NURSING A CHRONIC DISEASE
Let us say, just for an example, that you must care for your father, whose severe arthritis will require him to stay in bed for six months or more. Naturally, you will need to follow some of the suggestions 1 have made regarding the care of sick children and adults. But your main problem will be finding additional ways to keep your patient from being injured physically and emotionally by his long stay in bed.
A good hospital or nurse will insist that bedsores need not occur, and that they can be cured. It is very much easier to prevent them than it is to cure them. Be sure that you:
See that your patient’s weight is distributed as evenly as possible instead of being entirely on the buttocks.
Keep the bed free from wrinkles; dispense with rubber sheets if you can—and you almost always can.
Move your patient frequently.
Keep the skin dry and clean; use a little alcohol as a rub after bathing, and some talcum; give alcohol rubs.
Use rolls, or ring or doughnut cushions, to keep the weight off vulnerable spots such as the hip and ankle bones, the minute you discover the skin is at all red. Let the air come in contact with such spots for a little while every few hours.
Do not ignore even the smallest sore. Get your doctor’s advice and follow his directions.
If the patient can do so, have him exercise his legs by bending his knees and flexing his toes. This frequent mild exercise will encourage normal circulation and help prevent blood clots from forming.
Be sure to keep the patient’s routine from becoming depressing by varying it with treats and small surprises. The patient who must stay in bed for a long time needs to do things, not only for his own entertainment, but in order to feel useful. Persuade him to do something helpful, such as a regular story-telling or reading period for the children, or assisting them with their homework, or peeling vegetables, or making something for Christmas presents. One of the best pieces of nursing care you can give a chronically ill patient is to make a place, however small, for him in the home life of the family.
Help from others
In most cases of illness, you can get some help if you need it—and you often do. You may need a district nurse for an hour every day or once a week, or an absolutely reliable sitter on certain occasions. Perhaps your patient would benefit by some of the services that various agencies offer, such as a visiting teacher or schoolwork by mail for a partially disabled or slowly convalescing child, or training in some art or craft for a bed-ridden adult. Find out what is available in your community through your doctor, clergyman, or social agency.
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