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How to Get A Person Out of Bed
WHAT YOU NEED TO KNOW:
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 or her 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.
How to prepare a person for a transfer:
A bedridden person may be independent (needing minimal help) or totally dependent. An independent person should be encouraged to move himself or herself as much as possible. A totally dependent person 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? The person will need arm and leg strength, and be able to sit or stand up. Keep the person close to you during the transfer to increase stability. Ease him or her to the closest surface, such as the bed or chair, if he or she starts to fall.
- How tall and heavy is the person? 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 or her body or muscle problems? Choose the bed transfer method that will best protect him or her from injury.
How to prevent injury to yourself and to others:
- Use correct form. Do not stretch your back or turn at your waist during the transfer. Your body should be in a straight line, with a straight back and bent knees. Do not let the person wrap his or her arms around your neck or shoulders while you move him or her. This can injure your neck or back.
- 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 or her stand. Check the gait belt safety instructions to be sure 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 healthcare provider 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 or she can do to help. Ask other people to help move him or her, 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 to do before all transfers:
- 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 the person lie on his or her side facing the chair. Then slowly raise the head of the bed as high as his or her condition allows. As the person places his or her hand on your shoulder, slide your hand under his or her arm and around his or her back. Place your other hand under his or her opposite thigh. Help lift the person's chest and shoulders. Then help the person move his or her legs so he or she sits up, feet on the floor.
What to do after all transfers:
- Help the person sit with his or her back resting against the back of the chair. If the person is in a wheelchair, place his or her feet and arms on the chair rests.
- To transfer the person back into bed, follow the same directions for the method you used. After the transfer is complete, help him or her get comfortable.
How to transfer a person 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 or her legs. Stand toe-to-toe with the seated person. Bend your knees slightly and keep your back straight. Ask the person to put his or her hands on the edge of the bed if he or she can. Put your arms under the person's arms. Ask the person to help by using his or her arms to move his or her body to the edge of the bed. The person will stand briefly before he or she sits in the chair or wheelchair. You can help him or her stand using a gait belt:
- Use the rock-and-pull method to pull the person to a standing position with the gait belt.
- Face the person. Bend your knees and hips, but keep your back straight. Ask him or her 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 third rock, pull the person up to standing position. Do not bear too much of his or her weight.
How to transfer a person 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 or her arms. Stand toe-to-toe with him or her. Put your arms under his or her arms. Bend your knees and keep your back straight. Ask the person to bear as much of his or her own weight on his or her 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 or she stands.
- Pivot toward the wheelchair while you keep your knees against his or hers. Do not turn at your waist. Ask the person to grasp the armrests when he or she feels the chair against the back of his or her legs. Bend your knees, and keep your back straight as you help him or her to sit on the chair or wheelchair.
How to transfer a person 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 you move the person to a chair on your right, place your left knee between his or her knees. Position your right knee near the right front leg or wheel of the chair or wheelchair. Change legs when you transfer 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 or her 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.
How to transfer a person 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 or her 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 or her arms at his or her 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 or her knees. Place your right knee to the outside of and against his or her left leg. Change legs when you transfer the person to a chair or wheelchair on your left side.
- Ask the person to bend toward you, putting his or her 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 or her 1 to 2 inches off the bed each time. The rocking motion provides momentum to help him or her scoot from the bed to the chair. Do not bear too much of his or her weight. His or her feet should be flat on the floor.
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