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If someone is bedbound it means they are unable to move without assistance and spend the majority of their time in a bed or chair. This may be due to frailty, illness, declining health or injury.
More physical care - A bedbound person might need help to get to and from the toilet, help to sit up in bed or move from the bed to a chair, and help to change their position in bed to prevent pressure damage (bedsores).
More support with personal care - As they have become less mobile, they might need extra help to get washed and dressed.
Support with meals and drinks - It’s important that the person eats well and stays hydrated to support their health and will need help to prepare all their meals and drinks and may need assistance to eat and drink.
Encouragement to do light exercise - Even very light exercise can help someone to maintain some strength and mobility, for example gentle stretches.
Emotional support and companionship - It can be very lonely and isolating to be bedbound, so the person might need extra emotional support. Consider organising visits from family and friends or arranging for a befriender to come and chat, ask your district nurse for advice on befriending services.
When someone is bed bound/immobile, they are more vulnerable to skin damage and infections. Supporting them to stay clean is incredibly important to help prevent these. This might include washing their hands and face, brushing their teeth, mouth care, helping with washing and bathing including intimate areas.
For many, this level of personal care can be a big change in the caring role and could be difficult for both you and the person you care for. Having an open conversation can help you both agree on the best options to maintain good hygiene and help maintain their dignity.
You can ask the person you are supporting how they would like to be helped and allow them to complete some of the washing – if safe to do so. Also ask them what their routine would have been previously, what their favourite soaps and scents are, and if they have any anxieties.
You and/or the person you care for might be self-conscious, embarrassed, or uncomfortable at having to rely on you for such intimate care and may prefer a professional to support with this. This is OK and you can seek some support with this through a discussion with your district nurse who will discuss any health needs and support options available.
If someone sits or lies in the same position for a long period of time, they may develop pressure damage to their skin. This is predominately more common in people who are bedbound.
Pressure damage may form on heels, elbows, hips, lower back and other bony parts of the body. This might look like a discoloured patch of skin, feel warm, spongy, hard, or be painful or itchy. If you are concerned, please contact your district nursing service who will undertake an assessment and give advice.
To help prevent pressure damage, remind the person you care for to reposition to a new position frequently, or help them to do so if this has been recommended by your district nurse or other health care professionals. You might also be prescribed a specially designed mattress cushion or equipment. You can get support with this through your local district nursing team. If the person does develop pressure damage or redness, it is important to speak to their GP or district nurse, as if left untreated they can become infected and very painful.
If someone is bedbound, it might be difficult for them to go to the toilet independently or to get to the toilet in time. As their carer, helping someone to manage their bladder and bowel functions might become part of your role.
There are different types of equipment which can help, such as:
To decide on the best options for the person you care for, speak to your district nurse who can help you decide on the best course of treatment.
This can be a sensitive issue for the person you care for, and it might be difficult for you to adjust to giving this level of care. Speaking to a district nurse could also help you both deal with the emotional impact and find ways to maintain the dignity of the person you care for.
Becoming bedbound can be very isolating. There are some things you could consider doing to help the person to be comfortable and feel happier.
Make the room pleasant - Open a window for fresh air, let in natural light, put up photos and pictures that they like to look at, and keep the room clean and clear of clutter.
Help to keep them stimulated - Have a TV or radio available for them to watch their favourite programmes or listen to music. If possible, give them a remote control so they can choose what they watch and when to switch it off. Invite friends and family round for visits or encourage regular phone or video calls with loved ones.
Keep track of time - Being in bed for long periods of time can be disorientating. Having a visible clock will help them keep track of time, as will maintaining a routine, getting dressed every day and being able to look out of the window.
If the person is bedbound, especially due to frailty, it is incredibly important that they are moved or lifted in the correct way. That way you can avoid injury to them, and yourself.
Someone who is bedbound needs regular repositioning. You or carers might be prescribed equipment in to help and lift the person, for example hoists, bed guards, an electric profile bed or transfer boards or slide sheets, this may require more than one person to assist.
Specialised equipment can make a huge difference if you are caring for someone who is bedbound. That might be:
Adult social care can provide a care needs assessment for the bedbound person, and advise on claiming attendance allowance.
Paid care - If the person you care for becomes bedbound, your role might change dramatically. It can be helpful to remember that it is okay if you don’t want to, or don’t feel comfortable, taking on personal care. It may be something you would consider bringing in paid carers to do, who can offer specialist care. [URL for more information here]
Home services - There are lots of services available to have at home. That could include anything from an eye test to having a haircut or a visit from the dentist.
Care and medical support - Speak to a district nurse who can offer support for the person you care for, for example to help with wound care, catheter care and administering complex medication. And advise of other services available.
Support for carers - If you are struggling, either practically or emotionally, then do reach out for help It is important for all carers to take care of themselves too, the local adult social services proved a carer’s assessment.
Consider installing a key safe.
Many people who are bedbound would be unable to leave their home if there was an emergency, such as a fire. So, it’s very important to let the emergency services know if someone is bedbound and/or living alone.
You might like to contact the fire service and ask for a Safe and Well check. This is when they test or install fire alarms and check the home for any fire hazards. Importantly, they will also record someone’s situation so that if there was a fire they would know that someone is bedbound and where to find them quickly.
A number of different services can refer patients for a Community Nurse review. GP’s, acute Hospital, but patients/family can also self-refer to Community Nurses by calling the number below (8am- 8pm).
Patients who are currently on the Community Nurse’s or Palliative care caseload can self-refer to Urgent Community Response out of hours 8pm-8am.