7 Challenges of Caring for Patients Who Are Locked in a Paralyzed Body
Paralysis is a loss of function, sensation, and control of a body part. It is often the result of stroke, spinal cord injury, or multiple sclerosis, a disabling disease of the nerves.
Just how common is paralysis? The answer might shock you.
The latest study done by the Christopher & Dana Reeve Foundation revealed that about 1 in 50 Americans experience a form of paralysis. That’s about 5.4 million people in the US, or the populations of Los Angeles and Dallas combined!
Given this number, a lot of people find themselves caring for those who struggle with loss of function of a body part.
Paralysis can be either complete, with the total inability to move or feel in a body part, or incomplete, where there is some movement or sensation. It can affect the face, one arm or leg, both legs, the left or right side of the body, or from the neck down, depending on which part of the brain or spinal cord is injured or diseased. A person with quadriplegia, or loss of function of the arms, legs, and torso, will be more dependent than a person with only the legs affected, for example.
For caregivers, caring for a paralyzed patient can be taxing physically as well as mentally. Brace yourself for these challenges in patient care:
1. Lifting and Turning
Essentially, you are an extension of a patient’s parts of the body that have lost function. So, if they need to get out of bed, you will need the physical strength to lift and turn your patient. You must also know how to safely move the patient. Remember to use proper body mechanics to prevent pulled muscles and spinal cord injuries. Use lifters, turning sheets, supports, and other assistive devices so that you do not bear the patient's full weight.
2. Activities of Daily Living
Depending on the patient’s unaffected bodily functions, they will need varying levels of care daily.
For a quadriplegic patient, you will do most things for them, like transferring from the bed to the bathroom. You will start their bath and test water temperature because, other than loss of movement, they will most likely have little to no feeling in the affected body parts. Getting another companion to help give your patient a full bath is a good idea.
You will also need to help them eat, get ready for bed, and tend to grooming and hygiene needs. It may sound like a lot of work, but you will be rewarded with seeing your patient’s mental and physical health improve each day.
For those who are somewhat independent, for example, those who use a wheelchair and have their upper body functions intact, your role could be to simply prepare bath supplies and a change of clothes. You may also need to wash body parts they cannot reach.
3. Incontinence
Some patients with paralysis have bowel and bladder incontinence. When the nerves that control urination and bowel movement are also affected, the patient will have incontinence. The challenge is making sure that they stay clean and dry at all times.
You can support your patient by helping them use incontinence pads and washing and patting dry their genital areas after every soiling.
4. Meal Preparation
If you are a caregiver for a patient in their home, you might also need to prepare meals for them. If the patient has no trouble swallowing or is not constipated, prepare and serve a balanced diet that consists largely of fruits and vegetables.
If the patient has difficulty swallowing due to paralysis from the neck down, prepare thick and mashed foods, and give thicker liquids. You may use commercial food and liquid thickeners. For patients with constipation problems, prepare fiber-rich options. Always follow diet recommendations.
5. Bed Sores Prevention
Immobility, poor circulation, and moist skin are the main factors that cause pressure sores to develop. Bony areas, such the hips, lower back, and shoulders, press against the skin for an extended period because the paralyzed part cannot move on its own.
If your patient’s incontinence pads are soaking their buttocks, this is a big factor for pressure sores, too. You might also be tempted to pull the patient when you move them in bed, but this is a big no-no because their skin rubs against the bedsheet. Loss of movement, limited blood flow, wet skin, and shearing forces are a perfect recipe for pressure sores.
Turn your patient every two hours and keep the skin (especially bony areas) clean and dry. Ensure proper nutrition and hydration and exercise the patient’s affected parts. These techniques are the best way prevent pressure sores.
6. Patient Exercise
Loss of movement causes muscles to weaken and lose their bulk. The skin also becomes prone to breakdown. So, the patient should exercise the body parts that can still move. The caregiver must also perform passive exercises on the patient (move the paralyzed body parts to improve circulation and prevent muscle loss).
7. Emotional Stress
Your patient is likely prone to emotional downturns, especially if they have difficulty adjusting to their situation. The pain of losing their passions and function to paralysis can be overwhelming to the patient.
The patient may project their anger and frustration onto you. This is a challenge to overcome. Do not take their hurtful words personally.
You may have your own struggle as well, seeing a formerly healthy person become a dependent patient. Whatever you do, be strong, genuinely kind, and compassionate.
Caregivers can expect significant challenges while caring for patients with paralysis. If you are a health aide or a family caregiver, caring for these patients is a constant worry but you can make it work (with the patient’s and the healthcare team's help). And if the challenges get to be too much, find ways to take a break for some needed rest!
