How to make a bed for a bedridden patient?

According to the Family Caregiver Alliance, there are over 40 million unpaid caregivers in the U.S., many of whom are caring for a bedridden loved one. Learning how to make a bed for a bedridden patient correctly is a fundamental skill for caregivers, ensuring both the patient's comfort and hygiene and the caregiver's safety.

Quick Summary

Safely changing a bed for a bedridden patient involves teamwork, proper technique, and specific tools like a draw sheet to minimize strain and skin irritation. The process is a careful sequence of rolling the patient, replacing linens in sections, and ensuring the new sheets are smooth and wrinkle-free to prevent pressure sores.

Key Points

• Two-Person Technique: Enlist help when possible to safely roll the patient and handle linens, minimizing strain for everyone involved.

• Use a Draw Sheet: This tool is essential for easily moving the patient up or side-to-side without causing friction or pulling their skin.

• Prioritize Wrinkle-Free Sheets: Smooth, tight sheets are critical for preventing pressure sores, a major health risk for bedridden individuals.

• Communicate with the Patient: Explain each step clearly and check on their comfort level to foster trust and cooperation.

• Prepare Your Supplies: Have all clean linens, gloves, and positioning aids within reach before starting to make the process quicker and smoother.

• Maintain Hygiene: Always wear gloves, wash hands thoroughly, and handle soiled linens carefully to prevent infection.

Preparing for the task

Before you begin changing the bed, proper preparation is essential for a smooth and safe process. Gathering all your supplies and preparing the environment will minimize disruptions and reduce the time the patient spends in an uncomfortable position. Always wash your hands and wear gloves, especially if the linens are soiled.

Supplies needed:

• Clean top sheet
• Clean fitted sheet
• Draw sheet or slide sheet (recommended)
• Clean pillowcases
• Laundry bag for soiled linens
• Waterproof pad (if used)
• Pillows for positioning
• Sanitizing wipes

Setting the stage

If using a hospital bed, raise the bed to a comfortable working height to prevent back strain. Ensure the wheels are locked. Communicate with the patient throughout the process, explaining each step to keep them informed and cooperative. A helper, if available, can make the task significantly easier and safer for both parties.

The step-by-step process for an occupied bed change

This method, often taught to professional caregivers, minimizes patient movement and strain.

Step 1: Loosen and prep the dirty linens

Start by loosening all the linen from the side of the bed furthest from the patient. Remove the pillows, placing them in a clean area, and change the pillowcases if needed. Cover the patient with a clean blanket to ensure modesty while you work.

Step 2: Roll the patient to one side

With the help of another person if possible, gently roll the patient to the side, facing away from you. Ensure they are secure and close to the bedrail (if present), or have your helper provide support. The rolled-up soiled linens should be snugly against their back.

Step 3: Remove old linens and place new ones

On the now-exposed side of the bed, roll the dirty fitted sheet and any pads tightly towards the patient. Unroll the clean fitted sheet onto the mattress, tucking it in firmly. Next, place the clean draw sheet or waterproof pad, tucking its rolled half under the dirty linens, leaving a clean surface for the patient to roll back onto.

Step 4: Roll the patient to the other side

With clear communication, roll the patient over the 'hump' of dirty and clean rolled linens towards the clean side of the bed. Move to the opposite side of the bed. The helper's role is crucial here to ensure a smooth transition.

Step 5: Complete the linen change

From this side, pull the dirty linen free and place it in the laundry bag. Pull the clean fitted sheet and draw sheet taut, smoothing out any wrinkles. Wrinkles can cause skin irritation and pressure sores. Tuck all linens in firmly, using hospital corners if desired for a secure fit.

Step 6: Finalize top linens and positioning

Roll the patient gently onto their back, centering them on the clean bed. Place the clean top sheet and blankets over them. Create a toe pleat by lifting the top covers over the patient's feet to relieve pressure. Fluff pillows and position them for comfort and support. Use additional pillows to support limbs and prevent pressure points, especially on the heels and ankles.

Tools and techniques for preventing pressure sores

Proper bed making is critical in preventing pressure ulcers, which are painful and difficult to heal. Wrinkle-free, smooth sheets reduce friction and shear forces on the skin. Repositioning the patient every two hours is vital for distributing pressure. Here's a comparison of tools that can assist caregivers.

Tool	Description	Benefit	Usage Tip
Draw Sheets	A small, flat sheet folded under the patient's hips and back.	Reduces friction when moving the patient.	Grab the sheet, not the patient, to pull or turn.
Slide Sheets	Specialized, low-friction fabric sheets.	Easiest method for repositioning with minimal effort.	Place under the patient, slide, and then remove.
Wedge Cushions	Foam wedges for propping the patient on their side.	Maintains a 30-degree tilted position, offloading pressure from the tailbone.	Place firmly against the patient's back for support.
Heel/Elbow Protectors	Soft, padded devices that fit over vulnerable areas.	Prevents pressure and friction on bony prominences.	Ensure a good fit that doesn't restrict circulation.
Pressure-Relief Mattress	Specialty mattress designed to distribute pressure evenly.	Most effective for high-risk patients.	Follow manufacturer's instructions for use and cleaning.

Important safety and hygiene considerations

Beyond the physical process, several best practices ensure patient safety and maintain a hygienic environment.

Patient positioning and comfort

• Regular checks: Always check the bed and patient's position after finishing to ensure there are no wrinkles and the patient is comfortable.
• Bed height: Always lower the bed to its lowest position after making it to reduce the risk of fall injuries. Ensure bed rails are up if the patient's care plan requires them.
• Post-change check-in: Briefly check on the patient shortly after the bed change to ensure their comfort and make any necessary adjustments.

Infection control

• Gloves: Always wear gloves, as soiled linens can harbor germs. Dispose of them properly after use.
• Laundry: Place soiled linens directly into a laundry bag to minimize the spread of bacteria. Do not shake dirty linens, as this disperses microorganisms into the air.
• Hand washing: Wash your hands thoroughly with soap and water after removing gloves and completing the task.

Conclusion: Comfort through diligence

Mastering how to make a bed for a bedridden patient is a crucial part of providing compassionate and competent care. By following a careful procedure, using the right tools, and focusing on safety and hygiene, caregivers can ensure the patient remains comfortable and healthy while minimizing the risk of injury for both parties. Consistent practice of these techniques makes the process routine, allowing for a higher quality of life for the patient and confidence for the caregiver. For more information on safe patient handling, refer to resources like the Agency for Healthcare Research and Quality's toolkit for safe patient handling AHRQ Safety Program for Long-Term Care: HaVing Your Back.

Frequently Asked Questions

How often should you change the sheets for a bedridden patient?

For basic hygiene and comfort, sheets should be changed at least once or twice per week. However, if linens become soiled, they should be changed immediately to prevent skin breakdown and infection.

Can one person make a bed for a bedridden patient alone?

While it is possible for one person to make an occupied bed, it is much safer and easier with two people. A second person can assist with rolling and stabilizing the patient, reducing the risk of injury for both the patient and caregiver.

What is a draw sheet and why is it important?

A draw sheet is a smaller sheet placed over the fitted sheet, extending from the patient's shoulders to their hips. It is used to move and reposition the patient by grabbing the sheet instead of pulling directly on their body, which significantly reduces skin friction and caregiver strain.

How do you prevent bedsores while making the bed?

To prevent bedsores, ensure the fitted sheet is completely smooth and free of wrinkles. Reposition the patient every two hours to relieve pressure on different areas. Using a draw sheet and providing supportive pillows can also help redistribute pressure.

How do you make hospital corners?

To make a hospital corner, tuck the overhanging side of the sheet under the mattress at the foot of the bed. Take the loose edge of the sheet about 16 inches from the corner and lift it onto the mattress, forming a 45-degree angle. Tuck the excess fabric hanging below the angle under the mattress, then fold the top fabric triangle down over the side of the mattress and tuck it in.

What should you do if the patient can't be rolled onto their side?

If a patient cannot be rolled, change the bed linens in sections from the top of the bed to the bottom. This method requires careful maneuvering and may be more time-consuming but can be done with a patient lying flat on their back. A slide sheet can also be used to assist with this method.

What kind of gloves should be used when changing linens?

Disposable, non-sterile gloves (e.g., latex or nitrile) should be used. This protects both the caregiver and the patient from exposure to germs and bodily fluids. Always wash hands after removing the gloves.