Understanding How to Help: When you turn an older adult in bed, what can they do to assist and help make the roll easier?

Effective bed repositioning is crucial for preventing pressure injuries in older adults, who are more susceptible to skin breakdown. When you turn an older adult in bed, what can they do to assist and help make the roll easier, and how can caregivers facilitate this vital participation?

Quick Summary

Older adults can help with repositioning by bending their knees, using their arms for leverage, engaging their core muscles, and communicating clearly with the caregiver. Active involvement not only makes the turn easier but also promotes a sense of independence and dignity during movement.

Key Points

• Bend Knees: Creates a pivot point and shifts weight, making the lower body easier to move.

• Use Arms for Leverage: Pushing on the bed or pulling on a rail provides momentum and stability.

• Engage Core Muscles: Coordinated core engagement allows the body to move as a unit.

• Communicate Clearly: Verbal cues, like counting, help synchronize movement for a smoother roll.

• Assist with a Drawsheet: Actively shifting weight with the caregiver reduces friction and effort.

• Practice Regularly: Consistent practice with safe techniques improves coordination and confidence for both parties.

The Importance of Active Participation

Repositioning a loved one in bed is a common caregiving task, but it can be physically demanding for both parties. Encouraging an older adult to participate actively, even with limited strength, offers several key benefits. For the caregiver, it reduces the physical strain and risk of injury. For the older adult, it promotes a sense of agency and can help maintain some muscle strength and mobility. Moreover, working together creates a safer and more coordinated movement, which reduces the risk of accidental injury during the transfer.

Key Techniques for the Older Adult

Bend Their Knees

One of the most effective techniques for an older adult to assist in rolling is to bend their knees. By bringing their feet flat to the bed, they create a stronger base and a more favorable pivot point for the lower body. The bent knee on the far side of the body can then be pushed towards the caregiver, initiating the rolling motion. This simple action significantly reduces the amount of force the caregiver must exert to move the heavy, lower half of the body.

Use Arms for Leverage

Just as important as leg movement is the use of the upper body. The older adult can assist by pushing down on the mattress with their hands, which helps to lift and shift their upper torso. If the bed has a rail, they can also grasp it with their hand. Then, as the caregiver initiates the roll, the older adult can pull on the rail to provide additional momentum and control. Positioning their arms across their body in the direction of the roll also helps to streamline the movement.

Engage Core and Hips

For those who have some core strength, engaging the abdominal and hip muscles can provide crucial assistance. The older adult should be coached to tighten their core and use their hip muscles to push into the roll. This makes the body a more cohesive unit, moving in one smooth motion rather than multiple disjointed segments. The caregiver should give clear, simple cues, such as "On the count of three, let's roll," to help synchronize efforts.

Practice Good Communication

Verbal and non-verbal communication is a cornerstone of safe and easy repositioning. The older adult should voice any discomfort or pain immediately. The caregiver, in turn, must explain each step clearly and calmly. This includes explaining which direction they will be turning and what movements they should attempt. Counting aloud together can provide a rhythm for the movement, ensuring both parties are prepared for the action simultaneously.

Equipment That Can Help

Certain equipment can dramatically improve the rolling process, especially when assisting an older adult. A drawsheet, a smaller sheet placed over the fitted sheet under the person's torso, is invaluable. For the older adult, helping to move their body in coordination with the caregiver pulling the drawsheet makes the process feel much smoother and less jarring. Bed rails provide a secure handhold, and a hospital-style bed that can be raised or lowered offers ergonomic benefits for both parties, as the caregiver can work at a more comfortable height.

Practical Steps for Rolling Together

To roll an older adult towards you, follow these steps:

1. Preparation: Stand on the side of the bed you want to roll them towards. Explain the plan clearly. Make sure any tubes or medical equipment are not in the way.
2. Positioning: Help the older adult to bend their far knee and cross their far arm over their chest. Their feet should be flat on the mattress.
3. Instruction: Instruct them to push down with their hands on the bed or grab the bed rail and to push with their bent knee. Tell them you will roll on the count of three.
4. Action: On "three," gently pull on their shoulder and hip while they use their own strength to assist. Use the momentum they generate with their knees and arms.
5. Support: Once they are on their side, place pillows strategically to maintain the position and provide comfort.

Comparison of Passive vs. Active Assistance

Feature	Passive Rolling (No Assistance)	Active Assistance (Older Adult Helps)
Caregiver Effort	High physical strain; requires significant upper and lower body strength.	Reduced physical demand; less risk of back strain for the caregiver.
Older Adult Participation	Zero. Feels like being moved like an object, potentially undignified.	Promotes a sense of control and independence; encourages active movement.
Movement Quality	Often jerky or rough due to needing to overcome all of the body's weight.	Smoother and more controlled movement; can feel more fluid and comfortable.
Equipment Required	Often requires a drawsheet or additional personnel for safety.	May still benefit from equipment like a drawsheet or bed rail, but less reliant on them.
Safety	Higher risk of injury to both caregiver and older adult due to improper body mechanics.	Lower risk of injury with proper technique and coordinated effort.

Safety Precautions and Communication

Beyond the physical actions, safety and communication are paramount. Always ensure the bed wheels are locked before starting. Move slowly and deliberately, and be alert to any signs of discomfort. Check the skin frequently, especially at pressure points, to monitor for any redness or potential injury. After the roll is complete, ensure the older adult is well-supported with pillows to prevent them from rolling back and to distribute pressure evenly. A regular turning schedule is key to preventing pressure sores.

Conclusion

By encouraging an older adult to take an active role in their repositioning, caregivers can transform a difficult task into a safer, more collaborative process. Techniques such as bending knees, using arms for leverage, engaging core muscles, and clear communication are fundamental. When you turn an older adult in bed, what can they do to assist and help make the roll easier? The answer lies in these simple yet powerful cooperative movements. This approach not only protects the health of both caregiver and patient but also preserves the older adult's dignity and independence. For more on proper caregiving techniques, consult resources like the Family Caregiver Alliance.

Frequently Asked Questions

Can a person with very limited mobility still help with rolling?

Yes, even a small amount of active participation, like assisting with a knee bend or a slight arm movement, can significantly aid the caregiver and make the roll easier. Any effort, however minimal, is beneficial.

How does bending knees make rolling easier for an older adult?

Bending the knees brings the feet closer to the center of gravity, creating a fulcrum point. This shortens the lever arm of the legs, allowing the entire body to roll more efficiently with less force required from the caregiver.

What if the older adult can't bend their knees?

If knee bending is not possible, the caregiver can cross one ankle over the other in the direction of the turn. This still helps to initiate the roll and adds momentum to the movement.

How can an older adult use their arms to assist?

They can push down on the mattress or pull on a bed rail. The most important thing is to move their arms across their body in the direction of the roll, which helps guide the upper body during the turn.

Is using a bed rail for assistance a good idea?

Yes, for many older adults, a properly installed bed rail provides a secure and stable point to grab. This allows them to use their arm strength to help pull themselves over, aiding the caregiver significantly.

How can I communicate effectively with the older adult during the roll?

Before you begin, explain the process. During the turn, use clear, consistent verbal cues, such as counting "1, 2, 3, roll." Ensure your loved one is ready and comfortable with each step.

Why is it important for the older adult to assist with the roll?

Their assistance makes the movement safer and less physically strenuous for the caregiver. For the older adult, it helps maintain muscle function, promotes a sense of independence, and fosters a collaborative care environment.