moving patients that are immobile

susan

Registered User
Aug 18, 2003
125
0
east sussex
Dear All
Dad has recently been in the foetal position when we visit. Mum spoke to the manager as we are unable to communicate with the nursing staff due to lack of english!!
Dad is sitting in a very upright chair all day and only moved for meals and personal cleaning - he now rolls forward, curled up with his head on the arm of the chair - is this doing him any harm? He looks so uncomfortable and it distresses mum to see him sitting like this. She has just had put on his nursing plan for him to go to bed on a pressure mattress for 2 hours every afternoon - is this the right thing - can any one help with advice!?
I thought about getting a recliner chair - would this help?
Any advice would be really appreciated,
Love Susan
 

Jpr

Registered User
Dec 26, 2003
28
0
berkshire
getting appropriate help

Hi Susan

How distressing it must be for you and your mum to feel your dad is uncomfortable and not able to ask to be made comfortable.

It certainly sounds like your dad needs more support in his chair and to spend some time in bed during the day. He might even need some pressure relief in his chair during the day. Best practice for someone who is unable to reposition themselves would, as your mum suggest, involve the provision (and use of) pressure relieving equipment and changing their postion for them. Basic nursing care should involve looking to see if some looks comfortable before leaving them as well as checking they are comfortable throughout the day. If a reclining supportive chair is not available then it is often more appropriate to get people up for short periods such as meal times because it is easier change their position in bed.

Is your dad's in a nursing home or a residental care home? I don't know who's responsible for funding appropriate seating - partly because it depends on what sort of home he's in. Social or health care might be responsible - or not (and they're unlikey to volunteer the information!). But they would certainly be required to provide advice re the most appropriate chair for your dad. This advice might come from an occupational therapist (from Social services) or an NHS wheelchair service. It's possible that an 'appropriate' chair might be funded by through the NHS continuing care equipment budget, but I'm not sure if this applies in a nursing home.

There's a certain irony that if patient's speak a language other than English the NHS is obliged to pay for a translation service but if staff don't speak english we just have to make do!
hope some of this helps
Best wishes
Jill
 
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susan

Registered User
Aug 18, 2003
125
0
east sussex
Dear Jill
Thanks for your reply, went to see dad yesterday - yes he was in bed, but was disturbed to find his door shut and curtains drawn. His only protection to stop him falling out of bed was 2 arm chairs pushed against his bed - is this normal practice. We asked for him to be put to bed so that he could lay comfortably with his music on - he used to love it - also has a filthy cold - felt like he had a temperature - asked for nursing staff - but tied up with an emergency and paramedics - going in tomorrow to see how things are.
He does have a pressure pad when he is sitting in a chair, but only after we asked for it!!
Not overly happy with the nursing home at present, continually have to check up on how he is being looked after - really don't need it as it's bad enough seeing him in such a cabbage like state.
As you can guess we are well down the line, this destructive disease gets the better of me sometimes.
Sorry for whinging
Regards Susan
 

Jpr

Registered User
Dec 26, 2003
28
0
berkshire
I was saved the worst horrors of the illness with Mum when she had a massive stroke and refused to eat or drink. Although she had lost her speech it was quite clear to us and the nurses and doctors that she did not want active treatment. She was living in Canada and they took her 'living will' statements into account and agreed thankfully; Mum died about 10 days later in hospital.

It sounds like your dad should be in an electric profiling bed which would come with fitted cotsides. This would enable the carers and yourselves to change his position in bed easily because you can raise and lower the head and feet independently. (raising the feet stops people sliding down the bed.) The use of cotsides may or may not be appropriate. Sometimes they just mean people are falling from 'higher'. If they are used they should have 'bumpers' - padding to stop your dad barking his shins on them or getting caught in them. I'm not sure who is supposed to pay for this equipment these days, it may depend on what sort of home he's i,n but again it may come from the NHS continuing care budget.

One of the problems with the move out of geriatric hospitals in the early 90s was that acountants and politicians assumed that is would be cheaper and they still seem to think that any human body in the caring role is interchangable what ever their qualifications. The new'care standards' should help to improve training and quality of care but I really don't think that profit and nursing care are compatible. I would like to see the development of a 'hospice' provision for dementia patient similar to the one for people living with cancer. The standard of environment and care in a hospice is so 'healing' for both the patient and their families.

Hope this helps
best wishes
Jill
 

Geraldine

Registered User
Oct 17, 2003
143
0
Nottingham
Dear Susan

I would not have thought it is normal or indeed safe practice to try and prevent falls from bed wiith 2 chairs. My Mum sleeps in a bed in her Nursing Home with cot sides up and these are padded with what look like oversize cot bumpers. She always sits on a pressure cushion and sleeps on a special matress. I would also have thought that any specialist chair should be provided by the home. Do you think it might be worthwhile arranging an apointment outside your normal visiting hours to discuss things?
I wish you luck,

Geraldine