Home Care Tips
Looking After Yourself
You are as important as your loved ones. The demands of caring for elderly parents, an ageing spouse, or a loved one, can put any caregiver in a stressful situation. Take time to care for yourself in the midst of caregiving duties. Doing so prevents caregiver burnout and improves your wellbeing.
Skin care tips to prevent bedsores in long-term bedridden elderly
Severe bedsores can take months or even years to heal, so it is important to have the right nursing care skillsets to prevent bedsores.
Wash immediately after urination and defecation.
Keep the skin moisturised by applying moisturizers or bedsore cream after washing. Do not use talcum powder as it dehydrates the skin and makes the skin more prone to damage.
Adequate nutrition promotes healthy skin. It is important to ensure that there is enough protein, vitamin C and zinc in the elder’s diet.
Dehydration makes our skin fragile and more prone to damage. In addition to the fluids we consume from food, it is recommended that we drink 6 to 8 glasses of water (1.5 litres) per day, unless otherwise advised by the healthcare provider.
It is recommended that the elder turns his/her body every two hours during the day and every five hours at night.
- They can alternate between lying flat, lying to the left or lying to the right in different positions.
- When lying flat, put a pillow beneath the heel to avoid pressurising the heel.
- When lying on the side, place a pillow between their legs to prevent pressure from building up between their knees and ankles. If necessary, support their back with a pillow to maintain a side-lying position.
Remember to be gentle when turning the elder’s body. Avoid dragging, pulling, pushing and any other actions that could cause abrasion to the skin.
- If the elder needs to remain sedentary for a long time, change his/her sitting position at least three times per hour to release the pressure on the body. Examples of sitting posture change:
- Tilt to both sides
- Lean forward and backward
- If possible, support the body with both hands to lift the hips off the chair
- If the elder rests his/her feet on a stool for a long time, remind them to lift their feet regularly to avoid pressure on their heels.
When turning or changing body positions, look for wrinkles, fine lines, and tubular folds on surfaces under the elder’s body (e.g., clothing, incontinence pads, sheets).
Keep the bed soft, flat and wrinkle-free, and the bedsheet clean, dry and free of crumbs to minimise skin irritation.
Use a pressure relief mattress
Put a small pillow or a cushion on the body parts that get easily pressed and rubbed.
- Consult your healthcare provider on the right product/s to buy.
Check the elder’s skin at least once a day for pressure damage. Patients who must be bedridden or seated for long periods of time should have their skin checked every time they turn their body (at least once every 2 hours). If the patient is using medical equipment, remove or move the equipment at least once a day to check on the skin condition.
If you notice a change in the elder’s skin condition and suspect bedsores, consult the health care provider for early advice.
Rehabilitation techniques
Assist the elderly to sit up from bed
Here are some right techniques to help elders get up from the bed safely when they wish to move into a wheelchair.
1.
Let the elder bend at the knees and place the feet flat on the bed
2.
Tilt the elder’s knees to one side and help him/her roll over towards you with his/her head looking in your direction
3.
Help the elder lower his/her feet off the bed and support his/her shoulder with one hand and press the other hand on the hips
4.
Stand firmly with your legs spread. Make sure your centre of gravity is close to the bed and the elder. With one hand, use the hips as a fulcrum and push up the elder with the other hand into a sitting position
5.
Before the elder is stably seated, stand before the elder to support him/her
Information & demonstration by physiotherapist Lim Beng Kooi
Getting up from the bed without help
If the bedridden elder has regained some strength, the elder can practise sitting up safely on his or her own. Not only would this reduce the burden of the caregiver, but also makes the elder more independent.
1.
Lie flat on the bed
2.
Bend your knees, rest your feet flat on the bed, and put your hands on your stomach
3.
Turn over to one side and support yourself with your palm down on the bed
4.
Move your feet off the bed first and sit up by supporting yourself with your elbow and your palm
5.
Step onto the ground with both feet
Information & demonstration by physiotherapist Lim Beng Kooi
Helping the elderly to move from the bed to the wheelchair with a transfer belt
Frail elderly people who have mobility issues or are in an early recovering stage often have to move around in a wheelchair. However, it is not easy to help a person weighing tens of kilograms from the bed to the wheelchair as it may incur back pain or accidental strain on the caregiver or even result in a tragic fall for both. Caregivers may consult a medical staff before proceeding with the act. And when appropriate, use a transfer belt and other assistive devices to ensure the safety of both the caregiver and the elderly.
1.
Position the wheelchair at 45 degrees to the side of the bed with the wheelchair facing the side of the elder that has more strength. Lock the wheelchair and stow the pedals
2.
Have the elder sit on the edge of the bed and put on a transfer belt. If the elder feels dizzy, let him or her rest for a while
3.
In a face-to-face position, hug the patient's torso while holding the belt tightly. Stand in a lunge position with one foot between the elder's knees
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Adjust the posture so that the elderly can sit comfortably
Standing with the feet too narrow or too wide can also incur pressure and burden on the caregiver during the transfer. The feet should be spaced wide apart and in the direction of the transfer. Use a lunge stance with one foot standing between the elder’s knees.
Information & demonstration by physiotherapist Lim Beng Kooi
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Tzu Chi’s medical team’s mission is to “cure the body, the disease and the heart.” Master Cheng Yen, the founder of Tzu-Chi, discovered in her charity work more than fifty years ago that “sickness is the cause of poverty,” so she set up free clinics followed by hospitals in Taiwan’s remote villages. Tzu Chi’s medical mission in Singapore has evolved over two decades, from the early days of providing free medical services in neighbouring countries to establishing a community medical network locally, providing Traditional Chinese and Western medicine treatments, dental treatments, rehabilitation treatments, home care services, home palliative services, and so on, without deviating from the original intention, which is to relieve the suffering of sickness and put smiles back onto people’s faces.