Expert Column

Supportive Homecare

Bed Positioning: Part 1 of 2

February 11th, 2008
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It is important to pay attention to the position you lie in, and when you are confined to bed, you may need help in positioning. During sleep, we unconsciously change position many times a night. This keeps muscles moving and stops cramping, stimulates blood circulation and prevents skin breakdown.

In our skin care section, we talk about bedsores and how they are caused by excessive or prolonged pressure on bony areas of the body. Circulation to that area gets cut off, cells die, and a pressure sore results. If you are going to be in bed for a long period of time, you will need to be particularly watchful to avoid skin breakdown, as well as muscle atrophy, or wasting. (Skin breakdown is also referred to as bedsores, pressure sores, or decubitis ulcers.) Atrophy is caused by prolonged disuse of a muscle. The muscle actually shrinks in diameter causing weakness and sometimes paralysis.

There are three important steps you can take to avoid bedsores and muscle atrophy:

  1. Careful selection of the surface you will be lying on;
  2. Frequent change of position;
  3. Adherence to a specially designed exercise program suitable for your needs and capabilities.

We'll discuss the first two steps in this section; exercise programs are covered in Exercise.

Selection of Bed

Choosing the right bed or mattress is very important for those of you who may have to spend much time in bed. Look for the following features when making a selection:

The mattress should be pliable enough to provide cushioning for your shoulder blades, hips, and spine, since these areas will be carrying most of your weight while you are lying in bed. An "egg-crate" mattress is one made of foam that eases excess pressure in these areas. Water and air mattress also are excellent in terms of pliability.

egg crate

Air circulation is an important consideration in choosing a suitable surface. Plastic or other non-porous materials allow heat to build up next to your skin. This is an invitation for bacteria to gather, and also can cause chafing and raw skin. A "sheepskin" pad over the mattress will increase the circulation of air as well as provide extra cushioning.

Positioning

In addition to the mattress, the bed itself must be suited to your needs. You can rent hospital beds for use at home. These are particularly helpful because they can be adjusted to a variety of positions for eating, resting, and sleeping. The entire bed can be raised to assist your family in repositioning you, without strain for either of you.

You may remember seeing other bed attachments in the hospital, which can also be rented. For example, folding side rails can be a great help when you wish to turn from side to side. An overhead trapeze will give you much better leverage when repositioning yourself or when getting out of bed.

Trapeze


Read Bed Positioning: Part 2 of 2

Read Exercises for People With Limited Mobility

  

Editor's Note: This article was authored by Becky Moore, RN.

Posted in How to Care for Someone at Home, Positioning & Exercises for the Bedridden, Supportive Homecare

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2 Responses to “Bed Positioning: Part 1 of 2”
  1. SYLVA Says:

    ARE THERE EXERCISES FOR ELDERLY THAT ARE BEDRIDDEN? SIMPLE ONES? I TAKE CARE OF MY MOM…SHE IS BEDRIDDEN. THANK YOU.

  2. Lara Belonogoff Says:

    Hi Sylva,

    We actually have an entire section under our Hot Topics feature, which is called Positioning & Exercises for the Bedridden.

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