Being bed bound is certainly a great challenge for both, the patient, and the caregivers. There are several reasons and medical conditions that can leave any of us confined to a bed. Creating compassion via comfort means (among others) to ensure that the bed confined patient, your loved one, has all the adequate medical equipment and supplies.
The bed bound patient is undoubtedly one of the most in need of medical equipment. In addition, and depending on the condition, there are multiple disciplines in charge of the continuum of care of the bed confined patient.
I took some time, and researched several online stores for medical equipment and supplies for the bed bound patients. Within this article, there are some recommended sites that I hope will help you find what you need.
The Basics-Essential Home Medical Equipment for the Bed Confined Patients
Below are described basic medical equipment that are necessary for the bed confined patients. These are not only comfort care, but will assist your loved one to have a better quality of life.
- Hospital bed-with or without medical criteria, having a hospital bed is not only necessary, but essential in keeping your loved one and yourself safe. Talk to his or her primary care physician to see if you can get it ordered through your insurance.
- 3 in 1 commode. Because a bed confined patient naturally will not use a regular bathroom, the 3 in 1 Commode serve to aid when is potty time for the bed bound person. In addition, it can help in the shower.
- Wheelchair: owning a manual wheelchair is very essential; especially when you need to take your loved one out for either leisure, or a doctor’s appointment. Try 1800wheelchair.com, they have a huge variety of wheelchairs, and wheelchair accessories.
- Shower Chair: although your commode might serve as a shower chair, it is best to purchase separately a shower chair because it serves better its purpose. In addition, it is a pretty affordable item.
- Adult diapers-adult diapers are a must on these cases.
- Bed Pads & mattress protectors-essential for any bed bound patient; bed pads, and mattress protectors will protect your mattress from any accidents that might occur at any time.
- Ointments-to maintain skin condition, and to prevent wound development. There are several skin ointments to maintain skin moisturized and subsequently help with preventing wound development.
These are just to name a few. There are numerous items that are very much needed, depending on your family’s needs. Often times you will know what is needed when you actually need it; so hopefully now you got an idea of the basics, and saved yourself some time.
Other Useful Items
Next are described other useful items, that are not required on every situation; but definitely recommended on most cases.
- Hospital bed wound friendly mattress-although your hospital bed will come with a mattress; most hospital beds do not have a good quality mattress. Consider purchasing a good quality mattress to help prevent bed sores, ulcers, and wounds. Ulcers and wounds are very common in bed confined patients, and are also very difficult to heal.
- Tub Transfer Bench-it is a fancier version of the shower chair. It is wider, and better to use in the shower. Often times, the tub transfer bench is recommended by the occupational therapists due that it prevents better falls in the shower.
- Hoyer Lift: having a hoyer lift will tremendously assist every time you need to re-position, or take your loved one out of the bed. There are mechanical, and electronics hoyer lifts available in the market, and although expensive, they are worthy.
- Motorized Scooter-for those who can afford it, a motorized scooter or wheelchair is a great investment, but only if the bed bound person is able to operate the scooter. Otherwise, a standard manual wheelchair will be a better option.
- Lap Belt-when going out with your loved one, a lab belt while he/she is in the wheelchair is a great addition to help prevent accidents, and falls.
- Trach supplies-for those patients that have a trach, and need tracheal care. Try medicalsupplydepot.com
- C-pap supplies-for those patients in need of C-PAP supplies, try marsmedsupply.com for a list of c-pap supplies at great prices.
A website that I again want to recommend since I found to have a great selection of these items, at great prices is 1800wheelchair.com. They have a wide variety of items, and most of the above mentioned.
Medical Supplies Based on Medical Conditions
Many bed confined patients suffered from several comorbidities, and conditions that require extra supplies, and equipment, like the ones mentioned below. The need of the following cannot be determined on your own; unless you’re the one whom performed the tests required for each of the below medical equipment, and supplies.
- Enteral nutrition: Tube Feedings for example, are required when there’s a PEG tube placement or other similar procedures due to the patient’s failure to thrive. Your physician and/or dietitian will recommend a specific feeding supplement.
- Ostomy supplies-required for all those patients that went through an ostomy procedure-urostomy, ostomy,or ileostomy. These can be temporary or permanent. At healthproductsforyou.com they have great quality ostomy supplies, at excellent prices.
- Home Oxygen-your doctor or hospital staff will determine if you will qualify for home oxygen.
- Foley catheter-recommended mainly for those patients suffering from urinary retention.
There are many other health conditions not mentioned above, but the above are some of the most common. You will likely be made aware through a health care professional of a particular medical equipment or supply need.
Disciplines that might be Involved in the Care of the Bed Bound Patient
- Home Health Aides– either private duty or through health plan, typically Medicaid when contracted for several hours during the week. Discuss with your Medicaid case manager insurance about having a home health aide to care for your loved one.
- Doctors at Home-there are several home health agencies, or independent entities offering primary care at home. This is a great option due to the many challenges in trying to leave the home with the bed confined family member.
- Home Health Care-it must be covered by your insurance. Your primary care doctor or hospital may order home health care for many reasons. These are visits provided for two to three times per week from either a nurse, therapist, social worker or aide, for 45 minutes to 1 hour. This one isn’t permanent, and it requires your primary doctor to re-order it if he believes your family member still needs the home health visits. Additionally, the home health aide might only come for one to two times per week. Medicaid does not covers therapy visits.
- Home Infusion Pharmacy-for patients in need of enteral nutrition such as tube feedings or TPN. They may also provide with IV antibiotics if your physician prescribed those.
- Hospice–it is important to understand that hospice is not only for the terminally ill patients. Hospice is also a good choice when the focus is more palliative, or in other words, when you do not want aggressive treatment and instead to keep your loved one comfortable. Talk to your primary care physician if you are interested in hospice; or you may also contact a local hospice agency to see if your family member might qualify for hospice.
Community Program-Apply to qualify
Medicaid-consider applying for Medicaid (see Medicaid.gov) when caring for a bed confined patient to see if he/she qualifies. Medicaid has some State funded program that provide patients that are bed bounds, and other conditions with home health aides. In addition, Medicaid serves as a secondary insurance, and assists with covering the 20% in health expenses that Medicare doesn’t cover.
Medicaid–Long Term. When contacting Medicaid, consider requesting for long term Medicaid (applying doesn’t guarantee you will be approved). It has special, and particular assistance that the regular Medicaid does not have. In addition, it helps with long term placement at a nursing home, if pursuing this option.
Meals on wheels: contact your local health department to see if your community participates on meals on wheels program. These programs are available for many individuals that can’t leave the home, and provides with up to three hot meals per day.
Veterans: for the bed confined veterans, there might be special community programs through the VA that also provide with home health aides. The hours per week of home aides provided will be determined by the VA. Contact your local VA for more information about their available programs.
Communicate and Work as a Team
It is very important to communicate among your family members, about your bed confined loved one. Communication is key to a successful care for anyone, and making sure you are respecting, and considering each other’s point of view. See if your loved one had a living will, and ensure you are following his or her wishes (as long as it’s feasible, and reasonable).
Keep in mind that when there’s a living will on file, and the doctor and/or hospital already had access to the same, they must follow your loved one instructions, and as long as it is legal and ethical. You might not agree with it all, but again, it was his or her will; and eventually you will have to accept it.
To avoid future conflicts, it is always good practice to discuss end of life treatment and care with anyone in your family, especially when they are reaching advanced age. By discussing it in advance, it will help you feel better about any decisions you may have to make in the future.
Legally Authorize Person-Who Can Make Decisions?
Consider who is the legally authorize person for the family in bed. If, you are not sure then refer to the following LAP explanation. They are in order of who will be making health decisions (example the court appointed guardian supersedes all, and if the court appointed the guardian, he/she will make all decisions).
1. Court appointed guardian-if there’s one for the patient, the court appointed guardian will make all decisions, that might not only include health, but also financial decisions, unless the court order specifies otherwise. It is up to the guardian’s discretion to consider family wishes.
2. Health Care Surrogate-If your loved one completed one of these, then whomever he designated as the health care surrogate will make all health decisions. This does not include financial decisions, nor decisions after he or she is deceased.
3. Spouse-when there’s not an appointed guardian or health care surrogate, the spouse (must be legally married) will make all decisions.
4. Adult Children-when there’s no spouse, or guardian, or health care surrogate, the adult children will make all decisions. The majority of the children must agree to decision in healthcare (and not the eldest child like a popular belief). The adult children may defer decision making to one sibling in writing (valid on one hospital admission only).
5. Parents– when there’s no spouse, or adult children, if there are living parents, they will then make all decisions.
6. Siblings– when there’s no spouse, adult children or living parents siblings will make medical decisions-the majority will count.
7. Other family member-when all the above is missing, then other close family members-whomever is willing, will make decisions for the patient.
8. Close friend-when missing all the above, a close friend might be able to make health care decisions if he or she is willing to do so. Unless the patient has named a friend to be his/her health care surrogate, a notarized close friend personal affidavit will be required (provided by health care facility).
9. Social Work Proxy-when, after trying to find any family or friends by due diligence, the hospital has determined the need of a social worker proxy, hospital (likely their case management department) will hire a social worker proxy to make important medical decisions.
Because of all the potential dynamics when there’s no designated healthcare surrogate, having a living will when we are able to make our own decisions is necessary, especially to make your end of life wishes known and in writing. In addition, naming your most trusted person to make decisions for you (health care surrogate) in the event you are unable, it’s also strongly recommended. Most medical facilities have a free living will and health care surrogate form.
Our Responsibility-Keeping them Safe at Home
- Ensure that your loved one is treated with dignity, and try the best you can, to honor his or her wishes. The majority of the patients do not have a living will, but a great deal of them (and us in general) have expressed to their families about their end of life wishes.
- One essential task for any bed bound patient for ulcer prevention is turning the patient at least 3-4 times per day. If you do not turn your bed confined loved one, he/she WILL develop wounds, especially in the buttock area.
- Follow up with primary care physician-ensure your loved one has follow up with his/her doctor at least every three months; or based on your doctor’s recommendation. Like with any human being, follow up appointments at the primary doctors are key to maintain a good health, and to prevent or treat early stages of otherwise potentially harmful diseases.
Finally, but also very important-take some time off. It is OK and actually essential to have some “me time” from time to time. Taking care of a bed confined patient, often times can be very overwhelming, and tiresome.
Discuss with your other family members how you can alternate in the care of your loved one, or at least have someone cover for you while you are away.
I hope this article helped you. If you have any comments, suggestions, or questions feel free to leave a comment below, or send me an email at firstname.lastname@example.org.