Helping fall risk individuals function and move safely from situation to situation requires a combination of proper techniques, assistive devices, and a healthy dose of compassion. While seemingly intuitive, successful patient transfers rely on understanding each patient’s needs while adhering to evidence-based guidelines. Here are practical tips to help ensure their safety while promoting as much independence as possible.
Understanding Fall Risks
Fall risk patients are often older adults or people with medical conditions affecting their balance, strength, or coordination. Common contributing factors include:
- Weakness in muscles or joints
- Unsteadiness walking
- Vision impairments
- Cognitive issues, such as dementia
- Use of medications that cause dizziness or drowsiness
- Unsafe environments, such as cluttered spaces or uneven surfaces
Understanding these factors allows caregivers to tailor their mobility support strategies.
General Principles of Safe Mobility Assistance
Assess Individual Needs
Each patient has unique capabilities and limitations. Conduct a thorough evaluation of their mobility level, strength, and risk factors before assisting.
Promote Independence
Encourage patients to perform as much of the movement as they can safely manage. This helps maintain their confidence and physical condition.
Use Proper Body Mechanics
Caregivers should:
- Stand close to the patient to offer steady support
- Keep a wide base of support by placing feet shoulder-width apart
- Bend at the knees rather than the waist
- Avoid twisting the body while assisting movements
Move at Their Pace
Patients with limited mobility often need extra time. Rushing only increases the likelihood of falls and accidents.
Maintain Clear Communication
Clearly explain each step of the movement process and use verbal cues to guide the patient. For example, say, “We’re going to stand up now. Ready?”
Techniques for Specific Activities
Transitioning from Bed to Wheelchair
Preparation
- Explain the steps to the patient.
- Park the wheelchair next to the bed, parallel or at a slight angle.
- Put the brakes on and move the footrests out of the way.
Technique
- To get the patient into a seated position, roll the patient onto the same side as the wheelchair.
- Put one of your arms under the patient’s shoulders and one behind the knees. Bend your knees.
- Swing the patient’s feet off the edge of the bed and use the momentum to help the patient into a sitting position.
- Move the patient to the edge of the bed and lower the bed so the patient’s feet are touching the ground.
Transitioning from Bed to Chair
Preparation
- Ensure the area is free of obstacles, and the chair is stable and positioned close to the bed.
Technique
- Help the patient sit on the edge of the bed with their feet flat on the floor.
- Use a gait belt, if appropriate, to provide a secure hold.
- Bend your knees, support the patient at their waist or shoulders, and guide them to a standing position.
- Pivot together toward the chair and lower the patient slowly.
Walking with Assistance
Using Assistive Devices
Ensure canes, walkers, or crutches are the correct height and fit for the patient.
Technique
- Stand slightly behind and to the side of the patient.
- Offer light support under their arm or at their waist if needed.
- Encourage them to take small, steady steps, using the assistive device as directed.
Climbing Stairs
Preparation
- Confirm that the stairway is well-lit, free of hazards, and has secure handrails.
Technique
- Stand below the patient on the stairs to provide support if they lose balance.
- Instruct them to use the handrail and take one step at a time.
- Ascend with their stronger leg first and descend with their weaker leg first (i.e., “up with the good, down with the bad”).
Creating a Safe Environment
Remove Tripping Hazards
- Keep floors clear of clutter, loose rugs, or cords.
- Arrange furniture to allow clear pathways.
Enhance Lighting
- Use bright, even lighting in all areas, especially near staircases and hallways.
- Install motion-sensor lights for nighttime mobility.
Install Safety Features
- Add grab bars near toilets, showers, and bathtubs.
- Use non-slip mats in bathrooms and kitchens.
Ensure Proper Footwear
Patients should wear well-fitting, non-slip shoes or slippers.
Utilizing Assistive Devices
Gait Belts
A secure tool for providing support during transfers or walking assistance.
Walkers and Canes
Choose the device that suits the patient’s level of stability and strength.
Wheelchairs
For patients with severely limited mobility, ensure the wheelchair fits properly and is easy to maneuver.
Encouraging Physical Activity
Light Exercises
Activities like seated leg lifts, ankle rotations, or arm raises can help maintain strength and flexibility.
Balance Training
Under supervision, gentle exercises like standing on one leg or using a balance board can improve stability.
Engagement in Daily Tasks
Encouraging participation in small, manageable tasks fosters independence and mobility.
Monitoring and Adjustments
Regular Assessments
Reevaluate the patient’s mobility and safety needs periodically.
Be Vigilant for Changes
Monitor for signs of fatigue, discomfort, or increased difficulty with movements.
Adjust Strategies
Incorporate new tools or techniques as the patient’s condition evolves.
Training and Support for Caregivers
Seek Training
Enroll in courses on safe patient handling and mobility techniques.
Collaborate with Professionals
Physical and occupational therapists can provide valuable guidance tailored to the patient’s needs.
Practice Self-Care
Caregivers should rest adequately and seek help when needed to avoid burnout and injuries.
Emotional Support
Be Patient and Empathetic
Limited mobility can be frustrating for patients. Offer encouragement and celebrate small achievements.
Foster Trust
Trust is very motivating. Build confidence in your ability to provide safe and effective assistance.
Sources:
- National Institute on Aging
- National Library of Medicine
- MedlinePlus
- Johns Hopkins Medicine
