If a stroke, orthopedic injury or other cause has made a loved one dependent on an assistive device such as a wheelchair, walker or cane, it’s important to know the best way to help him with his mobility and safety. And safety — yours and his — is always first.
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“When providing care, keep in mind your own safety,” says Christine Schulte, MD, Outpatient Director for Rehabilitation and Sports Therapy Services for Cleveland Clinic Main Campus and Western Region. “You’re not going to provide much assistance if you hurt yourself in the process.”
Care providers should learn proper body mechanics to ensure that they have a clear understanding of their position in relationship to the patient when transferring the person or helping him move with his assistive device.
“The patient should always be as actively involved as possible,” she says. “Even if it’s limited, all mobility is a good thing.”
How to transfer someone from a bed to a wheelchair
- Position the wheelchair. When helping someone transfer out of a bed, start by moving the wheelchair leg rests out of the way, so that you can maneuver the chair as close to the bed as possible. Lock the wheels so the wheelchair doesn’t move.
- Get the person in an upright position. Have the person roll on his side and use his upper extremities to push himself into an upright position as his legs slide over the side of the bed.
“Using their body weight for leverage and to let their legs drop to pull their trunk up allows the patient to do more work,” Schulte says. “The person assisting is guiding, versus trying to pull them upright in bed.”
- Help him stand and pivot. Have the person lean forward with his nose over his toes to distribute the weight onto his good foot or feet. Then, help guide and pivot him on the weight-bearing foot or feet and lower him into the chair.
“If the person is very weak, you should tighten a belt around their waist to help guide them, and it gives the caregiver something to hold onto to guide their movement,” Schulte advises. “If they have loose clothing on, it’s just going to slip under your hands creating an unsafe transfer.”
How to help someone navigate stairs
When helping someone climb up stairs, it’s best to walk next to or behind him. If he starts to fall, it’s easier to nudge him forward. Keep your hand on his shoulders or on the belt to keep his center of gravity forward.
If he is descending, stand in front of him, since it’s easier to help him keep his balance than trying to hold onto him from behind if he falls.
Also, the person should lead with his good foot going up the steps, and with his bad foot going down the steps, so that the good leg is always initiating the movement.
“If they’re really struggling, there’s no reason they can’t sit on the steps and scoot themselves up and down until they get a little bit stronger,” Schulte says. They can also transition at the top of a stool, then a chair, then to a standing position.
Keep the disabled person’s home clear of clutter on the floor, such as extension cords, laundry baskets and throw rugs that can cause the person to trip or fall. Lastly, ensure that hallways and walkways are well lit so the person has a clear pathway that he can see.