When you turn an older adult in bed, what can they do to assist?

Statistics show that caregiver injuries are common during patient transfers and repositioning maneuvers, highlighting the importance of a team approach. This guide explains exactly what an older adult can do to assist when being turned in bed, making the process safer and more comfortable for everyone involved.

Quick Summary

An older adult with some mobility can significantly help during repositioning by bending their knees, using their arms for leverage by pushing on the bed, and following verbal cues. This collaboration reduces strain on the caregiver and promotes the individual's independence and dignity throughout the process. Communicating clearly is essential for a smooth and safe experience.

Key Points

• Use Leg Power: Bending knees helps the older adult redistribute weight, making the rolling motion more fluid and reducing strain on the caregiver.

• Provide Leverage: Pushing down on the bed with hands gives leverage to assist in the movement, empowering the older adult's participation.

• Maintain Control: Folding arms across the chest keeps the body aligned and prevents arms from getting caught, ensuring a smoother and safer turn.

• Communicate Clearly: Verbal cues from the caregiver are vital to coordinate the movement and ensure the older adult knows exactly what to do.

• Promote Independence: Encouraging active assistance fosters a sense of independence and self-efficacy, rather than helplessness.

• Reduce Caregiver Strain: When the older adult helps, it significantly decreases the physical effort required by the caregiver, reducing risk of injury.

• Prevent Pressure Sores: Frequent, assisted repositioning helps redistribute pressure, which is a key strategy for preventing painful pressure injuries.

The Benefits of Active Participation in Bed Mobility

Encouraging an older adult to participate in their own repositioning offers numerous advantages beyond simply making the caregiver's job easier. It helps to preserve the individual's independence, maintain some level of muscle strength and joint mobility, and contributes to their overall sense of dignity. When an older adult assists, the physical load is distributed, and the risk of injury from friction and shear forces on the skin is reduced, which is crucial for preventing pressure sores.

Active involvement turns a potentially passive experience into a cooperative effort, fostering better communication and a stronger sense of partnership between the caregiver and the older adult.

Practical Ways Older Adults with Mobility Can Assist

For older adults with some remaining mobility and cognitive ability, a few simple actions can make the turning process considerably smoother. These techniques utilize natural body movements and leverage to make the shift easier for both parties.

Bend the Knees to Create a Pivot Point

This is one of the most effective ways for an older adult to help. By lying on their back and bending their knees, with feet flat on the bed, they prepare their body for the turn. This action allows them to engage their legs, which are often the strongest muscles, and creates a more favorable pivot point for the rolling motion. The shift in weight makes the body easier to rotate as a single unit.

Use Arms for Leverage and Momentum

Instruct the older adult to place their arms across their chest. The arm on the side they are turning towards should reach for a bed rail, if available, or be used to push against the bed. This provides additional leverage and helps them initiate the movement. Using their arms effectively allows them to contribute to the momentum of the turn, making it less dependent on the caregiver's force alone.

Follow Verbal Cues for Coordination

Communication is the cornerstone of safe and effective repositioning. Caregivers should clearly explain each step, such as "on the count of three, please roll towards me." Having a verbal countdown ensures the older adult and caregiver are moving in sync, which is vital for preventing injury and executing the turn smoothly.

Assist with Leg Placement to Reduce Drag

As the turn is initiated, the older adult can help reduce drag by slightly lifting their feet. Alternatively, crossing one ankle over the other in the direction of the turn can help guide the hips and legs. The caregiver can assist with this motion, but the older adult's slight lift reduces the friction against the sheets, allowing for a gentler movement.

Step-by-Step Guide to Repositioning with Assistance

1. Communicate the Plan: Begin by explaining what you are about to do. For example, "I am going to help you roll onto your side now." This provides reassurance and allows for coordination.
2. Position the Environment: If possible, adjust the bed to a comfortable height for the caregiver and ensure the wheels are locked for safety.
3. Prepare the Older Adult: Ask them to bend their knees and place their arms across their chest.
4. Signal the Turn: Stand on the side of the bed you want them to turn towards. Use a clear, verbal cue like, "Ready? One, two, three, roll."
5. Guide the Movement: As they initiate the roll with their legs and arms, gently guide their shoulders and hips towards you. The use of a draw sheet can make this even easier by allowing the caregiver to pull rather than lift.
6. Secure the Position: Once they are on their side, use pillows or wedges to provide comfortable and stable support to prevent them from rolling back.

Active vs. Passive Repositioning

To illustrate the difference, here is a comparison of active versus passive repositioning.

Feature	Active Repositioning (Older Adult Assists)	Passive Repositioning (Older Adult Cannot Assist)
Caregiver Effort	Significantly reduced physical strain	High physical demand, requires careful technique
Older Adult Participation	Active, empowering, and engaging	Passive, requires no assistance from the individual
Independence	Fosters a sense of control and self-efficacy	Can feel less independent, relies entirely on caregiver
Safety	Safer for both parties, reduced risk of injury	High risk of caregiver injury without proper training/aids
Tools Needed	Potentially fewer tools, but draw sheet recommended	Often requires a draw sheet, mechanical lift, or second person
Communication	Essential for coordinated movement	Instructions still important for reassurance

When Passive Repositioning is Necessary

For older adults with limited or no mobility, passive repositioning is required. In these cases, the focus shifts to using proper techniques and tools to ensure safety for both the caregiver and the patient. A draw sheet is essential for this method, allowing caregivers to slide the individual without causing friction on the skin. The log roll technique, a coordinated maneuver where the body is turned as a single unit, is often employed. In scenarios involving a larger individual, two caregivers are often needed to perform the repositioning safely and comfortably. For individuals with a higher level of dependency, mechanical lifts can be used to ensure the safest transfer possible.

Resources for Safe Patient Handling

Learning and practicing safe patient handling is vital for caregivers to protect their own health and provide the best possible care. For comprehensive guidance on proper body mechanics and using assistive devices, authoritative resources are available. The Canadian Centre for Occupational Health and Safety offers valuable insights on this topic. Visit the CCOHS Safe Patient Handling Program for more information on how to protect yourself while caring for others.

Conclusion: Empowering Safety and Comfort

Understanding what an older adult can do to assist when being turned in bed is an empowering step for both them and their caregiver. By implementing simple yet effective techniques like bending knees and using arms for leverage, the process becomes more cooperative, safer, and less strenuous. Active participation promotes a sense of dignity and independence for the older adult while significantly reducing the physical demands on the caregiver. Regular communication, the use of appropriate tools, and adapting techniques based on the individual's abilities are the keys to a successful and comfortable repositioning experience for all involved.

Frequently Asked Questions

When you turn an older adult in bed, what can they do to assist?

If they have some mobility, they can assist by bending their knees, pushing down on the bed with their hands, folding their arms across their chest, and following the caregiver's clear verbal cues.

How does bending knees help during turning in bed?

Bending the knees shifts the body's center of gravity and creates a pivot point, making it easier to initiate the rolling motion and requiring less overall force to complete the turn.

Why should an older adult push down with their hands on the bed?

Pushing down with their hands provides upper body leverage, allowing them to contribute to the momentum of the turn. This reduces the caregiver's lifting effort and promotes the older adult's independence.

What if the older adult has limited mobility and cannot assist?

In this case, caregivers should use assistive devices like a draw sheet and, if necessary, have a second person assist. The "log roll" technique should be used for safety during passive repositioning.

Can using a bed rail help with the turning process?

Yes, if the bed is equipped with a rail, the older adult can hold onto it to help pull themselves over. This provides stability and additional assistance during the turn.

How does active participation benefit the older adult's health?

Participating in repositioning helps maintain muscle strength and joint mobility. It also fosters a sense of independence and self-efficacy, which is important for overall mental and physical well-being.

Is it safe to pull an older adult by their arms to turn them?

No, it is not safe. Caregivers should avoid pulling on limbs and instead guide from the hips and shoulders while using proper body mechanics. Pulling on arms can cause injury to the older adult.