Equipment to assist the carer
Various items of equipment may be available to help the carer care for you at home, such as a pressure-relieving mattress or commode. Your physiotherapist, occupational therapist, District Nurse or GP should be able to advise what equipment is available, how to obtain it and how to use it. The Red Cross provides a short-term loan of some items of equipment - if a healthcare professional has not made a referral to them, you can approach them directly. (See the Further information: equipment section.)
Some families find a baby monitor or video baby monitor helpful so they can keep an eye on you while getting on with chores or activities elsewhere in the house (though mobile phones may interfere with reception). A portable doorbell can also be useful. (These pieces of equipment are not available from Marie Curie Cancer Care or the NHS.)
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Washing
It is important for you to wash regularly, or for your carer to help you wash, for the following reasons:
- for your comfort
- for your morale and dignity
- so your skin can be checked for early signs of redness
- to prevent infection
It may be useful for your carer to know the following if they are helping you to wash:
- Remember to be very gentle.
- Rinse off soap completely and dry the skin gently but thoroughly.
- Change the water in the bowl several times during the wash.
- Keep the patient covered as you wash each different part of the body. Expose only those parts you are washing. This helps to keep the patient warm and also allows them to maintain their dignity.
- Talcum powder may be used in small quantities if the skin is not too dry, and if the patient likes it.
- Moisturising creams may be applied gently on dry areas such as elbows, heels and soles of the feet.
If either you or your carer doesn’t have the energy for a full wash, a good alternative occasionally is baby wipes. These are less invasive for you if you are tired and less tiring for the carer.
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Prevention of pressure sores
If you are confined to bed or sitting in a chair for long periods, you can become sore and numb at certain pressure points. Any bony part of the body can become sore if pressure on it is not relieved frequently. People who are very immobile and very thin are most at risk of developing sores. These can be uncomfortable and increase the risk of infection.
The best method of prevention is for you to change position regularly, whether in bed or a chair, with the carer’s help if necessary. Your District Nurse can advise you about how often this should be.
A regular change of bedding can also help.
During washing your carer should look for signs of redness on:
- the back of the head
- shoulder blades
- spine
- elbows
- the base of the spine
- hips
- heels
- ears
- ankles
As soon as they see such redness, or the development of a sore, tell the District Nurse, who can advise you on what to do.
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Mouth care
Many people who are seriously ill have problems with their mouth. Some of the most common problems are a dry mouth and lips, ulcers, infection, bleeding gums, too much saliva and altered taste.
Thrush is an infection which is common in people who are ill. It causes a very sore mouth and tongue, and can be recognised by white patches on the tongue, gums and inside the cheek. Report it to your GP as it can be treated easily.
You will be more at risk of mouth problems if you are struggling to maintain good oral care yourself, so do ask for help if you are finding it hard to manage yourself. Oral care can help to reduce the likelihood of infection and other problems, and can increase your comfort.
A soft baby toothbrush is best if your mouth is sore. Do use toothpaste –a small amount - but be aware that it can have a drying effect. You can rinse your mouth with water, saline solution (one teaspoon of salt in one pint of water) or a mouth rinse. (Do not use a sodium bicarbonate rinse, which can cause problems with mouth, teeth and your general health if you are very ill.)
If you cannot rinse your mouth, a foam stick can be used to remove the toothpaste - and a foam stick can be used to clean your teeth if a toothbrush causes discomfort. Foam sticks are used in some areas of the UK though not in others. Ask your District Nurse if they can supply them – if not, ask your District Nurse or pharmacist what they recommend.
False teeth should be cleaned as usual. If you are very ill, false teeth may lose their fit and can cause mouth ulcers. If you have mouth pain, do tell your GP. They may be able to prescribe suitable medication.
You can relieve a dry mouth with ice cubes or ice chips, frozen fruit, lemonade or tonic water. Tinned, unsweetened pineapple can cleanse the mouth and help a dry mouth.
Sugarless chewing gum may stimulate saliva production if your mouth is still able to produce saliva. A saliva substitute is available and can be helpful before you eat or have a conversation, but the effects only last 10-15 minutes and it may cause discomfort if you use it too much.
A thin layer of petroleum jelly (eg Vaseline) can help to prevent dry lips. Flavoured lip salves are not recommended since many people end up licking them off.
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Your appearance
You can boost your morale simply by putting on fresh clothes, wearing jewellery, or putting on make-up as appropriate – whatever you might usually do if going out or expecting visitors. Men as well as women can boost their morale by attending to their appearance. If you can’t manage this yourself, do ask for help.
Hair washing can be managed, even if you are bedbound, and can have a major impact on your morale. You can use:
- dry shampoo powders
- a special bowl with splash attachment - this may be available from your District Nurse
- a plastic sheet, towels and an ordinary bowl in the most comfortable position for the patient
Some District Nurses have stocks of a special hair washing cap which allows you to have a dry shampoo. Ask your District Nurse if they have any stocks.
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