Pressure ulcers or bed sore: are ulcers occurring as a result of skin and subcutaneous tissue injury due to poor circulation in the pressure area that come into contact with the bed.
Common locations of pressure ulcers:
Hips, elbows, heels, shoulder blades, knees, protruding areas of the ankle and head, ears and sacrum. The selection of appropriate clothes, active-passive exercise, personal hygiene, and massage can be applied to protect the patient.
Hygiene: Infection is one of the most common complications, especially after stroke. One of the problems of rehabilitation patients is difficulty in swallowing as well as poor oral hygiene. Difficulty in emptying the bladder following a stroke leads to the accumulation of urine and bacterial infection.
Inadequate fluid intake is one of the causes of the accumulation of urine. Therefore, it is important for post-stroke patients to take plenty of fluids and to have their catheters changed within twenty days. If the patient is using a cloth wipe, it is also very important to replace these cloth wipes at two to three hours intervals. This will both relieve the patient and ventilate the back of the patient. During the replacement of the cloth wipes, the urinary region and the areas that are in contact with the cloth wipes should be cleaned with wet wipes or a cotton cloth moistened with water. The perineum and the back of
The patients should be checked at certain intervals if the patients are able to maintain their own hygiene.
Bathing: After returning home, it would be beneficial for the patient to take a bath at frequent intervals (depending on the person’s health status). This stimulates blood circulation and allows the opening of skin pores. The patient can spend one to two hours in the bath each day. Bath time should be a relaxing time. The healthy hand can rub and massage the opposite side. Individuals are able to regain some function of the hemiplegic hand with time. It is important to set the temperature of the water to prevent burn injuries. It may be convenient automatic, touch less sensor sink. Showering should be preferred to a bathtub. It is beneficial to apply body massage with baby oil or lanolin cream after bathing
Bed Bath: Water-repellent products should be placed under the patient to protect the bed. Gloves must be used during the post-toilet cleaning of the patient. The cleaning procedure must be performed from top to bottom and from interior to exterior. After controlling the room temperature, up to two thirds of the hand bath should be filled with water up to 43 to 46 degrees. The patient’s body should be rinsed with soapy water from top to bottom, and from distal to proximal, and dried. The genital area should be cleaned from front to back. It is important to use a moisturizing lotion for moistening the skin.
Toilet: Toilet grip handles can be used to facilitate the ability to sit and stand. Sometimes, raising the toilet seat height can be of critical value.
Eating: Eating with other family members at the same table at home can improve the morale of the patient. In this regard, caregivers should encourage the patient. Non-functional body, sensory problems, difficulty swallowing and relaxed facial muscles can make it hard to eat. To divide the food into the small pieces, to use mixers when necessary, to wipe the patient’s mouth with a wet wipe, and to use a smock would be useful. Oral care is an important component of eating and appetite.
Exercise: The aim of exercise is to regulate the distribution of oxygen and metabolic processes enhance strength and endurance, reduce body fat, and improve muscle-joint movements. All of these benefits are necessary for good health and everyone should undertake a routine exercise program in daily life. There is no distinction between young and old people; however, strenuous exercise might have so risks. Exercising for 20 minutes or more, three times a week is sufficient. Fifteen – 25 minutes of daily exercise five or more days a week provides high level of benefits. The exercise period can be started with light warm-ups and completed with stretching exercise.
The Family of the Rehabilitation Patient
The patient’s family plays an important role in rehabilitation. To have a relevant and resourceful family that can provide care is an important factor affecting the rehabilitation process positively. What kind of problems the patient may experience and how these problems affect the patient should be explained to family members. In this way, it will be easier for the family to find solutions after the discharge.
If you are a relative of someone in need of rehabilitation, you should support and encourage him.
You should not leave the patient alone in hospital or the rehabilitation centre, and should make him/her feel that you are with them. Watching television, listening to the radio, playing chess or card games with family members may make the patient more comfortable. This is a good way to learn how rehabilitation works and how you can help the patient.