Taking Care of Someone in Bed

When someone is spending most or all of their time in bed, it can be a challenge to provide basic care. Like with most things, practice does help. Remember that safety has to be a primary concern. Do not do anything that you think might cause injury to you or the person you are assisting. Know your limits and talk with your hospice nurse and home health aide about what those limits are and how to ensure the best care.

Electric or “Hospital” Bed

Many people struggle with whether or not to move from their regular bed to an electric bed or “hospital” bed. Only you can know when this decision is the right one for you.

An electric bed does offer some practical advantages in improving comfort and making care easier.

• Caregivers can raise or lower the bed to provide bedside care at a comfortable and safe working height.
• Adjusting the height can make transfers easier and safer.
• The head and foot of the bed can be raised and lowered for the comfort of the person in bed. Also, some people choose to put the bed in the family or living room area so that the person using the bed is included in daily activities.

Tips for Using an Electric Bed

• For safety, the bed should stay in the lowest position possible except when raised while giving care.
• Placement of the bed in a room should allow for movement of caregivers on at least 3 sides of the bed.
• Bedside rails should be up for those who are confused unless someone is at the bedside to attend to them.
• For inclusion in household activities, place the bed in a family or living room. For maximal privacy and quiet try a bedroom. Do what works best for you.
• Don’t let the bed be a barrier to personal contact. If you have been enjoying physical closeness and intimacy, there is no need to stop now. If the bed is too narrow for two, try positioning it next to another bed and lowering the rail on that side.

Moving a Person Up in the Bed

A person in bed will often “slide” down toward the foot of the bed and need assistance moving up toward the head of the bed. To move a person to the head of the bed, use the following guideline.

• Ask the person you care for if you can help reposition them in bed.
• Raise the bed to a height that lets you keep your back straight.
• Lower the head of the bed.
• Remove the pillow from under the person’s head.
• Have them bend their knees and grasp side rails with both hands
• Bend your knees and hips – not your waist. Stand with feet shoulder-width apart.
• Put one arm under the neck and shoulder, the other arm under the thighs.
• On the count of 3 have the person in bed push up while you slide them up toward the head of the bed.
• Replace the pillow and adjust the bed to a comfortable position.

Using a “Draw-Sheet”

Using a draw sheet can make repositioning easier when caring for someone who is unable to move themselves. A draw-sheet is a bed sheet that has been folded in half and laid across the bed on top of the fitted or bottom sheet. The draw sheet is positioned under the heaviest part of the torso of the person you care for so that it can most easily assist you in moving them around in the bed.

To roll someone to their side:

• Stand on the side of the bed that you want them to face.
• Ask them to bend the knee opposite you. If they are not able, it may help if you lift the leg to a bent position.
• Reach across and lift the draw sheet on the opposite side. Slowly lift and pull toward you, gently rolling them toward you.
• Make sure the side rail is raised. Cross to the other side of the bed.
• Prop the person in a comfortable position by placing pillows under the draw sheet behind the back.

To move someone up in bed:

• Find someone to help. This is a 2 person job even with a draw sheet.
• If the person has a catheter bag, make sure that the tubing will not be pulled during repositioning.
• Tell the person you care for what you are going to do.
• Caregivers stand across from each other on opposite sides of the bed.
• Lower the head of the bed.
• Remove any pillows.
• If they are able, help the person in bed bend their knees and place their feet firmly on the bed. Ask them to assist by pushing with their feet.
• Ask the person to fold their arms over their chest and tuck their chin.
• Each of the caregivers will then roll the sides of the draw sheet up close to the person’s sides and grasp firmly.
• Bend your knees. Try not to bend at your waist.
• On the count of 3, you and the person assisting you lift up, shift toward the head of the bed and then lower.
• Reposition comfortably.

Changing Sheets with a Person in Bed

If the person you care for becomes too weak to get up safely, you may need to change the linens with them in the bed. It is helpful to think of the bed in two halves. You change one half of the bed while the person lies on the other. Then, you move them onto the clean half and change the other half.

• If they can tolerate it, remove all but one pillow and make the bed as flat as possible.
• Raise the bed to height that is comfortable for you while you work at the bedside.
• Help the person roll to one side of the bed. Use the draw sheet if you have on the bed. Be sure the rail on that side is up so they will not fall.
• Go to the side where you are facing his/her back. Loosen all the bedding on that side.
• Roll the soiled bedding, and tuck it under the person’s torso and legs.
• Put the clean linens on that side of the bed and tuck in the top, bottom and sides. If you are using a draw sheet or incontinent pad (chux), place them on top of the sheet. Fold and tuck the
• clean linen underneath the roll of linen you are removing.
• Pull up the side rail on the side you’ve been working from and help the person roll over the linen onto the clean side of the bed.
• Move around to the other side of the bed, lower the rails and pull out the dirty linen.
  • Unroll the clean linen and tuck in.
  • Reposition the person comfortable and cover with linens.

Changing a Disposable Brief or Pads on Someone in Bed

• Change soiled diapers, pads or linens promptly to prevent skin breakdown.
• Explain to the person you care for what you are going to do.
• Cover torso with a sheet and unfasten diaper tabs, roll the person onto one side. If the person is in an adjustable hospital bed, raise the side rail on the side away from you. The person can use the rail to help them roll to the side and hold themselves steady.
• Remove soiled materials and clean area with a mild soap and warm water.
• Apply a barrier ointment or cream.
• Place clean sheet, pad and/or diaper underneath the hip area, roll the person back onto the clean linen and fasten diaper.

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