By physiotherapist Peter Maindal
How long is the patient seated and how is long is the patient lying in bed? Over the course of a day it is quite normal for the patient to spend 16 hours in bed and 8 hours out of bed, for example in the seated position. When a patient's daily rhythm is listed this way, it becomes apparent that the positioning in the bed is particularly important.
With this perspective positioning becomes relevant to all people who are permanently bedridden or bedridden for an extended amount of time. Especially for people with decreased mobility and/or sensibility, people with deformities, spasticity and pain and people with pressure ulcers or at the risk of developing pressure ulcers. Positioning is also relevant to people with cognitive disorders and people that are restless and unstable. In addition, it is also relevant for people receiving hygiene and dressing procedures in bed.
Positioning is used when
Imagine a person with wounds on the sacrum and the tuberositas ischii on the left side. This person wants a mobilization solution where these wounds are taken into account and where attempts are made to develop a sitting position that ensures stability and relief.
The person will also typically be given a pressure reliving mattress, for example an alternating air mattress. Many will deem this as a good effort. However, facts are that the wound under the tuberositas ischii comes from the seated position, while the wound on the sacrum comes from lying in bed.
This clearly illustrate why it is important to do a proper relief of the sacrum when lying in bed. A pressure reliving mattress cannot do this alone – especially when the amount of time spend in bed, is taken into consideration.
When positioning in the lying position is considered in a situation like this, it will also be possible to work with stability and relief of wounded areas while in bed.
" Positioning will contribute to an improved healing process. "
When actively working with positioning, it is possible to give bedridden people stability and safety, which will leave them more calm and relaxed. Regardless of the situation, stability and safety will have a great influence on the perceived comfort and well-being.
It is evident positioning also has a clear influence on how different pathological circumstances can develop, as a part of the treatment but definitely also as a part of the preventive measures.
" Positioning also influence work health and safety. "
It is possible to position bedridden people in positions that make certain procedures easier for the care-givers, e.g. dressing and hygiene procedures. In situations like this a position offering good stability will have a positive impact on the persons perceived sense of safety and frequently have a calming effect on anxious and extrovert reacting persons. Thereby you make the procedure easier for the caregiver and thus improve work health and safety.
Good positioning can in some situations even result in the ability to perform lower hygiene alone, and thereby give a co-worker time to perform other tasks instead. This is also of ethical importance in regard to bedridden people’s dignity.
Read the next article about positioning: What is good positioning?