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Caregiver Guide and Instructions for Safe Bed Mobility

Published:April 28, 2017DOI:https://doi.org/10.1016/j.apmr.2017.03.003
      This educational page is designed to provide practical information and instruction for caregivers assisting individuals experiencing difficulty performing bed mobility tasks. Please view additional resources at the end of this educational page for important tips on lifting techniques, safe patient handling, falls prevention, body mechanics, and ergonomics.

      What is bed mobility?

      The term bed mobility refers to activities such as scooting in bed, rolling (turning from lying on one's back to side-lying), side-lying to sitting, and sitting to lying down. It also includes scooting to sit on the edge of the bed when preparing to stand or transfer.

      Why is bed mobility important?

      People with limited mobility from illness, weakness, injury, or disability may have difficulty moving in and out of bed. There is an increased risk of injury for the caregiver when assisting patients with limited mobility.
      • Brown A.R.
      • Mulley G.P.
      Injuries sustained by caregivers of disabled elderly people.
      • Suzuki K.
      • Tamakoshi K.
      • Sakakibara H.
      Caregiving activities closely associated with the development of low-back pain among female family caregivers.
      For the safety of the caregiver and the individual needing mobility assistance (here referred to as the patient), it is important that good body mechanics are always maintained.

      How do I start?

      The first step is to figure out how much help the patient needs and make sure that it could be provided safely and comfortably. Prior to assisting with bed mobility, consider the following important checklist and safety tips.

      Transfer checklist

      • Plan ahead. Clear the area and have needed equipment in reach.
      • If there are any lines/tubes or catheter, ensure they would not interfere with the performed activity.
      • Decide which side of the bed the patient should get out from based on their strength, comfort, and ease of transferring to a chair.
      • Position yourself to that side of the bed. The patient would roll toward you.
      • If the bed is adjustable, adjust the height to approximately your hips level.
      • If the bed has rails lower the rail on that side.
      • Inform the patient what to expect; involve the patient as much as possible.
      • Give clear directions; sometimes counting 1, 2, 3 allows the caregiver and patient to work together.

      Caregiver safety

      • Be as close as possible to the individual you are assisting.
      • Always use your leg muscles to lift and not your back muscles.
      • Remember to always bend at your knees, and keep your back straight.
      • Avoid twisting your back.

      Patient safety

      • Avoid forcing or pulling on the individual's limb.
      • Assist the patient on their weaker side.
      • “Minimize shearing forces on the skin.”
        • Johansson C.
        • Chinworth S.
        Mobility in context: principles of patient care skills.
        (p252)
      • If applicable, maintain all precautions set by the physician.
      • If you are ever unsure, get needed help.

      What are the steps to accomplish safe bed mobility?

      The following steps are for getting out of bed (from lying on the back to sitting on the edge of bed).
      The steps to transition from sitting to lying (on the back) are as follows:
      • 1.
        Have the patient sit on the bed (closer to the head of the bed) and away from the edge which allows for less repositioning once in bed.
      • 2.
        Assist the patient as needed to get into side lying position.
      • 3.
        Have the patient bend both knees and roll onto their back. Assist patient as needed.
      • 4.
        The patient can scoot in bed to adjust to a comfortable position. Assist patient as needed.

      Additional resources

      American Academy of Orthopedic Surgeons. Lifting techniques for home caregivers. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00096. Accessed October 24, 2016.
      National Institute of Health. Evaluations and training. Available at: http://www.ors.od.nih.gov/sr/dohs/HealthAndSafety/Ergonomics/Pages/ergonomics_home.aspx. Accessed August 9, 2016.
      United States Department of Labor, Occupational Safety and Health Administration. Safe patient handling. Available at: www.osha.gov. Accessed August 9, 2016.
      Vance E, Menant J, Lord S, Balance Research Group, NeuRA. Mini review: Non-slip socks and falls prevention. Available at: http://fallsnetwork.neura.edu.au/wp-content/uploads/2016/03/Non-slip-sock-mini-review.pdf. Accessed February 27, 2017.

      Authorship

      Caregiver Guide and Instructions for Safe Bed Mobility was developed by Archana Vatwani, PT, DPT, MBA, AIB-CCON (email address: [email protected] ).

      Disclaimer

      The information presented serves as general guideline and is not meant to be an exhaustive list of recommendations. It is not meant to replace the advice from a medical professional. Consult your health care provider regarding specific medical concerns or treatment. Also, notify your medical provider if you are experiencing any pain or problems/difficulties with these techniques. This information page maybe reproduced for noncommercial use to share with patients and their caregivers. Any other reproduction is subject to approval by the publisher.

      Acknowledgments

      I thank Leah Nof, PhD, MS, PT, Heather Hettrick, PT, PhD, and Melissa Tovin, PT, PhD, MA, for their assistance.

      References

        • Brown A.R.
        • Mulley G.P.
        Injuries sustained by caregivers of disabled elderly people.
        Age Ageing. 1997; 26: 21-23
        • Suzuki K.
        • Tamakoshi K.
        • Sakakibara H.
        Caregiving activities closely associated with the development of low-back pain among female family caregivers.
        J Clin Nurs. 2016; 25: 2156-2167
        • Johansson C.
        • Chinworth S.
        Mobility in context: principles of patient care skills.
        FA Davis Company, Philadelphia2012