Caring for the ears, eyes, nose and mouth

Contents Nose care

Ear care

Eye care

Oral care

What not to do

If you are caring for a weakened or immobile person, remember the rules of hygiene and special body care. Together with experts, we have prepared a guide on how to care for a person’s face and recommendations for procedures.

Things to remember:

Eyes. It is important to prevent purulent diseases.
Ears. It is important to prevent the appearance of wax plugs. They reduce hearing and create the sensation of tinnitus.
Nose. It is important to clear your nose of mucus and crusts. They make breathing difficult and cause discomfort.
Mouth. It is important to reduce the risks of developing stomatitis and ulcers. Proper care regulates salivation to moisturize the oral mucosa.

Important: Always warn the person about all your actions and manipulations. Even if he is sleeping or unconscious, and, as it seems to you, does not hear or understand you.

Nose care

Carry out the procedure daily and as needed.

You will need:

Cotton swabs or turundas made from gauze napkins. Sterile turundas can be purchased at the pharmacy or made from clean cotton pads: take half a cotton pad and wrap it around the end of a toothpick, then remove the toothpick and further tighten the turunda by twisting it.
Vaseline oil (or olive/baby moisturizing oil),
Towel or diaper.

Wash your hands and put on gloves.
Put an apron on the patient.
Soak a cotton swab (turunda) in a bottle of Vaseline oil. The stick (turunda) should be moistened evenly and moderately so that the oil does not drip from it.
Take the stick or turunda in your right hand. With your left hand, lift the tip of the patient’s nose and gently, with rotational movements, insert the stick (turunda) into the nostril.
If a sick person has dry crusts in the nose, hold the stick (turunda) for 1-2 minutes to soften them.
Remove the cotton swab using a rotating motion.
Take a clean stick (turunda), soak it in a bottle of Vaseline oil and repeat the procedure until the crusts are completely removed.
Treat the other nasal passage in the same way.

Important Do not insert a turunda or a cotton swab deep into the nasal passage - this can cause pain and damage the nasal mucosa or thin septum.

Ear care

You will need:

Boiled water at room temperature.
Water container.
Cotton pad (turundas or gauze pads).
Towel or diaper.
Absorbent diaper (if the person cannot sit).

Carry out the procedure 1-2 times a week, and also as the ears become dirty.

Wash your hands.
Place a towel or diaper on the patient's chest. If a person cannot sit, place an absorbent napkin (diaper) under his head.
Soak a cotton pad (turunda or gauze) in water and squeeze.
Using two fingers, gently pull back on the top of your ear to straighten your ear canal.
Gently wipe the pinna and area behind the ears.
Repeat the treatment 4-5 times, changing cotton pads (turundas, gauze napkins).
Treat the other ear in the same way.

Important

Do not clean the external auditory canal with sharp objects or cotton swabs - they can damage the eardrum or the wall of the ear canal, and also cause infection.
If you think that a sick person has a wax plug, consult a doctor. Don't try to get rid of it yourself! Tinnitus can be a consequence of infection or taking medications.

Eye care

You will need:

Boiled water (or chamomile decoction) at room temperature.
Water container.
Gauze balls (or cotton pads).
Towel or diaper.

Carry out the procedure daily in the morning after the patient wakes up, since during sleep, secretions form in the eyes, which stick together the eyelashes. Dry crusts may appear on the eyelids that need to be removed.

Wash your hands.
Prepare a container with water or chamomile infusion.
Place a towel on the patient's chest.
Take a gauze ball or cotton pad and soak it in the solution and squeeze it out.
Wipe eyelashes and eyelids from the outer corner to the inner.
Repeat the treatment 4-5 times, changing balls (cotton pads).
Blot the remaining solution on your eyes with a dry ball (cotton pad).
Treat the other eye in the same way.

Sometimes the patient's blinking process slows down, so the mucous membrane of the eye may dry out. To avoid this, you can use moisturizing drops (“Artificial tears”)—1-2 drops in the corner of the eye every 2 hours. Consult your physician before use.

Important

Do not wipe both eyes with the same gauze ball or cotton pad - you can spread the infection from one eye to the other.
Do not use cotton wool as it will leave lint on your eyelashes.
Do not wipe your eyes with a solution of hydrogen peroxide instead of water or chamomile infusion. If it comes into contact with the eyes, it may cause pain and irritation.

Oral care

Carry out the procedure daily in the morning and evening, as well as after each meal and after bouts of vomiting. Severely ill people are at increased risk of oral infections and require ongoing care.

You will need:

Brush and spatula for the oral cavity (can be purchased at the pharmacy).
Gauze napkins.
Freshly squeezed lemon juice with glycerin (1:2).
Capacity.
Waterproof diaper or towel.
Hygienic lipstick.

You can replace the spatula, gauze pads and lemon juice with glycerin with special oral care sticks - sold at the pharmacy.

Skin care products for a sick person: how to choose? We help you understand the variety of foams, dry shampoos, creams and lotions for hygiene, including in special cases - with bedsores, an established stoma, urinary and fecal incontinence Evgeniya RezvanCar Care Workshop

Care

Important It is not necessary to turn a bedridden patient from one side to the other while brushing your teeth - the entire oral cavity can be treated in a position on its side.

Turn the patient on his side so that his face is on the edge of the pillow.
Place an absorbent diaper under his head and on his chest.
Place the container under your chin.
Soak your toothbrush in lemon juice and glycerin.
Ask to open your mouth slightly or carefully, without using force, do it yourself with the consent of the patient.
Using a “sweeping” motion from top to bottom, move along the person’s lower and upper jaws. Repeat several times for 30-40 seconds.
Wrap the spatula in gauze and soak it in lemon juice and glycerin.
Gently treat the inner surface of the cheeks, tongue, sublingual area, and hard palate. If there is plaque on the tongue, it must be cleaned with a soft brush or spatula with a gauze cloth.
Apply chapstick to the person's lips (optional).
If the person is conscious, let him brush his teeth with a brush and toothpaste himself, and you help him if necessary! If it is difficult for the patient to get to the bathroom, organize everything for this in bed, using an apron, a towel and a spitting container. It is important that a person maintains independence as long as possible.

Important

To prevent inflammation of the oral mucosa (stomatitis), antiseptic solutions and sprays can be used. If the patient can rinse on his own, then in the form of a liquid; if not, in the form of a spray.
You can give a small piece of ice to dissolve 2-3 times a day. It will freshen your mouth.

What not to do

Do not carry out care without consulting a doctor if you have oral cancer. Sometimes, after chemotherapy, oval-shaped ulcers (aphthae) appear in the mouth. In this case, treating the oral cavity with a solution of lemon juice and glycerin is dangerous and painful.
Do not brush or toothpaste if the person is unable to get out of bed or sit up and has no way to rinse their mouth. In this case, use special sticks or a spatula with a gauze cloth.
Do not use a hard or medium-hard brush - this can damage your gums.

Important If a person wears dentures, it is important to take them out and carefully carry out oral hygiene to remove food debris and rinse the dentures themselves. Make sure they don't rub. If necessary, consult a specialist.

To make sure you do everything correctly, watch the webinars Peculiarities of caring for the mouth and nose in a seriously ill person and Peculiarities of caring for the eyes and ears of a seriously ill person.

And here you can download the memo so that it is always at hand

Participated in the creation of the material: E.N. Semenova, State Budgetary Healthcare Institution "Center for Palliative Care of the Department of Healthcare", E.A. Druzhinina, branch of the Tsaritsyno Hospice, Arif Ibragimov, State Budgetary Institution "Center for Palliative Care of the Department of Healthcare", State Budgetary Institution "NIIOZMM DZM".

The material was prepared with the participation of the “Caring Workshop”, a project of the Vera Hospice Charitable Foundation, using a grant from the President of the Russian Federation for the development of civil society provided by the Presidential Grants Foundation.

Flexible prostheses.

Removable dentures made of nylon or polyurethane are easy to remove from the mouth and clean by hand. The first thing to do is to rinse them with water (it is best to use boiled water), as this is the fastest, easiest and most effective way to remove food debris from dentures of this type; however, it is not sufficient for its complete comprehensive cleaning. The mechanical action of a soft toothbrush can achieve better cleaning of the denture, but it is necessary to use a special paste (flexible dentures are cleaned with a brush simultaneously with rinsing with water). Therefore, there are special solutions for flexible dentures. For some time (from 15–20 minutes to several hours), the prosthesis is immersed in a special antiseptic liquid. Solutions are sold ready-made or prepared by simply dissolving an antiseptic concentrate in water.

What types of mouth rinses can there be?

For self-hygiene, solutions with antibacterial, antiseptic, mineralizing, anti-inflammatory, and antifungal effects can be used. It is better to use a rinse selected by your dentist or hygienist, taking into account the condition of your teeth and gums.

Mineralizing. The basis of the solution is sodium fluoride or olafur. This is a mineral component that can penetrate the enamel structure and strengthen it. After rinsing, a protective film is formed on the surface of the teeth. It lasts for several hours, “saturating” the enamel with minerals. The use of such rinses reduces the risk of caries and reduces the sensitivity of enamel.

Antiseptic. The main component may be chlorhexidine, triclosan, or benzydamine in low concentrations. The solution destroys bacteria, protects against gum disease, slows down the formation of tartar, and improves the condition of gingivitis and some other diseases. After tooth extraction, rinsing with antiseptic solutions may be prescribed to reduce the risk of inflammation or dry socket formation. Rinse aids with an antiseptic effect are used as prescribed by the attending physician. They are usually used as part of complex therapy in the treatment of periodontitis, gingivitis and other inflammatory diseases. You cannot use them for too long: this is dangerous due to dysbacteriosis of the oral cavity, dry mucous membranes, and the appearance of halitosis.

Health-improving. They are made from extracts or decoctions of herbs, using essential oils. The effect is mild, supportive or preventive (not pronounced enough if treatment of existing diseases is needed). Such rinses can contain extracts of chamomile, myrrh, sage, eucalyptus, sea buckthorn, hawthorn, essential oil of geranium and other plants. Their effect is anti-inflammatory, restorative, restoring local immunity. Such products are used as a means of daily hygiene. Even with long-term use they do not cause side effects.

Alcohol based. They are classified as antiseptic, used as prescribed by a doctor, the ethanol content can be up to 27%. Effective for halitosis and inflammatory diseases of the oral cavity. They cannot be used by minors, people for whom alcohol is contraindicated, or drivers (after rinsing, the breath may contain alcohol vapor, and this is recorded during testing with a breathalyzer).

Some rinses are used as prescribed by a doctor for specific diseases or conditions. They may include:

diphenhydramine - for a local allergic reaction;
xylocaine or lidocaine - anesthetic effect (temporarily removes sensitivity);
nystatin, betamethasone, stomatidine - for aphthous stomatitis and other acute inflammations;
benzydamine is a pain reliever.

Putting drops into the nose

Warm the drops to room temperature;
Before use, the pipette is washed well and its sterile part is sterilized by boiling.
clean the nasal passages with a sterile cotton swab from mucus and crusts;
slightly tilt the child’s head back and turn it in the direction in which the medicine will be administered;
the palm of the left hand is placed on the forehead and the head is fixed, and the tip of the nose is raised with the thumb of the same hand;
trying not to touch the nasal mucosa with the pipette, inject 2-3 drops of the drug so that it gets on the mucous membrane of the outer wall;
leave the child's head in the same position for 1-2 minutes to evenly distribute the drug over the mucous membrane;
then, following the same rules, drops are instilled into the other half of the nose.