What is the difference between being bedfast, bedbound, and bedridden (immobile due to illness or disability)?

From the Guidelines

Bedfast, bedbound, and bedridden are distinct terms that describe a person's level of confinement to bed due to illness or disability, with implications for care planning and outcomes. The terms have subtle differences in usage and implication, with bedfast typically referring to temporary confinement during an acute illness or recovery period, bedbound indicating a more serious condition requiring significant assistance, and bedridden suggesting long-term or chronic confinement due to severe illness, disability, or advanced age 1.

Key Differences and Implications

• Bedfast: temporary confinement with an expectation of eventual mobility
• Bedbound: more serious condition requiring significant assistance due to severe physical limitations or medical conditions
• Bedridden: long-term or chronic confinement due to severe illness, disability, or advanced age These distinctions are crucial in healthcare settings as they inform care planning for issues like pressure ulcers, muscle atrophy, and psychological well-being, ultimately impacting morbidity, mortality, and quality of life 1.

Care Planning and Recommendations

Given the potential for prolonged bed rest to lead to deconditioning and related complications, early mobilization and physical activity are recommended as safe and feasible interventions to reduce the risk of further complications and improve functional recovery 1. Regular repositioning, skin care, range-of-motion exercises, and attention to nutrition and hydration are essential components of care for individuals who are bedfast, bedbound, or bedridden. Furthermore, individualized exercise prescriptions during hospitalization can help prevent functional decline and improve outcomes in older adults 1.

Prioritizing Morbidity, Mortality, and Quality of Life

In prioritizing morbidity, mortality, and quality of life, it is essential to consider the potential risks and benefits of mobilization and physical activity in individuals who are bedfast, bedbound, or bedridden. The risk of moving a critically ill patient should be weighed against the risks entailed by immobility and recumbency 1. By adopting a proactive approach to mobilization and care planning, healthcare providers can help mitigate the adverse effects of prolonged bed rest and improve outcomes for individuals with varying levels of confinement to bed.

From the Research

Definitions and Differences

• The terms "bedfast", "bedbound", and "bedridden" are often used interchangeably, but they can have slightly different meanings 2.
• "Bedfast" typically refers to a person who is confined to bed due to illness or disability, but may still have some mobility and ability to perform daily activities with assistance 2.
• "Bedbound" refers to a person who is unable to leave their bed and requires assistance with all daily activities, but may still have some ability to move or reposition themselves 3, 4.
• "Bedridden" typically refers to a person who is completely immobile and unable to leave their bed, often due to severe illness or disability, and requires full-time care and assistance with all daily activities 5, 2.

Implications for Care

• Bedridden patients require targeted care and attention to prevent complications such as pressure ulcers, deep vein thrombosis, and pneumonia 3, 6.
• Regular repositioning and turning of bedridden patients is essential to prevent pressure ulcers and promote skin integrity 3.
• Early ambulation and mobilization can help prevent complications and improve outcomes for patients with acute deep vein thrombosis 6.
• Bedridden patients may experience a range of physical and psychosocial challenges, including loss of autonomy, self-care skills, and physical decline, which can impact their quality of life and require specialized care and support 2.

Research Gaps and Future Directions

• There is a need for further research on the prevention and management of bedriddenness, particularly in older adults and those with severe mobility impairments 2.
• The development of targeted interventions and educational modules for caregivers can help improve the mobility and rehabilitative practices of bedridden patients 2.
• Further study is needed to explore the psychosocial dimensions of bedriddenness and promote opportunities for participation and self-determination among bedridden individuals 2.