What to do when someone can't get out of bed?

According to research, prolonged bed rest can lead to complications such as muscle weakness and pressure ulcers. Knowing what to do when someone can't get out of bed is crucial for preventing these risks and ensuring the individual's safety, comfort, and dignity.

Quick Summary

Taking immediate action is vital, beginning with a careful assessment of the situation and looking for signs of a medical emergency, which requires immediate professional help. The next steps involve using proper techniques to safely assist the person, evaluating the underlying cause, and exploring long-term support options, including assistive devices and professional care services.

Key Points

• Assess for Emergency: The very first step is to check for signs of a medical emergency, such as severe pain, breathing difficulty, or confusion, and call 911 if necessary.

• Use Proper Transfer Techniques: Learn safe lifting methods or use assistive devices like a gait belt to prevent injury to both the person and the caregiver.

• Identify the Underlying Cause: Determine if the issue is physical (pain, weakness, medication side effects) or emotional (depression, fear of falling) to address the root problem effectively.

• Implement Assistive Devices: Utilize tools such as bed rails, trapeze bars, or specialty mattresses to increase independence and prevent complications like pressure sores.

• Prioritize Mental Well-Being: Combat loneliness and depression by creating routines, encouraging mental stimulation, and fostering social connections through visitors or technology.

• Consider Professional Care: Consult with physical therapists, occupational therapists, or in-home care services for expert guidance on mobility, safety, and daily care.

Immediate Assessment: Is It an Emergency?

When you find a loved one is unable to get out of bed, your first priority is to determine if it is a medical emergency. Assess the person's condition for these critical signs:

• Acute illness or injury: Has there been a fall, or does the person have a sudden, severe pain? Look for visible injuries, sudden changes in consciousness, or signs of a stroke (e.g., facial drooping, speech difficulty, arm weakness).
• Severe pain or fever: Is the person in severe distress or running a high fever? An uncontrollable temperature can be a sign of a serious infection.
• Difficulty breathing: Are they short of breath or gasping for air? This is a medical emergency that requires immediate intervention.
• Confusion or disorientation: Is the person confused about where they are or what's happening? This can indicate a serious health issue.

If any of these red flags are present, you must call emergency services immediately. Do not attempt to move the person yourself, as this could worsen the injury.

First Steps: Safe Assistance and Communication

If the situation is not an immediate emergency, you can take steps to help the person safely. Patience and calm communication are key.

1. Communicate clearly: Speak calmly and ask simple questions to understand what the person is feeling. Ask, "Are you in any pain?" and "What do you need?".
2. Assess the environment: Ensure the area is safe. Clear any obstacles from the path and have essential items like water, phone, and medication within easy reach.
3. Encourage small movements: Suggest simple, gentle movements to help improve circulation and reduce stiffness, such as wiggling toes or rotating ankles.
4. Use proper techniques: If you need to assist them to a sitting position, remember to lift with your legs, not your back. Support their shoulders and knees as you roll them onto their side. A gait belt can provide a more secure grip.
5. Reassure and comfort: Recognize the emotional toll this can take on a person. Offer reassurance and maintain their dignity throughout the process.

Underlying Causes of Immobility

Inability to get out of bed can stem from various physical and psychological factors. Understanding the root cause is essential for long-term management.

Physical Causes

• Weakness or fatigue: Often due to illness, recovery from surgery, or a side effect of medication.
• Pain: Chronic conditions like arthritis or back pain can make movement difficult and painful.
• Falls or injuries: An undetected fall can result in an injury that prevents movement.
• Medication side effects: Some medications can cause dizziness, drowsiness, or weakness.
• Conditions affecting mobility: Progressive neurological disorders, such as Parkinson's disease, can gradually impact a person's ability to move independently.

Mental and Emotional Causes

• Depression: This is a common cause of reduced motivation and energy, making it a struggle to face the day.
• Fear of falling: After a fall, a senior may develop a strong fear that prevents them from wanting to leave the safety of their bed.
• Dementia: Cognitive impairment can lead to confusion and resistance to care.
• Loneliness or boredom: Lack of social interaction and stimulation can lead to withdrawal and lethargy.

Long-Term Solutions and Assistive Devices

For a person with chronic or progressive immobility, implementing long-term solutions and assistive devices is vital.

• Assistive devices: Equipment like a trapeze bar, bed rails, or adjustable beds can dramatically increase a person's independence and safety. A trapeze bar allows an individual to use their upper body strength to reposition themselves in bed.
• Pressure relief: Long-term bed rest can lead to pressure sores. To prevent this, use pressure-relieving equipment such as foam or air mattresses, specialty cushions, and implement a schedule for regular repositioning.
• Mobility aids: Devices like walkers, canes, or transfer aids can help with transitions from bed to a wheelchair or chair.

Feature	Assistive Devices	Specialized Beds	Professional Caregivers
Functionality	Helps with self-transfer and repositioning	Adjusts position to improve comfort and reduce strain	Provides expert assistance and monitoring
Cost	Relatively low one-time cost for rails, bars	Higher initial investment or rental cost	Ongoing expense, variable based on needs
Independence Level	High, promotes self-sufficiency	Medium, reduces effort for movement	Low, relies on external assistance
Best for...	Individuals with some upper body strength	Those who need frequent repositioning or have severe mobility issues	Complex medical needs or complete immobility
Availability	Widely available online and at medical supply stores	Requires special ordering from medical suppliers	Available through home health agencies

The Role of Professional Healthcare

While home care is essential, professional healthcare is often necessary to ensure the individual receives the best possible support.

• Physical therapy: A physical therapist can create a personalized exercise plan to improve strength, flexibility, and balance.
• Occupational therapy: An occupational therapist can help adapt the person's environment to maximize independence and safety.
• In-home care services: In-home caregivers can provide assistance with daily tasks like bathing, dressing, and eating, as well as offer companionship.
• Nutritional support: A balanced diet is crucial for maintaining skin integrity and overall health. A doctor or nutritionist can offer guidance on dietary needs.

Prioritizing Mental and Emotional Health

Being bedridden can be mentally and emotionally draining. Addressing these concerns is just as important as physical care.

• Create a routine: A predictable schedule for meals, activities, and rest provides stability and purpose.
• Encourage engagement: Promote mental stimulation through activities like puzzles, audiobooks, music, or virtual visits with friends and family.
• Support social connections: Facilitate regular visits or video calls to combat loneliness and isolation.
• Seek professional help: If signs of depression or anxiety are present, consulting a mental health professional can be beneficial. Caregiver support groups are also available for those providing care.

For more resources on supporting the emotional well-being of bedridden individuals and their caregivers, visit the National Council on Aging's support resources.

Conclusion

Responding to a loved one who cannot get out of bed requires a compassionate, thoughtful, and multi-faceted approach. Starting with a calm assessment of the immediate situation is paramount, followed by proper assistance and a thorough investigation of the underlying causes, whether physical or mental. Implementing the right combination of long-term strategies—including assistive devices, professional care, and a strong focus on mental and emotional health—is essential for promoting safety, well-being, and dignity. By being proactive and leveraging the right resources, caregivers can significantly improve the quality of life for those they serve. It is a challenge that can be managed effectively with preparation, knowledge, and empathy.

Frequently Asked Questions

What are the immediate red flags that require calling 911?

You should call 911 immediately if the person exhibits signs of a medical emergency. These include sudden, severe pain; difficulty breathing; signs of a stroke (such as facial drooping, slurred speech, or weakness on one side); or sudden confusion or loss of consciousness.

How can I safely help a person sit up in bed?

Use proper body mechanics to protect both of you. Have the person bend their knees and place their arms across their chest. Support their shoulders and knees as you gently roll them onto their side. From there, you can help them swing their legs off the bed while using your legs to push their trunk up into a seated position.

What if the person is refusing to get out of bed?

Refusal to get out of bed can be linked to depression, pain, or fear. Remain calm and empathetic. Try to understand their feelings and avoid being forceful. Offer encouragement and suggest small, manageable tasks, and consult a doctor to explore the underlying emotional or physical reasons.

How can I prevent pressure sores in a bedridden person?

To prevent pressure sores, you should regularly reposition the person—at least every two hours. Use pressure-relieving equipment like specialty mattresses or cushions, and keep the skin clean and dry. Inspect the person's skin daily for any signs of redness.

What kind of exercises can a bedridden person do?

Even in bed, gentle exercises can be beneficial. Encourage simple movements like stretching hands and feet, lifting arms and legs, and rolling from side to side. A physical therapist can provide guidance on appropriate, safe exercises to maintain muscle tone.

What are some assistive devices that can help?

Several devices can assist with mobility and independence. A trapeze bar can help a person reposition themselves using their upper body strength. Bed rails can provide support for getting in and out of bed. An adjustable bed can also help with sitting up and changing positions.

How do I care for a bedridden person's emotional needs?

Prioritize their mental well-being by creating a routine, encouraging social interaction (in-person or virtual), and providing mental stimulation through activities like reading or puzzles. If you notice signs of depression or anxiety, consider seeking professional mental health support.