How to assist someone to stand from the floor? A caregiver's guide

Falls are the leading cause of injury among older adults, with one in four seniors falling each year. For caregivers, knowing how to assist someone to stand from the floor safely is an essential skill that protects both parties from further harm.

Quick Summary

Safely assisting a person to stand from the floor requires assessing for injury, guiding them into a stable position, and using proper body mechanics to leverage their strength rather than lift them. This minimizes risk for the fallen person and prevents caregiver back strain.

Key Points

• Assess First: Always check for injuries before attempting to assist someone who has fallen. Call for help if a head injury or fracture is suspected.

• Use Proper Technique: The chair method is a safe, controlled way to help an uninjured person stand, using leverage and the person's own strength to avoid caregiver back strain.

• Avoid Underarm Lifts: Never pull a person up by their arms or from their armpits, as this can cause serious injury to both the individual and the caregiver.

• Utilize Assistive Devices: Transfer belts or mechanical lifts can significantly improve safety and reduce effort, especially for those with limited mobility.

• Know When to Call for Help: If the person is unconscious, in severe pain, or has a suspected serious injury, your first action should be to call emergency services, not to attempt a lift.

• Communicate Clearly: Talk through each step of the process to reassure and prepare the person, fostering cooperation and reducing anxiety.

Initial Assessment: Before You Help

Before taking any action, it is critical to assess the situation to ensure the safety of both yourself and the person who has fallen. Rushing to help can cause further injury.

Check for Injuries

First, ensure the person is responsive and conscious. If they are unconscious, confused, or have lost consciousness, do not move them. If you suspect a serious injury, especially to the head, neck, back, or limbs, call emergency services immediately. Look for visible cuts, bruises, or deformities that may indicate a fracture.

Communicate and Plan

Talk to the person and calmly explain what you are going to do. Ask them if they are in any pain. This communication is essential to gain their trust and cooperation. Reassure them that you are there to help and that you will go slowly.

Clear the Area

To prevent further falls or injuries, remove any obstacles around the person. This includes:

• Small tables or chairs
• Rugs or cords
• Pillows or blankets
• Anything that could obstruct your path or cause tripping

The Chair Method: A Safer, Step-by-Step Approach

For an uninjured person, the chair method is a controlled and safe way to help them stand. It relies on leverage and technique rather than brute strength.

1. Bring a sturdy, armrest-equipped chair to a position near the person's head, facing away from them. Ensure the chair will not slip. Use a non-slip mat if needed.
2. Guide them to a seated position. Assist the person to roll over to their side, then slowly help them push up to a sitting position. Their legs should be extended in front of them.
3. Help them onto their hands and knees. Once they are seated, guide them onto their hands and knees. This brings them closer to the chair.
4. Position their hands on the chair. Instruct the person to move their hands from the floor onto the seat of the chair. You should be positioned behind the chair to provide stability.
5. Lift one leg. Coach the person to bring one knee forward, planting the foot firmly on the floor. This provides a strong base for the next step.
6. Push up to standing. With one hand on their back for support, and the other on their arm, help them push off the chair and stand. Use your leg muscles to help them, not your back.

Comparison: Transfer Techniques for Caregivers

Choosing the right method for assisting someone from the floor is crucial for both parties. The following table compares two common approaches.

Technique	Safety Rating	Key Benefits	Potential Risks
Bear Hug/Underarm-Grip	Moderate (if done right)	Allows helper to control the person's center of gravity	High risk of back injury for caregiver if they lift with their back; can be uncomfortable for the fallen
The Chair Method	High	Reduces strain on the caregiver; puts the fallen person in control of their own movement; uses a stable base (the chair)	Requires the person to be mobile enough to follow instructions; needs a sturdy chair nearby
Underarm Lift (Solo)	Very Low	None; highly dangerous	Extremely high risk of back, shoulder, and arm injury for caregiver; can dislocate the person's arms or cause nerve damage

Using Assistive Devices for Extra Support

In some cases, using an assistive device can make the process safer and more manageable. The key is to have the equipment on hand and know how to use it correctly.

Transfer or Gait Belts

A gait belt is a device that goes around the person's waist, providing a secure handle for the caregiver.

• Ensure the belt is snug but not too tight.
• Hold the belt from the back to provide a stable grip during the standing process.
• This is especially useful for those with balance issues.

Using a Mechanical Lift

For individuals with very limited mobility, a mechanical lift may be necessary. These are operated by a caregiver and are designed to lift and transfer a person safely and mechanically, removing the need for manual lifting altogether.

Training for Safe Practices

To ensure both caregiver and patient safety, formal training is highly recommended. These programs teach proper body mechanics, lifting techniques, and how to use assistive devices effectively. Organizations like the CDC offer resources for fall prevention and caregiver training.

For more clinical resources and tools developed for healthcare professionals to reduce fall risk, consider exploring the CDC's STEADI Initiative.

When NOT to Attempt a Lift

There are situations where attempting to help a person up is dangerous. Knowing when to call for emergency medical help is crucial for safety.

• Visible Injury: If you see or suspect a fracture, especially in the head, neck, or spine.
• Unresponsiveness: If the person is unconscious or losing consciousness.
• Excessive Pain: If the person complains of severe, sudden pain that worsens with movement.
• Loss of Sensation: If they report numbness, tingling, or an inability to move a limb.
• Difficulty Breathing: If they have trouble breathing or show signs of shock.

Conclusion

Safely assisting a person to stand from the floor is a skill that blends assessment, communication, and proper technique. By first ensuring there are no serious injuries, then employing a controlled method like the chair technique, a caregiver can minimize the risk of harm to both parties. Understanding when to seek professional medical help and the benefits of assistive devices further reinforces a safe caregiving environment, promoting healthy aging and fall prevention.

Frequently Asked Questions

What is the most important thing to do immediately after someone falls?

The most important first step is to assess the person for any injuries before attempting to move them. Ask them if they are in pain and check for visible signs of trauma, especially to the head or neck. If they seem seriously hurt or disoriented, call for emergency medical help immediately.

What if the person cannot move their legs to stand?

If the person cannot use their legs to assist with standing, it is best not to attempt a manual lift. In this case, or if they have significant mobility limitations, a mechanical lift or professional assistance is required to prevent serious injury to both parties. A trained professional is equipped to handle such situations safely.

Can a gait belt be used to help someone up from the floor?

Yes, a gait belt can be very helpful in assisting someone to stand from the floor. It provides a secure, non-slip handle for the caregiver to use for support and guidance during the transfer, significantly reducing the risk of strain and injury.

How can I prepare my home to prevent falls?

You can prepare your home by clearing pathways of clutter, securing or removing throw rugs, improving lighting, and installing grab bars in bathrooms and stairways. Ensuring frequently used items are within easy reach also helps prevent overstretching or climbing.

What are the signs that I should not move the person who fell?

Do not move the person if they are unconscious, bleeding heavily, complain of severe pain, or if you suspect a head, neck, or spinal injury. Also, if they report numbness or can't move a limb, wait for emergency responders.

Is it better to roll or lift someone who has fallen?

For an uninjured person, it is almost always safer to roll and assist them to a sitting position first, rather than attempting to lift them directly from the floor. Lifting directly, especially from the arms or armpits, is dangerous and can lead to serious injury for both the fallen person and the caregiver.

Should I call for help even if the person seems fine after a fall?

It is a good practice to call for a check-up, especially for an older adult. What seems fine initially can mask a minor injury that may worsen. A healthcare professional can assess for potential internal injuries or less obvious problems that could lead to another fall.