Make your recipient comfortable
How many times has someone directed you to “make yourself comfortable”? It’s a given that upon visiting in a Southern home, your host will enjoin you to do just that. And you will respond by choosing the seat that appears most comfortable to you according to your preferences – and settle in.
Now think about the myriad times you have uttered the phrase “I’m uncomfortable.” Everyone has. Trying to sleep in a plane. Struggling to stay awake on a long road trip. Recumbent in the dentist’s chair (I don’t think uncomfortable begins to describe that feeling – at least for this dentophobiac). After sitting at your computer without a break for hours. Even not being able to find that just-right position in your own bed to fall asleep. That disagreeable feeling can have physical and mental causes: pain, exhaustion, anxiety, sadness, fear.
Today I want to talk specifically about the physical aspects of being uncomfortable and practical ways caregivers can remedy this for their loved ones. This is entirely different from providing “comfort care” – the gentle ministry of looking after a person in the last stages of life.
Persons of any age and with any health problems deserve to feel physically relaxed and as free from pain and constraint as possible. The ability to attain this desired state will directly affect the person’s mental and emotional state as well.
How well I know. Just over two years ago I was stricken with Guillain–Barré syndrome. Without hours, I could not walk, use my hands, or control my body movements. After a week at Duke Hospital, receiving treatment, I was deemed ready for rehab. To say the least, I was still sort of out of it. My normal body functions were returning, but this neurological attack had taken its toll. I was exhausted and longing for a good uninterrupted night of sleep. I was looking forward to being free from all of the necessary paraphernalia and getting comfortable in bed. Okay, I hear the chuckles from those who have been there. But this wasn’t just any hospital bed. This was a special “alternating pressure air pressure” mattress. My chart incorrectly noted that I had a pressure sore which made me eligible for this special mattress. I am sure many factors were involved; but I could not sleep – even rest comfortably – on that bed. In my mind, I was lying on a commercial size black plastic trash bag filled with wet straw that continually sloshed around. My entire body felt as if it was under attack – some areas more than others. The first night I slept less than an hour. When morning finally arrived I asked for help to transfer to the bedside lounge chair. I slept a few hours before my first therapy session. The second night was no better. I complained and received pain medication. What I wanted was comfort!
After another almost sleepless night, I complained louder and in more detail to a caring nurse. When I returned from my morning therapy session, the menacing mattress had been replaced with a foam one. I laid down and slept like a baby until my next therapy session.
The nurse apologized, admitting no one had noticed that my chart and my actual skin condition were not in agreement. I did not have a bed sore. The air bed was not required. I was so thankful. The rest of my stay went well, and I was ready to go home much sooner than anyone had thought possible. I am sure my recovery would have been hampered if I had continued to be deprived of sleep.
That experience left an impact on me concerning the importance of making your recipient comfortable. Sometimes it may be difficult to alleviate all pain, but surely a vital role of caregivers is to provide comfort to the extent possible. If your loved one has dementia, he may not be able to let you know the extent of discomfort he is feeling. Some indications are restlessness and moaning. When these occur, you should try to determine the source.
Even if your recipient continues to be mobile (able to move around) he will still spend at least one-third of his time in bed. Let’s start there. Unless a hospital bed is required, most people cared for at home prefer their regular bed. While this is usually a better choice for the recipient, it can present problems once the caregiver is required to provide in-bed care including incontinence care or when the recipient requires assistance getting in or out of bed and repositioning. The bed must be at the right height for the caregiver; it is not a good idea to sacrifice the back of the caregiver for comfort’s sake, so let’s look at two alternatives.
Good news! Many different designs of bed risers are now available to adjust the height of regular beds. This is a quick and easy fix. However, if your loved one currently sleeps in a queen or king size bed, you will probably need to scale down to a double. If the bed is too wide, it will be more difficult to turn and reposition your recipient. When the recipient is no longer ambulatory (bedridden) it is probably time to consider a hospital bed. If you do, choose one that is easily adjusted and consider investing in a high-quality mattress. Avoid plastic coverings just under the sheet. Provide “luxurious” sheets and blankets – at least ones that feel pleasant to the touch and are not rough and scratchy.
My go-to comfort measure for the bed is pillows. Find what works for your recipient. There are many shapes and sizes and uses – under the head and shoulder, placed between the knees, elevating the feet, tucked along the back, even soft ones to cuddle. Pillows can really make a difference in the comfort level and I encourage you to experiment until you here those lovely words, “My, this feels comfortable.” If the cognitive abilities of your recipient does not allow him to tell you how he feels, you must consider facial expressions and other physical indications of discomfort.
It is also important to provide a congenial chair or recliner which should be utilized as much as possible during the day, rather than staying in bed all the time. Even if she is “bedridden,” moving your recipient to a chair in the morning is a nice change of position and scenery. Make sure to reposition frequently, just as you would when your recipient is in bed. Pillows can also be used to improve comfort in a chair. Consider placing a rolled one behind the neck or a support room lower down on the back; under the arms for additional support, under the knees or to elevate feet.
Appraise the temperature of the room and your recipient’s preference to being warm or cool or just right. You can utilize the thermostat, a well-placed fan, or lightweight throws to achieve the ideal environment.
Good hygiene, including regular showers/baths/bed baths is a requisite for feeling comfortable, as is regular trips to the bathroom and/or incontinence care. Include frequent oral care as well as care for hair, nails and removal of unwanted hair. Do not forget your mom’s chin!
Clothes should be clean and soft, free from irritations such as tags and zippers. Well-fitting and supportive shoes may be preferable to slippers or socks, depending on the condition of feet. This is a good question to ask your doctor.
Keep your eyes and ears open and as much as possible, be responsive to the comfort needs of your loved one. Comfort can make a big difference in one’s attitude and overall well-being; and being uncomfortable can make even the sweetest person a little grouchy.
And remember that when it is time for you to get some rest, make yourself comfortable as well. You deserve it.