Clinically reviewed by What is bedridden patient care
When a person is confined to bed for weeks or longer, most of the harm that follows no longer comes from the illness that put them there. It comes from not moving.
Lying still causes pressure sores, joints that stiffen and fix, chest infection, clots in the leg veins, constipation and muscle wasting, often within weeks. In Urdu families call it bistar par para mariz.
Almost all of it is preventable with daily work done by the family. The physiotherapist's job is to teach that work, correct it, and keep pushing towards sitting, standing and moving where possible.
Symptoms you might have
- Redness over the tailbone, hips, heels or elbows that does not fade in twenty minutes
- Joints harder to straighten, a hand that stays clenched, or a foot that will not come up to a right angle
- Rattling or wet sounding breathing, a weak cough, or faster breathing
- One calf that is swollen, warmer and painful compared with the other
- Passing much less urine, or no bowel movement for several days
- Eating very little, losing weight, or coughing while drinking water
- Becoming withdrawn, confused or drowsy
Why it happens
- After a stroke, the commonest reason in adults
- A hip fracture, especially where surgery was delayed
- Advanced Parkinson's disease, dementia, or severe arthritis
- Spinal cord injury or paralysis from any cause
- A long hospital stay or severe illness, where strength was never rebuilt
- Fear after a fall, which keeps people in bed long after the body could manage a chair
- The family doing everything out of love, so a person who could still sit and stand stops doing either. This is the commonest avoidable reason of all
When you should see a physiotherapist
Ask for physiotherapy as early as the doctor allows, often in the first week, while the person is still in bed. The first few weeks decide how much stiffness and how many sores you face six months later. Dr. Zahra sees these patients at home.
Call a doctor the same day for: a fever; a bed sore that is open, smells, has pus, or has red hot skin spreading around it; sudden breathlessness or faster breathing; one calf that is swollen, hot and painful; sudden confusion or drowsiness; choking on food or water; or no urine passed for many hours. Go to hospital immediately for any sudden weakness, a new drooping face, or a sudden change in speech.
Al-Shama Physiotherapy Clinic
Ask about an appointment
اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
Fill this in and WhatsApp will open with your details ready to send.
یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Physiotherapy here is mostly teaching, because the family handles the patient the other twenty three hours. Six things are done daily.
- Positioning and turning: a change of position every two hours day and night, side lying at about thirty degrees, a pillow between the knees and one under the calves so the heels touch nothing
- Passive movement of every joint, ten slow repetitions once or twice a day, to the comfortable end of range. This prevents contractures, far easier to prevent than treat
- Chest physiotherapy: deep breathing, supported coughing, draining positions and percussion. Chest infection is the biggest avoidable danger when lying flat
- Pressure sore prevention: twice daily skin checks at every bony point, skin clean and dry, no rubbing of red areas. See the bed sores page
- Positioning splints to keep the hand open and the ankle at a right angle, preventing the clawed hand and dropped foot
- Sitting, transfers and standing practice, plus safe handling training so the carers are not injured
There is no operation for being bedridden. The aim is sitting, then standing, then moving, and preventing complications meanwhile.
Exercises, and what to avoid
What helps
- Turning every two hours with a chart on the wall and the time written down
- Moving every joint through its full comfortable range, slowly, once or twice a day
- Five to ten slow deep breaths every hour while awake, and sitting upright for meals
- Ankle pumps several times daily, and getting the person into a chair when allowed
What to avoid
- Pulling on a weak arm, or lifting under the armpits. This is the commonest cause of lasting shoulder damage
- Dragging the body up the bed across the sheet. That shearing is how pressure sores begin
- Forcing a stiff joint hard or fast, or letting the hand stay clenched
- Lifting alone a person heavier than you. Wait for a second pair of hands
What you can do at home
Protect your own back. Raise the bed to your hip height if you can, or kneel on the bed instead of bending over it. Feet apart, knees bent, back straight, turn with your feet.
Roll, do not lift. Bend the knees with the feet flat, cross the arms over the chest, then turn shoulders and hips together. To move them up the bed, use a folded bedsheet as a draw sheet with two people.
Keep the chest clear. Sit the person up as often as they tolerate, keep fluids going, and never lie them flat straight after food. If they cough on water, stop water by mouth and tell the doctor.
Protein at every meal, water through the day, and fibre. Keep a chart of turning times, food, urine and bowels, and temperature.
How long it takes
It depends on the cause. After an illness or a hip fracture, many people are sitting out of bed within days and walking with an aid in four to eight weeks of daily work.
After a stroke or a spinal cord injury, most neurological recovery happens over three to six months and continues more slowly to twelve or eighteen months. See the stroke rehabilitation and paralysis pages.
Some people will not walk again, and we will say so rather than let a family exhaust itself. The goals then are real: sitting out of bed, clean skin, a clear chest, joints that move, comfort and dignity.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
بستر پر پڑے مریض کو نقصان بیماری سے نہیں، نہ ہلنے سے ہوتا ہے۔ بستر پر زخم، جوڑوں کا اکڑ جانا، اور سینے کا انفیکشن روزانہ کی محنت سے رک سکتے ہیں۔
چار کام روز کرنے ہیں۔ ایک: ہر دو گھنٹے کروٹ بدلنا، رات کو بھی۔ دو: ہر جوڑ کو دس بار پوری حرکت دیں، ہاتھ کو مشت بند ہونے نہ دیں۔
تین: گہری سانسیں، ہر گھنٹے پانچ سے دس بار، اور کھانا کھلاتے وقت مریض کو سیدھا بٹھا کر رکھیں۔ چار: مریض کو گھسیٹیں نہیں، چادر نیچے ڈال کر دو لوگ مل کر کروٹ دیں۔
بخار، کھلا یا بدبودار زخم، اچانک سانس کی تکلیف، اچانک الجھن، یا بولنے میں تبدیلی ہو تو اسی دن ڈاکٹر کو دکھائیں۔
Roman Urdu
Bistar par pare mariz ko nuqsan bimari se nahi, na hilne se hota hai. Bistar par zakham, joron ka akar jana, aur seene ka infection rozana ki mehnat se ruk sakte hain.
Char kaam roz karne hain. Ek: har do ghante karwat badalna, raat ko bhi. Do: har jor ko das bar poori harkat den, haath ko musht band hone na den.
Teen: gehri saansen, har ghante paanch se das bar, aur khana khilate waqt mariz ko seedha bitha kar rakhen. Char: mariz ko ghaseeten nahi, chadar neeche daal kar do log mil kar karwat den.
Bukhar, khula ya badbudar zakham, achanak saans ki takleef, achanak confusion, ya bolne mein tabdeeli ho to usi din doctor ko dikhayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
How often should a bedridden patient be turned?
How do I move a heavy patient without hurting my back?
Why do bedridden patients get chest infection?
How do I stop the hands and feet going stiff?
When should I call the doctor for a bedridden patient?
Do you come to the house to train the family?
Related conditions
- Parkinson's disease physiotherapy
- Osteoporosis and weak bones
- Bed sores, prevention and care
- Balance problems in older people
- Falls and fall prevention