I know that the journey you and your loved one are on can be challenging, especially when facing a terminal illness. As an experienced hospice nurse caring for terminally ill patients, I want to provide you with some valuable insights on a common issue that may arise during this time: contractures.
What Are Contractures?
Contractures are when some parts of your body get stiff and hard to move. This can happen to your muscles, which help you move your arms and legs, or your tendons and joints, which connect your bones together. Sometimes, people who are extremely sick or injured must stay in bed for a long time, or they cannot move some parts of their body very well. This can make their muscles, tendons, and joints shrink and tighten, and they may feel pain or discomfort. Contractures can make it hard for people to do everyday things, like getting dressed, eating, or playing. That is why it is important to take loving care of your body and keep it active and flexible.
Recognizing Contractures
Contractures are not always easy to notice at first, but they can get worse over time. That is why it is important to pay attention to how your loved one moves and feels. Here are some signs that may indicate that they have contractures:
Limited Range of Motion: This means that they cannot move their body parts as much as they used to. For example, they may have trouble lifting their arm above their head, bending their knee, or opening their hand.
Stiffness and Tightness: This means that their muscles feel hard and tense when they try to move them. They may need more help or force to move their body parts.
Joint Deformities: This means that their joints look different or out of shape. For example, their fingers or toes may curl up or bend sideways.
Pain and Discomfort: This means that they feel sore or hurt in the areas where they have contractures. They may also feel more tired or restless because of the pain.
If you notice any of these signs, you should talk to your doctor or nurse. They can help you find the best way to treat and prevent contractures. They can also give you some tips and exercises to keep your loved one’s body healthy and comfortable.
Managing Contractures: Tips for Families
Contractures can make life harder for your loved one and for you. But there are some things you can do to help them feel better and prevent contractures from getting worse. Here are some tips for families:
Regular Position Changes: Try to help your loved one move around as much as they can. If they must stay in bed, help them change their position every two hours or so. This can prevent too much pressure on one part of their body, which can cause sores and pain.
Gentle Range of Motion Exercises: Ask the hospice care team to show you some simple exercises that you can do with your loved one every day. These exercises can help keep their muscles and joints flexible and strong. They can also improve blood flow and reduce swelling.
Warm Compresses: You can use a warm towel or a heating pad to gently apply heat to the areas where your loved one has contractures. This can help relax their muscles and ease their discomfort. But be careful not to make it too hot or leave it on for too long, as this can burn their skin or cause more damage.
Massage and Moisturize: You can also use your hands to gently massage your loved one’s muscles with some lotion or oil. This can help relieve their tension and keep their skin soft and moist. But avoid rubbing too hard or over the areas where they have sores or wounds, as this can hurt them or cause infection.
Supportive Devices: Sometimes, the hospice team may suggest using some devices to help your loved one’s joints stay in the right position. These devices are called splints or braces, and they can be made of plastic, metal, or foam. They can help prevent your loved one’s fingers, toes, wrists, or ankles from bending or twisting in a way that can cause more pain or deformity.
Pain Management: Contractures can be very painful for your loved one, and pain can make contractures worse. That is why it is important to make sure that your loved one’s pain is well controlled with the medicines that the hospice team prescribes. You should follow the instructions carefully and give your loved one the right dose at the right time. You should also tell the hospice team if the pain gets worse or if the medicines cause any side effects.
These are some of the ways you can help your loved one manage contractures. Remember that you are not alone in this journey. The hospice team is always there to support you and your loved one. They can answer your questions, give you more advice, and provide you with the resources you need. You can also reach out to other families who are going through the same situation. Together, you can make the best of each day and cherish the moments you have with your loved one.
How Nurses Can Assist in Managing Contractures
As nurses, we have a vital role in helping our patients and their families cope with contractures. Contractures are when some parts of the body get stiff and hard to move. They can happen when people are extremely sick or hurt and cannot move their body parts very well. Contractures can make it hard for people to do everyday things, like getting dressed, eating, or playing. They can also cause pain and discomfort. Here are some ways we can help:
Assessment and Education: We should check our patients regularly for any signs of contractures, such as limited movement, stiffness, deformity, or pain. We should also teach the families what to look for and how to prevent and treat contractures at home. We can give them some brochures, videos, or websites that explain contractures in a straightforward way.
Collaboration with the Care Team: We should work together with the physical therapists and occupational therapists who are experts in helping people with contractures. They can make a care plan that suits each patient’s needs and goals. They can also teach us and the families some exercises and positions that can keep the muscles and joints flexible and strong.
Provide Emotional Support: We should be kind and supportive to our patients and their families. We should listen to their feelings and worries and comfort them. We should also praise them for their efforts and achievements and encourage them to keep trying. We should remind them that they are not alone and that we are here to help them.
Pain Management: We should make sure that our patients’ pain is well controlled with the medicines that the hospice team prescribes. We should follow the instructions carefully and give the patients the right dose at the right time. We should also watch for any side effects or changes in the pain level and report them to the hospice team.
Patient Advocacy: We should speak up for our patients and their families and ask for any devices or resources that can help them with contractures. These devices are called splints or braces, and they can help keep the joints in the right position. They can also prevent more pain or deformity. We should also help the families find any financial or emotional support that they may need.
These are some of the ways we can assist our patients and their families with contractures. We should always remember that we are not just caring for their bodies, but also for their minds and hearts. We should treat them with respect and dignity and help them live the best life they can.
Conclusion
Recognizing and managing contractures in a terminally ill loved one is essential for maintaining their comfort and quality of life during the final stages of their journey. As a family member, your support and understanding are vital. And to my fellow nurses, let us continue to provide the best care possible to our patients and their families during this challenging time.
If you have any questions or need further guidance, don’t hesitate to reach out to the hospice care team. We are here for you every step of the way.
