Sunday, 20 December 2015

Elderly and dependent ~ get that bed comfortable!

When my mother, Ellen, moved to the rest home where she now resides bedding was provided as expected, but seemed a rather odd and random selection.  The bedcover was pink, not her colour at all, and I wondered if she was warm enough.  This was the start of a bedding overhaul that took place over a number of months, and looking back I wonder how it took me so long to realise certain things and make the necessary improvements.

In common with many elderly people Ellen's sleep pattern has been fitful and poor.  Despite being weary and in need of sleep she is often awake in the night and restless, so it is vital that her bed is as comfortable as possible.   

Fortunately she already had her own pillows, but a lot else was needed.

I started out by buying a pretty and reasonably priced duvet cover and pillow slip and put her own duvet in it, which was an immediate improvement not only to her comfort but also to the look of her room which is both bedroom and sitting room.  

I asked Ellen whether the mattress was comfortable enough, and she remarked that is was rather hard.  Oh dear!  My first attempt to remedy this was to bring in her woolrest underlay, which has a soft woollen pile formed from tufts of wool anchored in a thick knitted backing fabric.  That was an improvement, but not sufficient. 

Off I went to Para Rubber in South Dunedin where I asked their advice about foam underlaysThey sold me this good quality 'convoluted' one which I see they call an 'overlay'.  It cost over $100 but proved to be well worth it. 

Convoluted mattress 'overlay' by Para Rubber

I brought it home and unpacked it so that I could leave it to air out of doors on a warm sunny day before taking it in to the rest home.  Once this was done I took it in, stripped off all the bedding, placed it on top of the mattress, covered it with the woolrest and made up the bed as usual.  It made a big difference: the day after I asked Ellen how she had slept, and she responded "I slept like a log".  That didn't continue, but shows what a physical relief it was to have sufficient cushioning on top of that very firm mattress.

I bought a pretty corn-coloured bedspread which I thought would brighten up the room, but found that it was put away in the cupboard having been deemed an unecessary extra. 

I decided to put it to a different use, and when another member of the family produced a good quality sheet she had no use for and which combined well with it I set to work to make a duvet cover and pillow slip set.  It worked out well and is now a favourite:

I used the contrasting sheet for the reverse side of the duvet cover and pillow slips and from it formed a turnback edge on the upper edge of the duvet cover, where I know from experience the most wear occurs.  The pillow slips can be used with either side uppermost, with the corn-coloured side being perhaps more suitable for during the day when the bedroom is effectively also a sitting room.  Here they are with the top one reversed:

A soft mohair blanket was sought out for prettiness and light snuggly comfort.  After trawling the internet I discovered that Masterweave's Windermere range is the one to look for in New Zealand and that Arthur Barnett's (now trading as H and J Smith) was a stockist.  I chose a beautiful blue one for Ellen, but did admire the soft browns and cream of this alpaca throw

This was all satisfactory and added greatly to Ellen's comfort and the elegance of her room.  However, I still hadn't got her a nice set of sheets.  All the ones that had been in use when she was living in her own home were decidedly worn so no longer suitable.  The ones provided by the rest home were okay but not as nice as I wanted her to have.  One day when I was going through piles of old bed linen from Ellen's house one of my sisters happened to mention that Ellen had preferred flanelette sheets.  I was pleased to know this as Ellen hadn't thought to mention it, and I hadn't thought to ask.

For those who haven't come across flannelette fabric it is pure cotton and a little fluffy from being brushed, or at least it is when new.  Sheets are cosy and comfortable and I wondered why I hadn't thought of this before.  In these days of cut-price cheaply made imported goods flannelette, like everything else, comes in all different grades and it's very hard to know which ones are any good, but the labelling should give clues as to thread counts, and when closely examined it may be possible to see whether the fabric is reasonably closely woven and firm.  Lighter, softer and more loosely woven flannelette is unlikely to last as long; and the pile of poorly woven fabric 'pills' (rub into tiny balls) very rapidly.  I managed to find some that looked satisfactory at Farmers and bought two pairs, which proved to be good and have been in use ever since.  They are just as comfortable in summer as in winter and indeed can be just the thing when the weather is so hot that one throws off other bedding.  Annoyingly these are commonly regarded as winter bed linen so are not likely to be stocked by many shops at other times of the year.  

Every item of personally owned bedding has to be name labelled, just like everything else.  Even so it's very easy for these to be mislaid in the rest home's big laundry so it helps if they are distinctive or if staff know to put them through with other personal washing.

One other bedding item needs to be mentioned: just as in hospitals, rest homes commonly put waterproof drawsheets on the bed of anyone who might have an incontinence problem.  Some of these can be uncomforable.  With two good sets of sheets available there is no reason at all for a drawsheet to be placed on top of the bottom sheet - it can go underneath it.  It is very surprising to have to explain this to staff, but may be necessary.  The comfort of the resident is what's important.

When Ellen was hospitalised a few months ago I was once more confronted by the uncomfortable bed situation in which there was a very hard utilitarian mattress and a complete absence of comfort in other bedding.  Now alert to these matters I noticed this the first day she was there and wondered how I could remedy the situation.  

After careful thought I brought in a double-sized duvet lined with a thick layer of dacron, and asked the help of the nurse on duty to help me put it on underneath the bottom sheet folded double.  We carefully rolled Ellen from one side to the other so that we could do this without getting her out of bed.  I had also brought in her special mohair blanket.  This was an immediate improvement.  She was having a terrible ordeal with her illness and every small degree of comfort helped.  She asked for her special yellow duvet and pillows to be brought in as well.  I checked with the doctor that this would be okay, and he heartily endorsed the suggestion.  The doctor said that the familiarity of her own bedding would provide much needed reassurance during her ordeal and so would be helpful to her.  As I expected to be there a lot during her stay there I wasn't unduly concerned that anything would go missing.  All items were of course already name labelled.    

Two other items were to be very much needed during Ellen's stay in hospital: these were eye shades and ear plugs.  The barrage of the noise and glare of hospital wards is an ordeal in itself.  At one stage Ellen, who was upset and confused as well as ill, said to me "Can you turn those people down?", meaning that the volumn at which visitors of the woman in the bed opposite were talking amongst themselves was too much for her.  I went to find a nurse to ask if ear plugs could be provided.  They were.  Eye shades and ear plugs vary, so a set that are known to suit the individual are a "must have" for anyone going into hospital. 

In conclusion: I found it was necessary to revise everything to do with Ellen's bed and bedding, and in doing so to ask her questions, repeatedly over time in fact, to establish exactly what was and was not comfortable about her bed, what was working and what was not, and to find out what her preferences really are.

The need to ask questions, to be imaginative about what is needed, and to take time working out which solutions work best have been strong themes in my mother's care, along with the need to advocate on her behalf.  Like many other frail elderly people she does not necessarily articulate what's important to her, and without spending quiet time simply being with her over a lengthy period I wouldn't have known or even guessed many of the things I now know.  I've had to observe and listen and use my imagination in unexpected ways.

Patient, quiet and undemanding attentiveness can bring a rich harvest.  This exactly describes what my mother gave to me when I was growing up, which I took for granted and didn't really notice.  I realise this in a special way now that I am giving this back to her.  Through my own understanding the circle becomes complete.  I hope I can do my share in passing this on.

But understanding is of little value unless it leads to action, so I encourage you too, to get that bed comfortable, and may we all sleep well!

My other articles in the "Elderly and dependent" series can be found via the link below:

    No comments: