient's legs and fasten adhesive tabs.
Replace patient's clean trousers or undergarments by placing one foot at a time into the openings. Roll up the legs of trousers to make it easier and faster to get feet through openings. Bend patient's knees and slide fabric over them. Assist patient in raising hips. Pull fabric up to patient's waist. Fasten any buttons, snaps or zips.
Remove top half of patient's clothing (i.e. gowns, shirts, undershirts, bras). Unfasten any front buttons or snaps. Gently raise patient's head and shoulders and support them with one arm (a second caregiver may be needed for this). Remove patient's arm from sleeve by pulling the fabric down gently. Repeat on patient's other side.
Continue to support patient's head and shoulders while replacing clean gown, shirt, undershirt or bra. Place patient's weakest arm into sleeve first. Bring fabric around patient's back and place other arm into sleeve. If the garment goes over the patient's head, place both arms in sleeves and then gently pull garment over patient's head. Lower the patient back onto mattress and fasten any buttons or snaps.
Remove patient's socks by gently grasping the top of one sock and pulling the fabric gently down the patient's foot. Repeat with other sock.
Turn clean sock inside out. Place over patient's toes and gently pull fabric over foot. Repeat with other sock. Choosing short socks may ease this procedure. If the patient's feet are prone to swelling, you may need to use a larger size to reduce patient discomfort. If the sock has seams, turn them to the outside to prevent pressure sores.
Position patient comfortably in bed and attend to any other needs before leaving room.
Remove and dispose of gloves.
- Establish a routine of bathing and dressing the person at the same time each day. Choose a time when the patient is generally calm and agreeable so the experience is less confusing or frightening.
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