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Caring for a bedridden patient: what matters most

Three enemies threaten a bedridden patient: bedsores, chest infection and dehydration. All three are prevented by simple actions every two or three hours, and all three end in hospital if neglected. Care is not complicated — it is a matter of rhythm.

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What to do right now

Turn every 2 hours
Back, side, other side. Pillows under the sacrum, heels and elbows. Inspect the skin daily: redness that does not blanch under pressure is the first stage of a bedsore.
Hydrate and count
At least 1.5 litres a day unless restricted by a doctor. A dry tongue, dark urine and confusion mean dehydration — the commonest cause of readmission.
Breathing exercises
Blowing up a balloon or blowing through a straw into water five times a day. Semi-upright position during and after feeding.
Skin and hygiene
Daily washing, immediate nappy changes, barrier cream, dry skin folds.
Catheter, tube, stoma
A urinary catheter is changed every 2–4 weeks, a feeding tube per instructions. Leakage, pain or fever means calling a crew rather than waiting for the scheduled visit.

Call an ambulance if

Fever above 38 °C without an obvious cause — pneumonia or urinary infection
Breathlessness, wheezing, productive cough
A bedsore with an open wound or black crust
No urine for 8–12 hours or a blocked catheter
No bowel movement for 4–5 days with bloating or vomiting
Sudden weakness, confusion, refusal of food and drink

What not to do

Do not use ring cushions under the sacrum — they compress vessels
Do not massage reddened areas — it worsens the damage
Do not feed the patient lying flat — risk of aspiration
Do not flush a catheter yourself without training

What the crew does

Examination: temperature, saturation, chest, abdomen, skin
Urinary catheter change, feeding tube placement, stoma care
Injections and infusions as prescribed, bedsore dressing
Admission for pneumonia, dehydration or bowel obstruction

This page is for information and does not replace a medical examination. If the condition worsens, call the crew: +7 (985) 887-82-52.

This page in Russian: Russian version.

Questions

Who should visit a bedridden patient free of charge?

The district doctor on request, a community nurse for prescribed injections and, where indicated, a palliative care service. In practice visits are infrequent and families buy additional help.

How much do home procedures cost in Moscow?

Call-out 6,000 ₽ plus the procedure by the price list: an injection from 2,000 ₽, catheter and infusion by the list. Several procedures in one visit work out cheaper.

How do we get nappies and a mattress free?

Through the individual rehabilitation programme after disability is registered — an application to social services. It takes weeks, so the first period is usually self-funded.