How to care for a patient after a major stroke. Home care after a stroke. Prevention of infectious diseases

15.03.2020 Climax

The main risk of complications in the care of stroke patients is the occurrence of pressure ulcers. At the slightest sign of skin redness, sanitize the reddened area with gauze, moistened with a weak solution of potassium permanganate or camphor alcohol.

To prevent pressure ulcers, you can also dry the reddened skin with a hair dryer. In the rehabilitation of bedridden patients, anti-decubitus mattresses and beds, and inflatable rings are also actively used. If bedsores do arise, then they should be treated with sermion ointment or sea buckthorn oil.

Caring for a bedridden patient after a stroke also includes measures to revitalize the patient. First of all, if the patient's limbs are paralyzed, then it is necessary to change the position of these limbs several times a day. The arm should be straightened at the elbow and set aside 90 degrees, you can put a cotton swab under the arm. The paralyzed leg is bent at the knee joint at an angle of 15 degrees and rests against the headboard, placing a roller and trying to achieve the fullest possible flexion of the foot.

You can also carry out passive gymnastics of a paralyzed limb. Movements are carried out without the active help of the patient himself. With one hand, you should grasp the limb just above the joint being developed, with the other hand, just below. The volume, number and pace of movements should be gradually increased. At the same time, it is very important to carry out breathing exercises.

If the patient is not paralyzed, then it is very important to activate him, gradually restoring the range of movements. Before starting active exercise, you should consult your doctor. To begin with, the patient should be seated on the bed for a few minutes, after which you can gradually raise him and help him walk around the room. In no case should the patient be overworked. It is best to drive the patient at first. After a stroke, patients often inadequately assess their strength, trying to immediately start walking on their own. It is very important that they do this under supervision.

Massage is an important part of stroke care. However, this issue should be treated very scrupulously - improper performance of massage, especially massage of the patient's paralyzed limbs, can worsen the condition. When massaging the flexors of the arms and extensors of the legs, it is best to use only light stroking. The massage is performed daily for 20 minutes.

Features of caring for bedridden patients at home

This article is provided by the medical company " Dobromed", Providing services of private ambulance and emergency care in Ukraine. I have added explanations of some medical terms to the material.

Bedside care- this is a lot of work, patience, moral, psycho-emotional and physical stress. Anyone has already faced the problem of caring for a bed patient at home, be it younger brother, a person with the flu, a grandmother with sciatica, or a mother with high blood pressure at least once in her life. If such a situation is short-lived, then it even has some positive aspects. You have the opportunity show concern in relation to a loved one who is in a weakened state, spend more time with him, communicating on important topics. But when this situation has been going on for more than a week, a number of serious problems... requiring professional help.

Possible complications of caring for bedridden patients

With improper care of bedridden patients, complications :

violation nutrition a patient that leads to a violation of the excretory function (for example, to constipation);

violation innervation and circulation... leading to bedsores ;

other problems that can cause a deterioration in metabolism and malfunctioning of organs and body systems in general.

Doctors most often have to deal with bedridden patients with acute cerebrovascular accident(ACVA, also called strokes). Such patients often have no speech ( aphasia - speech impairment with organic lesions of the speech sections of the cerebral cortex), there are paresis (weakening of muscle strength due to violations of their innervation), paralysis (complete absence of voluntary movements) and other dysfunctions requiring attention and special skills in caring for bedridden patients. To bring a man back to normal life and to minimize the consequences of the disease, specialists need time, a carefully thought out and planned treatment and rehabilitation plan, as well as deep experience of working with patients in a similar condition.

Many nosological forms (diseases) require special skills in caring for bedridden patients by doctors. Patients are looked after at home for a long time nurses... who know how to behave with the patient, have the skills to perform the basic tasks associated with caring for bedridden patients. They maintain hygiene, monitor vital signs, provide the patient with comprehensive assistance. But from time to time it is necessary call a qualified doctor at home... so that he carries out a full examination and prescribes the correct treatment on time. He can indicate the need for hospitalization, if this is required based on the patient's state of health. The condition of the patient and his further recovery depend on the initial examination, as well as on time prescribed and correct treatment.

Psycho-emotional state of the patient and relatives

In caring for the sick at home important role plays not only physical, but also psycho-emotional side of the situation... The caregiver's job for an unhealthy person is not only about maintaining hygiene... changing the bed and performing the prescribed intramuscular injections, but also in creating a comfortable emotional environment conducive to a speedy recovery. You need to communicate with the patient respectfully, while not focusing on his illness... Excessive compassion not only does not produce results, moreover, it is harmful. Relatives are very it's hard to keep this line... caring for a loved one. This is another reason why nursing care is considered more appropriate from a professional perspective.

A serious illness of a loved one, his suffering and pain often leave a serious imprint on the psycho-emotional state of relatives. It is difficult for them every day to watch how their mother, child or loved one suffers at home. In addition, the patient also experiences discomfort in some situations associated with new difficulties. Professional caregivers are trained to remain calm in any case, transmitting this attitude to patients.

Based on the above arguments, one can come to the conclusion that far not everyone can provide proper care for the sick... To accomplish this task and create optimal conditions for recovery, you must have a lot of valuable skills, deep experience and strong nervous system... This is not an easy job that only a specially trained professional can do.

The following types may be useful to a bedridden patient medical products and equipment :

Functional bed two-section or three-section: helps to give the patient's body the required position, which can be changed by raising the head and foot end of the bed. The height is also adjustable, and the lateral protective grilles prevent the lying patient from rolling to the floor.

Anti-bedsore mattress with a compressor for the prevention of bedsores.

Bactericidal irradiator... intended for disinfection of indoor air in the presence of people. It has a built-in fan and an ultraviolet irradiator that disinfects the air in the inner chamber. Ultraviolet light should not penetrate outside. The protective cover of the illuminator prevents the formation of ozone.

Bath for washing your hair in bed... very convenient for washing the head of a bed patient, allowing you to keep other parts of the body dry. Has a hole for draining water into a bucket through a hose.

Toilet chair... can be used for physiological o (t) management if the patient is able to sit on his own.

Photo source: http://www.novosibhospis.ru/prokat.html

Additional tips:

Bed should not be too soft. The sheet should be free of folds, as these lead to pressure ulcers. Oilcloth can cause maceration (fluid soak and swelling) of the skin and can also cause pressure sores. It is warmer and better to use several light woolen blankets than one heavier wadded blanket. The patient is allowed to wear only thin (old) cotton underwear, and fasteners and ties should be in front.

Place near the bed nightstand(chair). If a bedridden patient must take medication strictly at the appointed time in your absence, prepare several small cups, stick a patch on them and write the hours of admission on it.

If the patient difficult to drink cup, buy a sippy cup or use a cocktail straw.

If the bedridden patient suffers fecal and urinary incontinence... you can use adult diapers or adult diapers. If you do not have enough funds, make rags from old linen for a change. Do not get carried away with diapers, they do not allow the skin to breathe.

The room of a bedridden patient must be ventilated at least 5 times a day for 10-20 minutes, covering it warmer in the cold season. It is advisable to dust off and do wet cleaning as often as possible.

Be sure to consider patient desires... He knows better what he needs and is comfortable.

If the bedridden patient's condition worsens, Do not leave him alone (especially at night). Make a bed for yourself next to him. Turn on a night light or low light to keep the room dark.

How to turn a bed patient (video)

The sequence of actions when turning a lying patient is described and demonstrated.

Note here that to facilitate the turn of a heavy person

How to care for a patient after a stroke?

Among the most terrible diseases of mankind, stroke is one of the first places. If your relative or loved one has been visited by a similar illness - a stroke, you should be prepared for its consequences. Even in the most difficult situation, there is always hope for the restoration of vital functions. And this requires competent care for the patient after a stroke, not only from the attending physicians, but also from the household.

Stroke bed rest and care

Regardless of the severity of the stroke, the patient will spend the first time in bed. Often, an ischemic attack causes a left-sided or right-sided stroke, so that the person is paralyzed. The most important thing in the process of caring for a patient is to avoid being in one position for a long time. Turn the patient over every 2-3 hours, be sure to perform therapeutic exercises, observe the position of the limbs paralyzed by a stroke - not on weight, but using garters and rollers.

Supine position

The main thing here is to preserve the mobility of the bedridden patients in the shoulder joint and prevent pain in it. To do this, the paralyzed hand is placed on a nearby stool, pillow or other hill. It is important that the arm is extended at the elbow joint, the fingers are extended, and a natural distance is maintained between the torso and shoulder. This can be achieved with a roller or a 500g salt bag.

Leg position: to maintain correct blood flow, a roller is placed under the knee and maintain an angle of 15-20 degrees. The foot should be in a neutral position, which can be achieved with a support. If the stroke is unilateral, try to copy the movements of the healthy and diseased leg.

Lying on a healthy side

It is important to provide support after a stroke to the recumbent limbs: bend the paralyzed parts of the body at the joint and put a pillow under them.

Lying on the paralyzed side

The head of the patient with a stroke should be slightly tilted downward. If the arm is paralyzed, straighten it at a 90-degree angle to the torso and turn it over to the top with the palm. It is better to take a healthy limb back to bedridden patients.

Recovery assistance

As mentioned earlier, bedridden patients should be provided with a complex of exercise therapy or massage every 3-4 hours. At the same time, it is recommended that relatives doing the exercises take a special massage course. The main principles of restorative gymnastics after a stroke are as follows:

Care for paralyzed patients should be done with caution. No movement should be painful or uncomfortable;
Additionally, it is recommended to carry out breathing exercises, simultaneously with physiological;
Patients should learn to independently perform at least basic positions and exercises;
Only consistency and patience will help to achieve results: patients will have to go through all the stages from bed to crutches, walkers, sticks, etc.

When helping the patient to learn to walk again, you should always support him with the sick side.

How to properly feed patients after a stroke

Eating food for patients after a stroke may seem difficult, since the centers of the brain system can lose the most important functions - swallowing, chewing, salivation. Only after the attending physician determines the patient's ability to eat will a diet be developed. In any case, be prepared to purchase a blender and a steamer to prepare soft diet food for the sick for the first time.

If the patient has uncontrolled salivation, you will have to tie up a terry towel and regularly lubricate the corners of the mouth fat cream to avoid dermatitis.

Food should always be served with the healthy side of the mouth. Make sure the patient has swallowed the previous one before adding a new dose. Also, try not to feed the patient too hot or cold food, so as not to provoke esophageal cramps. It is also better to avoid dry and solid foods: any dish can be turned into soup, porridge, soufflé. After feeding, patients should remain in a horizontal position for at least 40-50 minutes.

Assistance in dressing, monitoring patients

Here are some guidelines for nursing:

Observe carefully the condition of the skin, take preventive measures in the fight against skin diseases, bedsores, etc.
Monitor the indoor climate, try to keep the room cool. If the temperature rises, you should give aspirin, paracetamol.
Observe the calorie content of the diet, as well as the temperature of the food.
Make sure to keep the stroke patient busy during the day so they don't get depressed.

When should a doctor be called?

If an unreasonable rise in temperature occurs.
If severe pain occurs in the paralyzed part of the body.
Swelling, bedsores on an immobile part of the body.
Other manifestations of deterioration in well-being.

How to dress and wash a patient?

Actually, the washing procedure involves taking a comfortable sitting position. If you are helping a patient, you need to put on clothes first of all on the affected side. When undressing, the order is reversed; first, a healthy limb is released.

The washing process implies the absence of drafts and obstacles. Try to make sure that your face and hands are washed first and that the soap or shampoo is well washed. Use a portable shower if possible. If the patient is paralyzed and washed in a sitting position on a chair, the legs should have rubber supports. Dental care: You should brush your teeth after every meal and use an electric appliance as a razor.

So, caring for patients after a stroke is completely dependent on loved ones. If you have little time to provide such assistance, hire a professional nurse, a rehabilitation doctor, take care of purchasing the necessary equipment. Full care, attention, patience bring up to 50% of the result - the stroke will be defeated.

Rehabilitation of bedridden patients after a stroke is a long and difficult process. The physical aspect of caring for a disabled person is complicated by his negative emotional state, which often turns into prolonged depression. A bedridden patient perceives a stroke as the collapse of his usual life, when, unexpectedly, from a full-fledged person, he abruptly turns into a helpless burden for his relatives. In order to overcome all difficulties and restore the lost functions of the body, it is necessary to know the basic rules for the full care of such a category of patients.

Medical care principles

Restoring a bed patient at home includes a set of care measures aimed at preventing the threat of a recurrent stroke and the emergence of serious complications associated with the patient's constant stay in bed.

Bedsores

First of all, this is the prevention of pressure sores that affect soft tissue and capable of leading to tragic consequences.

To ensure normal blood flow in problem areas of the body, forced to experience constant pressure, the following care measures are designed:

periodic change in the position of the patient's body (every 2-3 hours);
daily examination and hygiene of the skin;
regular bed linen change;
sanitizing the skin with antiseptics, anti-inflammatory ointments;
carrying out qualified massage.

In the fight against the disease, technical means of rehabilitation of bedridden patients after a stroke have proven themselves effective: functional beds, orthopedic pillows, anti-decubitus mattresses, absorbent linen, absorbent sheets. Special medical devices facilitate not only the physical and psychological state of a lying person after a stroke, but also the work of a nurse in caring for him.

Pneumonia and venous thrombosis

The result of insufficient blood circulation in bedridden patients after a stroke can be such serious pathologies as hypostatic (congestive) pneumonia and thromboembolism. With pneumonia, thick and viscous sputum accumulates in the bronchi, the lungs swell and become inflamed, disrupting the patient's respiratory functions. Simple breathing exercises (inflating balloons, blowing air bubbles out of the water using a tube), vibration and drainage massage of the chest can prevent disease and improve ventilation of the lungs.

Stagnation of venous blood in lower limbs creates a risk of blockage by a detached thrombus of the pulmonary artery, which often ends in instant death. Caring for a bedridden patient after a stroke at home requires the use of compression knitted stockings or elastic bandages to normalize blood flow in the legs to prevent thrombosis. Taking medications that reduce blood viscosity is carried out only as directed by the attending physician.

The danger of congestive pneumonia lies in the sluggish nature and mild symptoms in the initial stages of the disease. Pathology is difficult to diagnose and poorly treatable, in 70% of cases leads to the death of the patient.

Nutrition

Nutrition of a person who has suffered a stroke is the most important aspect of the process of rehabilitation measures aimed at the patient's recovery. The limited motor activity of a lying patient disrupts intestinal motility and complicates the digestion process. Many paralyzed people after a stroke have impaired swallowing and chewing functions, as well as the ability to eat independently. Therapeutic diet and care consists in feeding the patient at the onset of the disease with soft, semi-liquid food enriched with fiber. Such food, in combination with choleretic drugs, well activates intestinal motility and helps to avoid constipation. Fiber is found not only in natural products, but also sold in pharmacies as a powder that can be mixed with any liquid to the desired consistency.

A bedridden patient after a stroke should receive a daily diet of no more than 2000 kcal of calories. The emphasis is on boiled vegetables, lean meats and fish, and dairy products. It is advisable to exclude fatty, salty, spicy foods, sweets, baked goods from the menu.

Recovery activities

Turning over a bed patient after a stroke is necessary for medical, hygienic care, feeding and massage. It is important that the patient's posture on the bed is not static, does not give him discomfort and painful sensations... All paralyzed parts of the body should assume a natural position, and the process of flexion of the limbs should alternate with periods of relaxation. These "passive" exercises will help maintain joint mobility in immobilized limbs. To create a gap between the body and limbs, dense rollers are used, small pillows, which not only fix the position of the patient, but also improve blood flow, preventing the appearance of prickly heat.

Physiotherapy

All recommendations on how to care for a bedridden patient after a stroke at home are given by the attending physician based on the indicators of the severity of the patient's condition and the type of disorder. He also coordinates the procedure and a set of exercises for medical gymnastics, the purpose of which is:

improve muscle tone;
normalize the blood circulation process;
to establish the work of internal organs;
prevent limb contracture.

Simple movements of flexion, extension, rotation of arms and legs, warm-up of fingers, hands, feet are performed after the acute phase of the disease, when the patient tries to sit or stand on his own. Exercise therapy must be supplemented breathing exercises and revitalizing massage.

The main condition for remedial gymnastics is regularity and a gradual increase in the load. Exercises started in the first 2-3 months after a stroke help to achieve good results.

Organization of everyday life

The general requirements for the room in which the patient is located are: cleanliness, Fresh air, the absence of unnecessary items that block the approach to the bed and make it difficult to care for a stroke. The remaining factors of how to care for bedridden patients at home after a stroke are determined by which hemisphere of the brain the blood supply was disturbed from.

How to arrange care for a bedridden patient after a stroke

Competent care of a patient with the consequences of acute cerebrovascular accident - cerebral stroke - is no less important than treatment. This is especially true for bedridden patients - people who are bedridden for a long time due to a disease of the cerebral vessels, the symptoms and causes of which may be different, but led to the same result - paralysis. In patients with severe complications of ischemic brain disease, treatment lasts for years. Successful rehabilitation and even the survival rate of such patients largely depends on the quality of care. And the personal hygiene of the patient plays an important role in this, ensuring cleanliness, convenience and a positive attitude that help recovery.

Read in this article:

Comfort of the patient with bed rest

One of the most unpleasant consequences of a stroke can be paralysis of the limbs, often unilateral. Such a patient needs help to take the correct and comfortable body position and change it every 2-3 hours, fixing the paralyzed limbs according to the following scheme:

On the back. To ensure good blood flow throughout the body, the paralyzed hand must be placed on a cushion (pillow) - it must lie in a natural position, the fingers are straightened. Bend your legs slightly, put a roller under your knees so that there is an angle of about 20 degrees.

On a healthy side. It is imperative to support the paralyzed limbs - bend the leg and / or arm, put it on a roller (pillow, stand). They should lie comfortably and in no case "hang".

On the paralyzed side. Make sure that the head is slightly down. Put the paralyzed arm at an angle of 90 degrees to the torso, bend it comfortably, turn the palm up.

Lying patient toilet - solution options

One of the common signs of cerebrovascular accident after a stroke is urinary incontinence. In such a situation, the patient (both lying and mobile) requires special hygiene products: diapers and urological pads. Diapers are usually used for moderate to severe incontinence - they can be produced in different models - simple, with elastic bands, with "wings", "breathable" materials, etc. - it all depends on individual preferences. Urological pads are used for mild incontinence. In case of normal operation excretory system for a patient (including a lying person), it is preferable to use a boat. As a rule - soft rubber. But the choice is better left to the person himself. In the situation of using diapers, it is important to keep in mind that the patient needs to be washed every time after changing the "diaper" - wet wipes are only a temporary measure, they are advised to be used no more than 1-2 times a day. In case of diaper rash, the affected skin should be lubricated with a protective cream.

Skin Care & Bedsore Relief

Prolonged bed rest with a cerebral stroke can lead to serious complications such as bedsores - this is a very dangerous condition for health and life. If bedsores develop, you should immediately consult a doctor! However, there are a number of effective methods their prevention:

anti-decubitus cellular inflatable mattress. It relieves the skin surface and prevents bedsores from forming;

change in the position of the patient's body every 2-3 hours;

light massage to improve blood circulation.

Special anti-decubitus creams help only to some extent (and cannot be a treatment). Among other cosmetics, they are very effective. protective creams(from diaper rash in the diaper area, under the breast in women, armpits). For wet skin, zinc creams are used, for dry skin, nourishing creams. Talcum powders are not recommended: they remain in the folds of the skin and lead to even more irritation.

Cleanliness and indoor climate

An important factor in recovery from acute ischemic cerebral disease, the consequence of which was a stroke, is the cleanliness and healthy climate in the room where the patient lies. The air should be slightly cool, 17-20 degrees, the room should be ventilated 2-3 times a day (as well as in the morning and at night) - this will ensure a sufficient supply of oxygen. In chronic cerebrovascular accident, symptoms of the disease often correlate with the indoor climate. Remember: breathing problems are a common companion to strokes and prolonged bed rest. When the body temperature rises, antipyretic drugs should be given (in agreement with the doctor). Wet cleaning and changing bed linen should be done daily. After feeding the patient, be sure to check his bed for fallen crumbs, drops of food, etc. Also, watch out for wrinkles and wrinkles on the patient's clothes and on his bedding - such little things can cause bedsores and skin irritation.

Washing the body and head of the patient

After ischemic stroke, cognitive impairment often manifests itself in the patient's untidiness. It is important to monitor the regularity of the required procedures. Washing, washing the body and head of the patient is carried out in a sitting or reclining position (if the patient is in serious condition). Hygiene procedures with soap and water can be replaced special means – wet wipes, foam for "dry" washing and "dry" shampooing only in exceptional cases, for example, if the patient is not feeling well or the doctor did not recommend that he wet his skin with water. In the usual way, you need to wash the patient completely. This is done with a damp towel, liquid soap solution, a jug and a basin - in fact, it is "washing", wiping the body. For shampooing, you can use special inflatable baths - I substitute them under the head from behind under the neck according to the principle of shampooing in a hairdresser. "Dry" products (if necessary, use them) are applied to the skin or hair for a few minutes, and then wipe the skin / comb out the hair with a comb.

Dressing and other grooming procedures

A person caring for a bedridden patient needs to carefully monitor all aspects of the patient's hygiene. In particular, brush the patient's teeth after each meal - with a soft toothbrush or cotton swab(especially carefully if a person has diabetes mellitus). Men regularly shave their face with an electric razor (with a conventional razor you can get hurt, which is very dangerous in this position). Handle your nails very carefully, it is best to file with a soft file to avoid cuts. When dressing the patient, the sleeve is first put on the paralyzed arm, then on the healthy part of the body. When undressing, reverse the order: first, a healthy limb is released. Overhead clothing is not recommended. Fabrics should be natural, absorbent, soft to the touch, thin seams. Perfect option- a hospital vest, if a person is comfortable physically and psychologically. For many patients, it is very important to be well-groomed and tidy, especially when lying down. Your task is to do everything to make your loved one feel “in order”.

Where to go if there is a bedridden patient in the house

Instructions: how to get outside help

Bedridden patients require round-the-clock care and medical supervision.

Taking care of the patient is difficult not only physically and morally - it is also a constant material cost. Therefore, it is worth figuring out where to go for help if the patient is bedridden in the house.

Nina Kolomenskaya

Shared her own
experience

Contact the local polyclinic

The condition of the bedridden patient must be monitored daily. Call your GP at your home. He will examine the patient, prescribe treatment and decide which specialized specialist to invite additionally.

At the home of the bedridden patient, at the request of the therapist, all narrow specialists are required to come - a neurologist, ophthalmologist, otolaryngologist (ENT), surgeon, oncologist, urologist, endocrinologist, cardiologist and other doctors.

At home, they do an electrocardiogram, take tests, and carry out treatment. For example, in the presence of ulcers, the surgeon prescribes treatment with a daily visit to the patient by a nurse to perform dressings.

If necessary, an ophthalmologist will come to the house. He will identify visual defects, fit lenses or prescribe glasses, find glaucoma, cataracts, or retinal detachments. The neurologist may prescribe a course of treatment with daily injections, which should be carried out by a nurse from the clinic.

If the therapist says that specialized doctors do not come to your home, do not believe it. Contact the management of the polyclinic and make sure that narrow specialists are sent to you.

According to Federal Law No. 323, bedridden patients have the right to receive free medical care at home. The district polyclinic must provide the necessary medical services in accordance with general guidelines.

Excerpt from the law:

Article 19. Right to medical care

1. Everyone has the right to medical assistance.

2. Everyone has the right to medical care in a guaranteed volume, provided free of charge in accordance with the program of state guarantees for free provision of medical care to citizens, as well as to receive paid medical services and other services, including in accordance with a voluntary medical insurance contract.

A therapist and specialized doctors from the district polyclinic are obliged to come to the house of the bedridden patient.

Apply for Social Security

Within 10 days, you will be given an individual program where the type of services, quantity and duration of provision will be indicated.

Excerpt from the law:

Article 16. Individual program

1. An individual program is a document that indicates the form of social services, types, volume, frequency, conditions, terms for the provision of social services, a list of recommended providers of social services, as well as social support measures carried out in accordance with Article 22 of this Federal Law.

"On the basics of social services for citizens in the Russian Federation"

Services are divided into guaranteed and additional. The guaranteed ones are free or paid partially. Extras are always paid.

Non-governmental social service centers, which are included in the Register of Social Service Providers, provide services free of charge under the program, partly free of charge and for a fee.

According to Federal Law No. 442, it is planned to provide eight types of social services. The patient can be provided with medical services - follow-up, diagnostics, treatment, monitoring of medication at home.

The individual program may include support services for people with disabilities with speech impairments or household help - grocery shopping, cleaning, etc.

The state does not provide carers. If you need a nurse, you will have to hire her additionally through advertisements, acquaintances, through recruiting agencies or contact the CSO.

When hiring in a CSO, the state will cover part of the cost of a nurse. But only in cases where the need for a nurse is spelled out in the individual program issued by the social protection department.

The department of social protection will be given an individual program. It will contain a list of social services that the patient will receive free of charge.

Register the patient with a public hospice

For some incurable diseases, patients have the right to seek help from the state hospice, which is a palliative care institution.

Excerpt from the law:

Article 36. Palliative health care

1. Palliative care is a complex of medical interventions aimed at relieving pain and alleviating other severe manifestations of the disease, in order to improve the quality of life of terminally ill citizens.

2. Palliative care can be provided on an outpatient basis and in an inpatient setting health workers trained to provide such assistance.

"On the basics of protecting the health of citizens in the Russian Federation"

Hospice is a special institution where patients and their relatives receive medical, social, psychological, spiritual and legal assistance.

Indications for treatment - oncology, chronic progressive diseases of a therapeutic profile, consequences of trauma, irreversible disorders of cerebral circulation, various forms dementia, including Alzheimer's and other diseases.

In order to register with the state hospice, you need a referral. For example, if you have an oncological patient of the 4th clinical group, a referral will be given by a district oncologist.

Hospices have hospitals and an outreach service that provides home assistance. With appropriate symptoms and a place in the hospital, the patient will be admitted to a hospice. Access to the hospice for family and friends is allowed 24 hours a day, 365 days a year.

The terminally ill can get help from the public hospice. You need a referral to register with a hospice.

Call charities

There are many charitable Orthodox and non-Orthodox foundations. Find a list of organizations in your city and call.

Find charity home nursing services that provide loan equipment for the patient: a special bed, an anti-bedsore mattress, wheelchair for transportation.

Invite a health visitor to your home. He will show and tell you how to properly care for a bedridden patient.

Charitable organizations provide free assistance in caring for bedridden patients.

Handle disability and patient care

Call your GP. He will determine whether the patient has indications for disability and will draw up documents on the 088 / y form for passing the medical and social examination (MSE).

If, when drawing up documents, the conclusion of narrow specialists is required, then relatives in the district polyclinic submit an application for their visit to the patient.

Within a month after the submission of documents to the ITU bureau, a commission leaves for the patient's home to conduct an examination. The commission decides to assign a disability, send for additional. survey or deny assignment to the group.

If the disability has been assigned, then with the decision of the commission (pink certificate), you must contact:

1. To the regional branch of the Pension Fund of the Russian Federation at the place of residence for registration of monthly payments. In the FIU, it is possible to replace benefits for medicines, sanatorium-and-spa treatment, benefits for utility bills and transportation for cash payments.

2. To the department of social protection to receive social services, which are required depending on the group of disabilities.

3. In the MFC to receive benefits for utility bills.

4. To the district polyclinic to receive benefits for medicines.

This is a rough list of institutions. The complete list depends on the group of disability and benefits that a disabled person is entitled to.

Excerpt from the law:

Article 28.1. Monthly cash payment to people with disabilities

1. People with disabilities and disabled children have the right to a monthly cash payment in the amount and in the manner prescribed by this article.

2. The monthly cash payment is set in the amount of:

1) disabled people of group I - 2,162 rubles;

2) disabled persons of group II, disabled children - 1,544 rubles;

3) disabled persons of the III group - 1 236 rubles.

"O social protection disabled people in the Russian Federation "

The monthly cash payment to the disabled and disabled children is indexed every year. These figures are indicated at the time of the adoption of the Federal Law.

If you have a disability and you yourself are caring for a disabled person, contact the FIU to apply for caring for a disabled person.

So you will receive a monthly allowance and work experience will go to you. You can apply for care if you do not work anywhere, do not receive benefits, and do not have income in the form of a salary or pension.

Excerpt from the law:

1. To establish, from July 1, 2008, monthly compensation payments in the amount of 1200 rubles to non-working able-bodied persons caring for a disabled person of group I, a disabled child under the age of 18, as well as for the elderly in need of constant outside care upon the conclusion of a medical institution or those who have reached the age of 80 (hereinafter referred to as compensation payments).

Compensation payments are established for one non-working able-bodied person in relation to each specified disabled citizen for the period of caring for him. "

"O compensation payments persons caring for disabled citizens "

Stroke is called acute disorders of cerebral circulation (abbreviated - ONMK). With this diagnosis, the patient spends some time after the attack in the hospital. Then he is discharged and sent home for further treatment and recovery. Most often, people are struck by the ischemic type of disease, the chances of rehabilitation after which are much higher when compared with a hemorrhagic stroke. Now caring for a patient after a stroke falls on the shoulders of relatives, close people. This is a difficult task, since the consequences of such diseases can be serious, a person loses the ability to self-service, and one has to help in all aspects of his life.

A person who has suffered a stroke needs quality care.

When servicing bedridden patients after a stroke or partially deprived of some functions, it is important not only to properly care for, but also to follow some tips to preserve your own privacy. Some people, whose loved ones are paralyzed, often cannot withstand such changes, break down, and become depressed. This negatively affects everyone.

Common Tasks

The attending physician should explain in detail how to care for patients after a stroke. Each case has its own characteristics. Someone needs help with exercise, cooking and washing periodically. In case of serious brain damage, a loved one will have to drink, wash, spoon-feed and take careful care of the bedridden patient. When the patient is bedridden, it is the hardest to work with. But here you can't give up. Yes, caregivers have to go the most difficult period... You need to be prepared for this in advance, but also not to put an end to your personal life.

There are several main tasks in the home care of a person paralyzed by a stroke:

protection against pressure sores;
prevention of pneumonia;
normalization of digestion;
prevention of thrombosis;
measures to prevent relapse.

These are five tasks that must and must be done regularly. We will tell you separately about each of the directions. Plus, you will learn how not to turn your own life into hard labor and maintain a positive outlook on life, despite the trials that have befallen your shoulders. This is important, because caring for patients after a stroke takes a lot of time and effort, you become dependent on them, you can rarely take time for yourself.