Becoming Bedridden and Being Bedridden: Implications for Nursing and Care for Older People in Long-Term Care: A Scoping Review

Abstract

Background

An increasing number of individuals aged 60 and older will rely on healthcare services, particularly due to increased physical limitations and mobility restrictions. This implies an increase in permanently immobile, often bedridden people who require targeted care. Mobility impairments progress gradually, leading to loss of autonomy and self-care skills, physical decline, functional deterioration, disability, etc. This review synthesises research findings on the implications of becoming and being bedridden for nursing care of older people in long-term care.

Objectives

The aim of this scoping review was to explore the current state of research on the topic of bedriddenness in older people in the context of long-term care and to identify research gaps.

Methods

We analysed English and German language peer-reviewed publications from the electronic databases MEDLINE (PubMed), CINAHL, LIVIO and Scopus. Publications from 1998 to 2023 were included if they addressed ‘bedriddenness’, the ‘process of becoming bedridden’, ‘prevention’ and the ‘consequences of bedriddenness’, and the ‘care of bedridden people’. The PRISMA-ScR guidelines were used.

Results

We identified 250 publications based on the defined inclusion criteria. We included 47 in detail condensing their content and organising them according to developed categories, bedriddenness and its prevention, development, consequences and care, which were the subject of intensive research. Although researchers have focused on risk factors for the development of immobility and its negative consequences for those affected, they paid little attention to self-determination and the organisation of life in bed, which enables those affected to participate. Different ideas regarding the term ‘bedriddenness’ indicate the need for a consensus definition.

Conclusion

Our review shows that articles strongly focus on the process of becoming bedridden. Many publications examine bedridden people's care by emphasising the perspective of (informal) caregivers and the challenges they face. The perspective of bedridden people, together with the consideration of psychosocial dimensions of bedriddenness and the promotion of opportunities for participation, should be focused on in further research. Appropriate concepts for training and nursing practice would be helpful.

Implications for Practice

Bedriddenness is a phenomenon that mainly affects older people, particularly those living in nursing homes. Concepts should be developed that reflect the reality of bedridden people's lives. Targeted interventions to improve the mobility of people with severe mobility impairments are important. Therefore, it is essential to establish educational modules for (informal) caregivers that consider mobility and rehabilitative practices as an integral part of care.