Good Body Mechanics and Safe Transfer Techniques

DEAR VANESSA,

I will provide home care to a client who has maintained bed rest for a long time. What advice can you offer regarding transferring or moving him safely? 

- ALLAN

DEAR ALLAN,

If the client has been bedridden for a long time, he may revert to a favorite position. Here are some long-term considerations to keep in mind: frequently assess him, and turn him more often as needed; use a lift (draw) sheet as often as possible to prevent shearing force on his fragile skin; and allow him to assist with moving and positioning whenever possible to promote independence. Be aware of the client’s personal space; seek permission before intruding in his territory. Do not attempt moving the client if he complains of dizziness or lightheadedness. In the absence of a hospital bed and equipment, a bed that places the client at your waist level is appropriate.

You must learn self-protection and teach the client to protect himself. Learn good body mechanics for transferring or moving a patient. Maintaining correct body alignment is the key to proper body mechanics; it promotes balance and helps coordinate movements. Arrange for adequate support; use mechanical aids if help is unavailable. Keep back, neck, pelvis, and feet aligned. Avoid twisting. Flex knees and keep feet wide apart to increase stability. Use arms and legs (not back). Slide patient toward yourself using a pull sheet. Tighten abdominal and gluteal muscles in preparation for move (to minimize strain).

Weakness and hypotension are common in an older adult on bed rest so make slow, gradual position changes. Wear shoes with a nonslip surface during transfer or ambulation (have the client wear shoes with a nonskid surface, too). Be sure the area is free of clutter, wet areas, and rugs that may slide.

Perform safety and maintenance checks of the client’s ambulation devices on a routine basis, and do periodic assessments to ensure that he is using his ambulation device(s) properly. Has his family consulted a physical therapist for additional assistance or exercises? Observe his response to his exercise program and take notes.

- VANESSA