In a climate of skyrocketing health care costs and budget cuts, assistance with recuperating or aging parents or loved ones is becoming evermore difficult to obtain. Many adult children or spouses face responsibilities as the full-time caregiver of their loved one, and must stay at home. Often, the caregiver receives no professional instruction in how safely to transfer a loved one in and out of bed, to a chair or wheelchair, or in a variety of other daily activities requiring assistance.
In addition to the emotional toll care giving can take on an individual, the physical toll can be enormous. I cringe when I see a caregiver grabbed around the neck while moving someone, or when I witness the poor biomechanical position people get themselves into while assisting someone in or out of bed. Severe back and neck injuries are common among caregivers. In this article, let’s look at some safe techniques for assisting people in transfers.
The first and most important thing you can do is use a gait belt. Easy to find and inexpensive at medical supply stores or pharmacies, a gait belt is usually 2 to 3 inches wide and fastens with either velcro or a buckle. Use the gait belt by securing it snuggly around the patient’s waist. If the person has a colostomy bag or some other abdominal surgical procedure, place the belt above or below that area. Now you have something secure to hold near the person’s center of gravity.
Using the gait belt makes your assistance safer for both you and the person you’re helping. A gait belt will help you anytime you assist someone to walk or move from one position to another.
It’s important to allow a patient to do as much as possible, which helps him or her grow stronger and more independent, and saves you from risking injury. Avoid having the person grab onto you; instead use the following techniques:
First, if the person is lying on his or her back and is able to bend the knees and lift the buttocks, encourage the patient to move closer to the edge of the bed. If a person cannot move the legs but is able to move the arms, a “trapeze” can be purchased at a medical supply store and attached to the bed. This allows a person to pull him or herself up and assist in the move.
Once on the edge of the bed, have the patient roll on the side facing the edge. To help in sitting up, grasp the gait belt and instruct this two-part movement: First, bring both the legs over the edge of the bed while pushing with the top arm down onto the bed. Next, after the patient is halfway up, the bottom hand can help support and push up to a sitting position.
This maneuver is one of the easiest ways to safely get a person in a weakened state to sit on the edge of a bed. If you are assisting someone who can use a walker, have him or her push off the bed—not pull on the walker. You, as the person assisting, should stand on one side of the person, holding the walker steady with one hand and holding the gait belt at the back-center with the other hand.
When someone is unable to stand alone and needs assistance to transfer from sitting on a bed to a wheelchair or commode, place it as close to the bed as possible. If a person has had a stroke or has one side weaker than another, always place the chair/commode toward the stronger side. If the armrest is removable, remove the side closest to the person. Make sure that a wheeled bed or chair is locked.
Also avoid wearing socks on a wood or linoleum floor. Get slippers or shoes with traction for both helper and helped. Now stand in front of the person so that one of your legs is blocking the weaker knee and the other leg is turned toward the chair. Have the patient help you by pushing off the bed, then have him or her place the hands on your shoulders, but not pull on your neck. Once standing, the patient can reach for the chair armrest.
So…..with one easy motion or with a 1…2…3 count hold the gait belt and assist the person to stand—locking the weak leg straight with your own—then gently pivot the person into the chair. When transferring back to bed from a chair, remember that for the person to stand up from a seated position the nose must be forward over the knees to bring the center of gravity forward. Ask the person to slide as far to the edge of the seat as possible before attempting the transfer.
Do your best to avoid feeling impatient, especially with someone suffering from Alzheimer’s. Never yank on the person you’re assisting because you could cause harm to either or both of you. And don’t strain yourself by trying a dead lift.
If you feel back, neck or shoulder pain as a result of caregiving, realize that you must take care of yourself first or you won’t be able to assist anyone else. A physical therapist trained in manual therapy can assist you with these types of injuries. Practicing a good core stability program can strengthen the muscles required for lifting and transferring people. Regular “tune-ups” with a trained physical therapist can assist in keeping you out of trouble.
If you are a caregiver, remember to care for yourself as well.