What is Bedrest Really Like?

Purpose:  Eliminating pressure is the cornerstone of most treatment programs for pressure ulcers.  A common prescription for treatment of ischial or coccyx pressure ulcers in sitting dependent patients is bedrest 24/7.  Most patients find it difficult to carry out this directive, and are labeled noncompliant by caregivers.

Objective:  To communicate to prescribers the rigors of bedrest through interviews with patients attempting to follow that directive.

Method:  Extensive interviews were done with 5 patients who were prescribed bedrest for pressure ulcers on the ischials or coccyx and who are insensate in the wound area.  Interviews were done during 24/7 bedrest, or within 3 weeks of ending bedrest and weaning onto a normal sitting schedule.  Interviews were done by the same interviewer from a prepared list of questions.  The general nature – but not the individual questions - of the interview was communicated to the participants ahead of the interview.

Results:  This qualitative study paints a picture of the lived experience of “bedrest”.  Common themes include feelings of isolation, despair, lethargy, and resignation.  Self-blame was found in statements such as - why did I let this go so long?  Lack of sensation in the area of the wound made bedrest even more difficult to accept, for example - If I could feel it, it would be easier. Appreciation for friends, family, and caregivers was often repeated.  Frustration at the slowness of wound healing, (it will never end) were also common.

Conclusion:  The small sample size hinders firm conclusions, but the consistency of the responses gives the viewer a picture of what most patients on bedrest are probably experiencing.  The viewer will have a greater appreciation for the seriousness of the bedrest prescription, and be less cavalier with the noncompliant label.