Try: Provide privacy as necessary especially if the person is just learning how to eat independently again tell the cr what foods are on the tray sit down next to the cr and make pleasant conversation throughout the meal even if the cr cannot answer or respond encourage cr to do as much as possible for him herself during the meal even if cr is almost totally dependent on the caregiver (cg) to feed him the cg should still try to involve the cr in the process as much as possible for example by asking the cr to hold his own napkin when assisting cr to eat use a spoon not a fork offer cr small bites of food slowly give the cr enough time to chew and swallow each bite offer the cr small sips of liquid frequently between bites

Materials: Spoon napkin meal tray cup with straw drinking straw

Categories: Sage, Topic, Maintenance, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: lippincott’s essentials for nursing assistants by carter pj 2007 philadelphia lippincott williams & wilkins pp 448-9

Keywords: Bedbound eating chewing swallowing feeding

*This information is listed as a Tip and is not explicitly medically licensed

Try: If movement causes cr pain wait about one hour after giving pain medication to bathe him during the bath ask cr if caregiver (cg) is rubbing too hard or too lightly everyone has a different sense of touch provide privacy during the bath if cr is in a hospital bed raise or lower the bed to lessen the strain on the cg’s back bath time is also a good time to brush and style hair and shave the cr attending to the cr’s usual grooming habits or p

Materials: Mild soap wash cloths or sponge fresh pajamas hair brush and comb razor and shaving cream or electric razor after shave lotion

Categories: Sage, Topic, Maintenance, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: Helps raise the cr’s spirits and maintains the cr’s dignity keep the cr’s favorite perfumes or colognes and offer them to cr after a bath information references best practice caring for the bed bound client by compassionate community care 2009 available at

Keywords: Bedbound bath bathing grooming pain dignity

*This information is listed as a Tip and is not explicitly medically licensed

Try: Make sure cr is awake and alert enough to eat and drink and avoid giving cr any medications which may cause drowsiness prior to feeding prepare food and fluids according to any directions position the cr in as upright a sitting position as possible using pillows or repositioning the bed chair if possible if the cr has dentures or partials make sure that they are in place and fit securely involve the cr psychologically, try to make mealtime a social time as much as possible honor and include food cravings likes and dislikes do not stand above the cr because this will require him to tilt his head back and open his airway causing food to enter the airway allow time for effective swallowing between bites assist the cr in removing food from the mouth that they are unable to swallow whenever possible use a straw for liquids so that the cr can control the amount he wants to drink sucking through a straw also exercises and strengthens swallowing muscles if possible consider preparing moist food items that include sauces or gravies because they help the cr chew and swallow better avoid fluids or foods that are very cold or very hot consider feeding the cr small meals every few hours to increase food intake rather than feeding the cr three meals a day if choking occurs try to get the cr to cough also clean the cr’s airway if needed try to identify the reason for choking modify feeding fluids and food if necessary after the meal is over help the cr clean and rinse mouth offer fluids especially water hourly if possible keep a fresh supply at bedside

Materials: Pitcher of water at bedside napkin or paper towels moistened wash cloth

Categories: Sage, Topic, Maintenance, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: bathing and skin care by head to toe care llc 2009 available at

Keywords: Bedbound feeding nutrition chewing

*This information is listed as a Tip and is not explicitly medically licensed

Try: Bring in a small night stand with a drawer where cr can put all of his necessities also help cr arrange a walkway in the room to avoid falls clear clutter from all walkways and make sure that cr has room to turn around

Materials: Small night stand with a drawer

Categories: Sage, Topic, Maintenance, Medical Physical

Information: n/a

References: guide to in-home senior safety by home watch care givers available at www homewatchcaregivers com

Keywords: Clutter in bedroom falls trouble finding things

*This information is listed as a Tip and is not explicitly medically licensed

Try: caregiver (cg) should begin by washing his hands for 15 seconds with soap and water sit the cr in an upright position using pillows or bed chair positioning if available check that the feeding solution is within the safe use date unclamp the tube and attach appropriate syringe pull back on plunger to see if there is any stomach contents left from the previous feeding this determines whether or not the cr is digesting the feedings if there is more than 50ml remaining stomach contents hold off on feeding and seek further instructions if less than 50ml is left in stomach contents remove the inner plunger of the syringe or the bulb n a bulb syringe and pour the feeding into the barrel of the syringe the feeding will flow from the syringe into the feeding tube this will take about 10-20 minutes depending on the amount of feeding that has been instructed if using a feeding bag pour the feeding into the bag set the rate as instructed hang the bag as directed when the feeding is completed pour water into the syringe or bag to flush the syringe or bag and tube remove the syringe or bag and clamp the tube securely keep the cr in an upright position for at least 30 minutes after the feeding wash the syringe or bag with soap and water rinse with water and dry thoroughly syringes may also be cleaned in a dishwasher

Materials: n/a

Categories: Sage, Topic, Maintenance, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: bathing and skin care by head to toe care llc 2009 available at

Keywords: Bedbound feeding feeding tube

*This information is listed as a Tip and is not explicitly medically licensed

Try: Assemble linens roll together a pull sheet bed pad or disposable paper pad discuss what is going on with cr before and during the process return bed to the flat position keep cr on his or her side by pulling up on pull sheet remove all positioning pillows loosen bottom of the soiled bed linen behind cr’s back roll soiled bed linens toward the center of the bed and tuck under the cr as far as possible under the pull sheet begin placing clean fitted sheet and tuck under the cr without touching the soiled linen place previously rolled together pull sheet and bedpad or disposable paper pad roll the soiled pull sheet and tuck under the cr allow cr to roll onto his or her back move to the opposite side of the bed remove all soiled bed linens find the leading edge of clean linen unroll and complete making bed position cr for comfort

Materials: Clean linens clean bed pad

Categories: Maintenance, Personal, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: Adapted from the head to toe care llc intenet website www headtotoecare com making an occupied bed 2009

Keywords: Bedbound changing sheets linens bed making the bed occupied bed

*This information is listed as a Tip and is not explicitly medically licensed

Try: Assemble all bathing equipment and supplies talk with the cr about the bathing process before and during the process and try to make it an enjoyable process adjust the room temperature for added warmth and ensure privacy shut curtains and doors pay special attention to folds in skin under breasts under abdomen and between legs and private areas and bony areas back of head ears hips spine heels elbows , look for redness opened areas or reports of pain wash and pat dry cr thoroughly as moisture can cause chaffing apply small amounts of body powder to a clean soft dry wash cloth and then dust skin lightly, avoid breathing in powder apply skin lubricants in small amounts with gentle rubbing motion use gentle touch when repositioning during bath ppulling fragile skin across sheets can cause irritation and breakdown the skin after bathing provide clean dry bedding and gown pajamas assist in turning and repositioning the cr for comfort and to avoid one position for more than 2 hours as this may cause skin problems

Materials: Wash cloths pan with warm water mild soap skin lubricant body powder clean pajamas or gown clean sheets

Categories: Sage, Topic, Maintenance, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: bathing and skin care by head to toe care llc 2009 available at

Keywords: Bedbound bathing bed bath

*This information is listed as a Tip and is not explicitly medically licensed

Try: Assist the cr into a sitting position if possible if not position the cr on his or her side explain the task to the cr before and during mouth care wash your hands and put on a pair of disposable gloves place towels around the front of the cr’s neck and under his or her mouth fill a drinking glass half full of fresh water and moisten the tooth brush or several oral swabs apply a small amount of toothpaste to the toothbrush or oral swab ask the cr to open his or her mouth or gently open the mouth for the cr gently move the sponge or toothbrush from top gum down the upper teeth rinse the toothbrush or use another oral swab move the toothbrush or oral swab from bottom of gum to top of lower teeth until all teeth have been cleansed with clean toothbrush or new oral swab cleanse the tongue from back to front to remove any debris or thick oral secretions if the cr is able to rinse his or her mouth mix a small amount of mouthwash in water and ask the cr to rinse and spit into an empty glass if the cr is unable to rinse his or her mouth moisten an oral swab in a mixture of one part mouthwash to ten parts water and swab the mouth moisten lips with small amount of petroleum jelly or commercial lip moistening product remove the towel cleanse toothbrush and place on a paper towel to allow the brush to dry throw away used oral swabs remove disposable gloves and wash your hands remove the drinking glasses rinse and clean as usual

Materials: Disposable gloves soft toothbrush or oral swabs also called oral sponges toothpaste three drinking glasses pitcher of fresh water towel mouthwash

Categories: Sage, Topic, Maintenance, Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile

Information: n/a

References: Adapted from the head to toe care llc internet website www headtotoecare com mouth care 2009

Keywords: Bedbound teeth brushing teeth mouth mouth care dental care

*This information is listed as a Tip and is not explicitly medically licensed

Try: Help the cr write a menu plan that includes a lot of fiber and plenty of water make sure there are plenty of juices fresh fruits fresh vegetables and beans in the meal plan avoid an excess of red meat dairy products and potatoes encourage the cr to get plenty of exercise

Materials: Materials supports notebook and pen menu plan grocery list

Categories: Maintenance, Medical Physical, Personal, Some Supervision, Fully Aware, Somewhat Aware

Information: n/a

References: n/a

Keywords: Constipation menu meal planning groceries fiber diet

*This information is listed as a Tip and is not explicitly medically licensed

Try: Closely monitor the cr’s diet keep a daily food log to help avoid potential problems encourage the cr to drink at least eight cups of water per day encourage the cr to drink several glasses of prune and or apple juice per day encourage the cr to include 21-30 grams of fiber per day in his or her diet

Materials: Food log juice water fiber

Categories: Maintenance, Medical Physical, Personal, Some Supervision, Fully Aware, Somewhat Aware

Information: n/a

References: Adapted from the mayo clinic internet website www mayoclinic com dietary fiber information

Keywords: Constipation menu meal planning groceries fiber diet

*This information is listed as a Tip and is not explicitly medically licensed