How To Get A Person Out Of Bed

WHAT YOU SHOULD KNOW:

How To Get A Person Out Of Bed (Discharge Care) Care Guide

When you perform a bed transfer, you help a bedridden person move from the bed to a chair or wheelchair. You also may help move him back into bed. You can use the pivot transfer, scoot transfer, or slide board transfer. A gait belt can be used with any of these transfers. You can hurt a bedridden person or yourself when a bed transfer is not done correctly.

AFTER YOU LEAVE:

Prepare the person for a transfer:

Assess the person. Bedridden people may range from independent (needing minimal help) to totally dependent. Those who are independent should be encouraged to move themselves as much as possible. Totally dependent people cannot move out of bed without your help. Consider the following as you plan the bed transfer:

  • Can the person help with the bed transfer? Assess his arm and leg strength and ability to sit or stand up. Keep the person close to you during the transfer to increase stability. Ease him to the closest surface, such as the bed or chair, should he start to fall.

  • Can he follow directions? Does he want to help? Assess the person's understanding and willingness to help with the transfer.

  • How tall and heavy is he? You may need to adjust the height of the equipment or get special devices for some transfers.

  • Does the person have any equipment or wounds on his body or muscle problems? Choose the bed transfer method that will best protect him from injury.

  • Does the person have any special orders from caregivers? Check his activity orders.

Prevent injury to yourself and others:

  • Use correct form. Do not stretch your back or turn at your waist during the transfer. Your body should be aligned (in a straight line), with a straight back and bent knees. Do not let the person wrap his arms around your neck or shoulders while moving him. This can cause you a neck or back injury.

  • Look around the room. Check for floors that are slick or not level. Remove throw rugs and pets before bed transfers. Tidy up the area around the bed to prevent falls. Make sure the person you are transferring is wearing shoes or socks with nonslip soles.

  • Choose the right equipment. You can use a slide board to move the person from the bed to a chair or wheelchair. Gait belts, also called transfer belts, can help him stand. Check the gait belt safety instructions to ensure the belt can be used for bed transfers. Place the gait belt over the clothing around the person's waist. Tighten just enough so you can easily fit both hands underneath the belt. Do not use any equipment before a caregiver has shown you how to do so correctly.

  • Prepare the person and other people. Tell the person you are transferring what will happen and what he can do to help. Ask other people to help move him, depending on the transfer method.

  • Work together with the person being transferred and your helpers. You and your helpers can count out loud to 3 to coordinate efforts to help the person stand or move. Avoid sudden movements during the transfer. Quick changes in position can cause falls.

What you should know for all transfers:

Before the transfer:

  • Place the chair or wheelchair beside the bed. Angle the chair or wheelchair parallel (on the same line) or at a 45-degree angle to the bed. The foot of the wheelchair or chair should face the same direction as the foot of the bed. If you are using a wheelchair, move or remove its footrests and lock the wheels.

  • If the bed is adjustable, change the height of the bed so the person's feet can touch the floor. If the bed has side rails, lower them before the transfer. If the bed has wheels, lock them.

  • Help the person sit up on the side of the bed. Help him lie on his side facing the chair, then slowly raise the head of the bed as high as his condition allows. As the person places his hand on your shoulder, slide your hand under his arm and around his back. Place your other hand under his opposite thigh. Help lift his chest and shoulders, and help him move his legs so he sits up, feet on the floor.
After the transfer:
  • Once he is in the chair or wheelchair, help the person sit with his back resting against the back of the chair. If the person is in a wheelchair, place his feet and arms on the chair rests.

How to transfer someone using the pivot transfer with a gait belt:

To use this method, the person must be able to sit with help and to bear some weight on his legs. Stand toe-to-toe with the seated person. Bend your knees slightly and keep your back straight. Ask him to put his hands on the edge of the bed if he can. Hug the patient under his arms. Ask him to help by using his arms to move his body to the edge of the bed. The person will stand briefly before sitting in the chair or wheelchair. You can help him stand using a gait belt:

  • Use the rock-and-pull method to pull him to a standing position with the gait belt.

  • Face the person being transferred. Bend your knees and hips, but keep your back straight. Ask him to place one hand on your shoulder.

  • Grasp the belt with your palms toward you. Gently rock back and forth about 3 times with the person.

  • On the 3rd rock, pull the person up to standing position. Do not bear too much of his weight.
To transfer the person back into bed, follow the same directions. After the transfer is complete, help him get comfortable.

How to transfer someone using the pivot transfer without a gait belt:

  • Without a gait belt, you can ask the person to stand by pushing off the bed with his arms. You are still toe-to-toe and hugging him, with bent knees and straight back. Ask him to bear as much of his own weight on his feet as possible. On the count of 3, raise the person to a standing position as you straighten your knees. Keep your back as straight as you can while he stands.

  • Pivot toward the wheelchair while you keep your knees against his. Do not turn at your waist. Ask the person to grasp the armrests when he feels the chair against the back of his legs. Bend your knees, and keep your back straight as you help him to sit on the chair or wheelchair.
To transfer the person back into bed, follow the same directions. After the transfer is complete, help him get comfortable.

How to transfer someone using a slide board:

Slide boards are stiff, smooth, and slippery. They act like a bridge between the bed and chair or wheelchair. The person being transferred must be able to sit up when using this method. Use a gait belt with the slide board.

  • Move the bed so it is no more than 2 inches higher than the chair or wheelchair.

  • Position the slide board between the transfer points. Slide one end of the board under the person's buttocks. Place the other end of the slide board on the chair or wheelchair seat.

  • When moving the person to the chair on your right, place your left knee between his knees. Position your right knee near the right front leg or wheel of the chair or wheelchair. Change legs when transferring the person to a chair or wheelchair on your left side.

  • Grasp the gait belt near the person's hips, with your palms toward you. Slowly slide him on the slide board toward the chair or wheelchair.

  • Keep your back and body in a straight line, and pivot your feet as you move.

  • Remove the slide board. You can leave the belt on after the transfer to help the person return to bed.
To transfer the person back into bed, follow the same directions. After the transfer is complete, help him get comfortable.

How to transfer someone using the scoot transfer:

For this transfer method, the height of the bed and chair should be within 2 inches of each other. The person must be able to sit with help and to bear some weight on his legs. Use a towel to cushion the edge of the seat. A gait belt can help move the person. Use the rock-and-pull method:

  • Ask the person to place his arms at his sides or to reach for the chair with one arm.

  • Face the person. Bend your knees and hips, but keep your back straight. If you are moving the person to your right, place your left knee between his knees. Place your right knee to the outside of and against your patient's left leg. If you are moving the person to the left, reverse these directions.

  • Ask the person to bend toward you, putting his weight on you. You will lean back slightly.

  • Grasp the belt with your palms toward you. Use 2 to 4 small rocking movements to scoot the person over by lifting him 1 to 2 inches off the bed each time. The rocking motion provides momentum to help him scoot from the bed to the chair. Do not bear too much of his weight. His feet should be flat on the floor.
To transfer the person back into bed, follow the same directions. After the transfer is complete, help him get comfortable.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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