The Hygeine of the Comatose...

I was watching Kill Bill earlier today, and it brought to mind a question.

In the movie, Uma Thurman awakens from a 4-year coma. When she attempts to step out of bed, she falls to the floor because of the atrophy in her leg muscles. While she’s on the ground, you can clearly see that her legs are clean-shaven.

Now, I know that this is Hollywood, and not reality. And Ms. Thurman probably shaved her legs the day of the shoot, or sometime soon before.

But it made me wonder:

Do hospitals have someone who goes around to comatose females and routinely shaves their legs and armpits (this is more of an American question than a worldwide question…I know that some countries - and some American females, as well - don’t adhere to the same hygenic standards as Americans do)? What about trimming finger- and toe-nails? Cut their hair? Wash their hair? Is this supposed to be the responsibility of the hospital, or one of the patient’s family?

My mother is a nurse in a nursing home, and I’ve asked her these questions, but that seems more specific to geriatrics than a comatose patient, as some of her patients do have the ability to at least help in their grooming.

Just adding another related question… do comatose peope have any bowel movements? I know their urine is stored in a sack from a catheter typically.

I wasn’t aware of anything unhygienic about hairy legs and arm pits. Unwashed, certainly. But not hair in itself.

Perhaps you meant “adhering to the same female grooming standards”?

I’m afraid I don’t have an answer to the question, but besides being ‘just a movie’, in the case of “Kill Bill”, perhaps Buck took extra special care of Uma, keeping her shaved, as she was a source of income and entertainment for her.

Hooray! A question I can partially answer!

I don’t know about long term coma patients, but I’ve worked in a palliative care ward and am currently working on a stroke ward, and have helped nurse patients that are either out of it because of a massive stroke or brain damage or because they are on very heavy painkillers.

Comatose patients get washed once a day, in bed. Their mouths are swabbed out (Coke is surprisingly good at getting gunk off lips), their hair is washed if it needs it and their nails are clipped.

This is all done by either a nurse or a nurse’s aide, assisted by an orderly to help turn the patients and make the bed under them, and (if they’re nice, like me :)) help wash 'em.

Shaving legs and armpits on women is generally ignored – there’s no reason the family couldn’t do it but if someone’s comatose hairy legs are the least of anyone’s worries. Men do get their faces shaved if they didn’t start with a beard but that’s because your face is more visible than your legs!

Hadn’t thought of this! It’s also possible he cleaned her up especially for her “client” that day.

Also, I imagine that the comatose grow their hair and nails more slowly than the, um, non-comatose.

In real life I doubt any coma patients are shaved, but does someone brush their teeth? Seems like this would be a tricky task. Does a person who doesn’t eat solid food need their teeth brushed?

Almodovar’s movie “Talk To Her” is about coma patients and taking care of them–it’s another movie, of course, but I thought it was interesting.

Yes, because you can still get cavities. Tooth-brushing is accomplished by swabbing the mouth with a special Q-tip-like swab that has been impregnated with a dental cleaner.

And, to answer this question, yes, the comatose still sometimes poop.

Robin

MsRobyn is partly right. If the patient has no secondary bleeding problems, there’s no reason to not use a tooth brush. The excess fluid is taken care of by suction.

awldune Why would you think their hair grows slower? It doesn’t, in fact, brain injured patients sometimes become more hirsute. I’ve seen hair on noses and foreheads, and no, we don’t shave that.
Male patients are usually shaved daily. If they had facial hair at admission, its maintained unless it interferes with care. For example, if they have a breathing tube through their mouth, it has to be taped to their face. Most hospitals have a relative sign a consent to remove purposely grown hair. (head and facial)

Silentgoldfish We couldn’t get by without people like you to help. :slight_smile:

beltbuckle At the risk of a TMI I’ll just say, yes, comatose people have bowel movements. Long term, programs of, um, stimulants and bulking agents are used to control the frequency and consistancy. Adult diapers are used, to protect the innocent.

The other routine “maintance” necessary, is frequent exercise. Turning the person from side to side at 2-4 hour intervals is necessary to prevent pressure sores. Passive range of motion exercises keep muscles supple. In bed soft “boots” or just high top shoes are put on and taken off on a schedule to prevent foot drop.

Their hair is combed or brushed every day, and washed whenever it needs it. There are even stylists who specalize in bed-ridden patients to cut their hair when necessary.

This is a deliberate hijack but I think some others might be curious…

How much does it cost to be in a coma for 4 years, in a hospital? Is it any more or less expensive per day if you’re in there for say…burns (constant bandage changes) or a disease like malaria?

Do patients usually stay in the hospital for the length of their coma, or if “the money runs out” can they be sent home and cared for by a relative?

Seems like alot of special care is given to these unfortunate folks. It must get expensive…

I only know critical care rates. I’ve had burn patients in the ICU for over a year at $2300/day. Procedures are extra. That’s $839,500/year. Plus probably, another $50,000 for extras.
Long-term care facilities are, of course much less, but I don’t know how much less.

I’m not sure what this means … could you expand? :slight_smile:

When some is bed ridden, coma or not, the Achilles tendon shortens, causing the toes to point down. If/when the person is able to stand, they’d have to stand tiptoe.
Even if its certain the person will never get out of bed again, foot drop can be painful. If very severe, it can compromise circulation in the foot.
The soft boots are soft foam sponge, on a rigid frame. Usually, only one is made for the patient, and the care giver moves it from foot to foot every couple hours.
High top shoes can be on both feet. As long as they fit perfectly, they can be left on for 4 hour intervals.
Did I cover you question, Shrinking Violet?

Yes - thanks picunurse. :slight_smile:

I don’t think this is done in the UK … at least, it wasn’t done for me when I spent 3 months in a hospital bed last year. :dubious: I’ve had foot drop in my right foot since childhood (paralysed Achilled tendon) and now, from your description, I have foot drop in the other foot too … tho’ I guess it doesn’t matter too much as I’m a wheelchair user after losing the ability to walk 3 years ago (aggressive Spina Bifida).

Whilst I was in hospital I befriended someone who had been bed-bound (severe burns) for six months, and she didn’t have this treatment either.

Can a Brit medico confirm we don’t do this here?

sorry about the hijack, but I’m still wondering how The Bride woke up, examined her hands, and instantly deduced how long she’d been comatose. I asked about that before, but nobody knew.

Does anyone around here know how to use the damn ‘spoiler’ tags in GQ when telling stuff about recent movies that I’m looking forward to seeing soon? I have managed to avoid every review about KB I and II since they came out so I could sit down and watch the two together next week.

Thanks all. Good luck with your coma people. Sheesh. “SPOILER”

I’d have to guess that she was fastidious about her nails, and could accurately determine time passage based upon growth.

I knew I’d been out for better than two weeks because there were no sutures or clamps in my leg, and I’d seen the bone after splitting it open. :smiley:

It’s been awhile since I saw the movie, but was she looking at her hands, or was she looking at her stomach, and just had her hands over it?

And Stockton…to make a spoiler box, just type it like…

[sXoiler]This is text inside a “spoiler” box. Little Nell is Darth Vader’s mother, and they killed her by shoving a tank of compressed air in her mighty jaws.[/sXoiler]

…Just spell “spoiler” without the “X”.

The Bride was looking at the lifeline on her palm. Apparantly she was trained to know the passage of time using it. I didn’t even know you could do that.

In *Blue Lagoon[/], Brooke Shields is holding a starfish while she’s crouching in the sea.

As she gently lowers the starfish back to the water, you can see her smooth, hairless, tanned leg.

I think the Hollywood types may be offended at hairy actresses, although I believe Oprah did not shave under her arms for her role in Beloved.