When someone is older and frail, there may come a time when they are unable to get around as they could before, and even become bedbound. This can be a significant change for you both practically and emotionally. The person you are supporting will need more physical support, and it can be upsetting to see a decline in their health.
In this article we will talk about what it means to be bedbound, how you can best care for someone who is bedbound, and what support is available should you both need it.
What does it mean to be ‘bedbound’?
If someone is bedbound, it means they are not able to move around safely or comfortably. This can be because they have limited mobility, an injury, pain, or even because they are very weak overall.
Someone can become temporarily bedbound, perhaps because of an injury, surgery or specific treatment. Other people may become bedbound in the long-term if their health is gradually declining.
This will differ depending on the individual, but might involve:
- More physical care. You might need to help them to get to and from the toilet, help them to sit up in bed or move from the bed to a chair, and help them to change their position in bed to prevent bed sores.
- More support with personal care. If they have become less mobile, they might need extra help to get washed and dressed.
- Support with meals and drinks. It’s important that the person eats well and stays hydrated to support their health and you might need to prepare all their meals and drinks.
- Encouragement to do light exercise. Even very light exercise can help someone to maintain some strength and mobility, for example gentle stretches.
- Emotional support and companionship. It can be very lonely and isolating to be bedbound, so the person might need extra emotional support. You might consider organising visits from family and friends or arranging for a befriender to come and chat.
When someone is bedbound, they are potentially more vulnerable to skin issues, bed sores and infections and so supporting them to stay clean is incredibly important. That might include washing their hands and face, brushing their teeth, helping with washing and bathing including intimate areas, and cleaning wounds.
For many, this level of personal care can be a big change in the caring role, and it might be difficult both for you and the person you care for. The person might be self-conscious or embarrassed at having to rely on you for such intimate care and may prefer a professional to support with this. By having an open discussion you can both agree the best options to maintain good hygiene and help maintain their dignity.
To support with this you could ask the person you are supporting how they would prefer to be helped and allow them to complete some of the washing – what is safe to do so. Also asking them what their routine would have been previously, what their favourite soaps are and if they have any anxieties.
Carers have told us that at times it can be difficult to support someone with washing, however they suggest talking to the person you are supporting, and if either of you are not comfortable then to seek some support with this through their needs assessment.
If someone sits or lies in the same position for a long time, they may develop bed sores. These are also called pressure sores or skin ulcers and are more common in people who are bedbound.
Bed sores usually form on heels, elbows, hips, lower back and other bony parts of the body. They might look like a discoloured patch of skin, feel warm, spongy or hard, or be painful or itchy.
To help prevent bed sores, remind the person you care for to shift to a new position every couple of hours, or help them to do so. You might also consider getting a specially designed mattress or cushion, you can get support with this through your local Occupational Therapy team. If the person does develop bed sores, it is important to speak to their GP or district nurse as if left untreated they can become infected and very painful.
If someone has limited mobility or is bedbound, it might be difficult for them to go to the toilet independently or to get to the toilet in time. As their carer, helping someone to manage their bladder and bowel functions might become part of your role.
There are different types of equipment which can help, such as:
- Commodes
- Hand rails
- Continence pads
- Raised toilet seats
- Protective bed covers.
To decide on the best options for the person you care for, speak to their GP or continence nurse.
This can obviously be a sensitive issue for the person you care for, and it might be difficult for you to adjust to giving this level of care. Speaking to a specialist could also help you both deal with the emotional impact and find ways to maintain the dignity of the person you care for.
If the person is bedbound, especially due to frailty, it is incredibly important that they are moved or lifted in the correct way. That way you can avoid injury to them, and yourself.
Someone who is bedbound needs repositioning every two hours. You might need to get equipment in to help and lift the person, for example hoists, bed guards, an electric profile bed or transfer boards or slide sheets. Or it might need more than one person, in which case you may need to get extra caring support (we talk more about this in the ‘Bringing in support’ section below).
It is important that you take care of yourself – it can be easy to injure your back if you try and lift someone incorrectly. There are courses available to help carers learn more about moving and handling safely. Search online for one in your area, or find out if your local council runs one.
Becoming bedbound can be very isolating. There are some things you could consider doing to help the person to be comfortable and feel happier.
- Make the room pleasant: Open a window for fresh air, let in natural light, put up photos and pictures that they like to look at, and keep the room clean and clear of clutter.
- Help to keep them stimulated: Have a TV or radio available for them to watch their favourite programmes or listen to music. If possible, give them a remote control so they can choose what they watch and when to switch it off. Invite friends and family round for visits, or encourage regular phone or video calls with loved ones.
- Keep track of time: Being in bed for long periods of time can be disorientating. Having a visible clock will help them keep track of time, as will maintaining a routine, getting dressed every day and being able to look out of the window.
Specialised equipment can make a huge difference if you’re caring for someone who is bedbound. That might be:
- Hospital bed – which allows someone who is bedbound to sit up more easily and can be adjusted to help them get out of bed. Talk to your GP or healthcare professional to find out how to access one.
- Pressure relieving mattress – to help prevent bed sores. You can access these through an occupational therapy assessment or social care needs assessment.
- Overbed table – so that drinks, phones and remote controls are easy to get hold of.
- Extra pillows and positioning wedges – to help the person stay comfortable.
- Bed rails – for extra safety.
- Transfer boards, slide sheets and hoists – to make it easier to help move the person.
We share more information about this, including how to access equipment, in: ‘Equipment and technology to help someone live independently at home’.
- Paid care: If the person you care for becomes bedbound, your role might change dramatically. It can be helpful to remember that it’s okay if you don’t want to, or don’t feel comfortable, taking on personal care. It may be something you’d consider bringing in paid carers to do, who can offer specialist care. It might also be that some tasks, such as lifting someone to the shower, takes more than one person.
You can find out more in our guide: ‘Introducing paid help for someone who is older and frail’.
- Home services: There are lots of services available to have at home. That could include anything from an eye test to having a hair cut or a visit from the dentist.
We share more information about this in: ‘How to access home appointments and services’.
- Laundry: It's likely that there will be a lot more laundry if the person you care for becomes bedbound. Changing bed clothes regularly can make life much more comfortable for them. Additional washing can have a financial impact, so have a conversation with your water provider and energy suppliers to discuss if they have schemes available to support you with this.
- Care and medical support: It may also be useful to speak to a district nurse who can offer support for the person you care for, for example to help with wound care, catheter care and administering complex medication.
- Take care of yourself: Some carers find it very difficult when the person they care for becomes bedbound. If you are struggling, either practically or emotionally, then do reach out for help.
Many people who are bedbound would be unable to leave their home if there was an emergency, such as a fire. So it’s very important to let the emergency services know if someone is bedbound and/or living alone.
You might like to contact the fire service and ask for a Safe and Well check. This is when they test or install fire alarms, and check the home for any fire hazards. Importantly, they will also record someone’s situation so that if there was a fire they would know that someone is bedbound and where to find them quickly.
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