[A Must-Read for Those Caring for Bedridden Family Members] Top 10 Tips for Hiring a Domestic Helper to Care for People with Disabilities or Those Confined to Bed: A Complete Guide to Preventing Pressure Sores, Lifting and Positioning Techniques, and Providing Support

Caring for a family member with a physical disability or who is bedridden is a tremendous physical and emotional challenge for any family. Hiring a foreign domestic worker (a “sister”) to assist can greatly alleviate the stress on family caregivers. However, bedside care involves a range of nursing knowledge and safety techniques; if not handled properly, it can easily lead to injuries for family members or the domestic helper. This article compiles the top 10 golden tips for hiring a domestic helper to care for individuals with disabilities or those who are bedridden, helping you establish a professional and safe home care routine!

I. 10 Tips for Hiring a Foreign Domestic Worker to Care for People with Disabilities or Those Confined to Bed

Tip 1: Prepare the necessary care supplies and pressure-ulcer prevention equipment in advance

Before the foreign domestic worker arrives, the household should prepare the necessary equipment based on the family members’ needs:

• Medical Care Beds and Air Mattresses: For individuals who are unable to turn themselves over, an air mattress is the most critical tool for preventing bedsores.
• Transfer aids: such as transfer belts, transfer boards, or patient lifts, which reduce the physical strain on domestic workers.
• Hygiene Supplies: A sufficient supply of adult diapers, diaper pads, leak-proof skin protection cream (zinc oxide cream), and wet wipes.

Tip 2: Strictly follow the "turn the patient every 2 hours" protocol

People who are bedridden for long periods are highly susceptible to developing pressure ulcers due to prolonged pressure on specific areas of the skin, which can even lead to serious infections.

• Regular Positioning: The foreign domestic worker is required to strictly follow the schedule of assisting the family member with repositioning once every two hours (alternating between left-side, supine, and right-side positions).
• Placing cushions: Place soft cushions under protruding bones (such as the sacrum, ankles, the area between the knees, and the elbows) to reduce friction.

Tip 3: Review proper transfer techniques to prevent injury to both parties

Many foreign domestic workers have a habit of using their bare hands to forcefully pull on the joints or lower back of bedridden individuals, which can easily result in joint dislocations for family members or lower back strains for the domestic workers.

• Guide them on proper form: Teach domestic workers to use their leg muscles rather than their lower back, to bend their knees and hips, and to keep their backs straight.
• Using Support and Lifting Techniques: Make good use of lifting straps, and whenever possible, have two people (such as the employer and the domestic worker) work together to perform difficult transfers.

Tip 4: Prioritize Skin Care and Personal Hygiene

The skin of bedridden individuals is delicate, so cleansing and drying are crucial:

• Daily Wiping and Diaper Changes: Clean the baby promptly after the diaper becomes wet. After drying the area, apply a skin-protecting cream to prevent irritation from waste.
• Check the condition of the skin: Instruct the domestic worker to carefully observe the skin for redness, abrasions, or abnormal warmth while washing the patient or turning them over, and to notify the employer immediately if anything unusual is found.

Tip 5: Master Techniques for Preventing Choking and Tube Feeding

If a bedridden patient needs to be fed or requires a nasogastric tube (NG tube):

• Elevate the head of the bed to an angle of 45 to 90 degrees: When eating or being fed, the head of the bed must be elevated, and the patient must remain in a sitting position for 30 to 60 minutes after eating. Lying flat immediately after feeding is strictly prohibited to prevent tracheal aspiration leading to aspiration pneumonia (Aspiration Pneumonia).
• Adjusting food texture: Based on the recommendations of an occupational therapist or doctor, puree food or use a thickener to thicken beverages.

Tip 6: Create a clear medication management and blood pressure/blood sugar log

Bedridden patients usually need to take a variety of medications on a regular basis:

• Pillbox Portioning: Employers should pre-portion medications by week and time in advance.
• Daily Vital Signs Log: Prepare a logbook and ask the foreign domestic worker to measure and record blood pressure, heart rate, blood sugar (if applicable), and the number of bowel movements each day.

Tip 7: Consider Offering a Higher Salary or Caregiver Allowance (Salary & Allowance)

Caring for bedridden or disabled individuals is extremely demanding work (including physically lifting and carrying them and being on call at all times, even at night):

• Salary Recommendations: Employers are advised to offer salaries higher than the statutory minimum wage (such as a nursing allowance of approximately HK$2,500) to attract foreign domestic workers with a nursing background or extensive experience.
• Adequate Rest: Ensure that domestic workers have sufficient rest time to prevent safety lapses in care resulting from excessive fatigue.

Tip 8: Provide Financial Support for Foreign Domestic Workers to Attend Community Care Training Courses

In Hong Kong, community organizations (such as the Red Cross, St. John Ambulance, or major private care centers) offer workshops on bedside care and lifting techniques (Elderly & Disabled Care Training) specifically designed for foreign domestic workers. Led by professional nurses, these workshops cover techniques for lifting, bathing, and tube feeding, enabling foreign domestic workers to provide care with greater professionalism and confidence.

Tip 9: Provide Care and Emotional Support

Providing long-term care for a bedridden person can be emotionally draining. In addition to checking on the physical well-being of family members, employers should also regularly check in on their domestic workers’ mental well-being and offer praise, red envelopes, or small rewards at appropriate times to help them feel respected and valued.

Tip 10: Seek out a professional matchmaking support platform—HelperLibrary

Caring for people with disabilities or those who are bedridden requires a high level of professionalism, and finding the right domestic helper with a nursing background is the key to success.

• Precise Matching: The HelperLibrary App is the only platform in Hong Kong that features dedicated sections and tag-based categorization, helping employers quickly filter for foreign domestic helpers with a nursing background or experience caring for bedridden or disabled individuals.
• One-Stop Consultation for First-Time Employers: HelperLibrary is currently the only support platform on the market that provides comprehensive professional consultation and support services to first-time employers. Whether it’s the hiring process, handling paperwork, or communication and coordination after the helper starts work, HelperLibrary is here to help employers resolve any issues they may face.

II. Frequently Asked Questions (FAQ)

Q1: If a foreign domestic worker needs to frequently turn a bedridden family member over or change their diaper at night, leading to sleep deprivation, how should the employer handle this situation?

Answer: If a family member requires frequent care at night (e.g., every 2–3 hours), this is equivalent to working a night shift. Employers must arrange for the domestic worker to catch up on sleep during the day (for example, by allowing 2–3 hours of undisturbed rest at noon or in the afternoon), or have family members share some of the caregiving responsibilities at night; otherwise, chronic sleep deprivation may lead to accidents while providing care.

Q2: When hiring a foreign domestic worker with a nursing background, what documentation should I check?

Answer: During the interview, you may ask to see the foreign domestic worker’s nursing degree certificate obtained in their country of origin (such as the Philippines or Indonesia) (Diploma / Bachelor of Science in Nursing), their nursing license, or a caregiver certificate issued by a professional organization. You can also conduct a video interview to assess their knowledge of nursing terminology in English and their ability to handle practical situations.

Q3: If a foreign domestic worker is injured (e.g., a back sprain) while assisting a bedridden family member, is the employer liable?

Answer: Yes. Under Hong Kong law, employers must purchase qualified workers’ compensation insurance (domestic worker insurance/work-related injury insurance) for their foreign domestic workers. If a domestic worker is injured while performing their duties, the insurance will cover the related medical expenses and sick leave pay. Therefore, providing appropriate patient-handling equipment and training in advance is crucial for the protection of both parties.