How to care for someone who cannot walk?: A comprehensive guide for caregivers

According to the CDC, over 13.7% of American adults have a mobility disability, making mobility assistance a common aspect of caregiving. Knowing how to care for someone who cannot walk is crucial for ensuring their safety, comfort, and dignity.

Quick Summary

This guide provides practical strategies for managing the daily care of an individual with limited or no mobility. It covers topics from safe transfers and preventing bedsores to maintaining hygiene and supporting emotional well-being.

Key Points

• Home Accessibility: Modify the living space with ramps, grab bars, and clear pathways to prevent falls and improve independent mobility.

• Safe Transfers: Use proper body mechanics and assistive devices like gait belts or transfer boards to move the individual safely and prevent injury to both parties.

• Pressure Ulcer Prevention: Reposition bedridden individuals every two hours and use specialized cushions or mattresses to prevent painful bedsores.

• Maintain Hygiene: Establish a regular hygiene routine, including bed baths, oral care, and incontinence management, to ensure comfort and prevent infection.

• Emotional Support: Provide empathy and encourage independence to help the individual cope with the emotional impact of limited mobility.

• Use Assistive Devices Wisely: Choose the right mobility aids based on the individual's needs, from simple walkers to mechanical lifts for heavier lifting.

• Caregiver Self-Care: Prioritize your own physical and mental well-being by seeking professional help, taking breaks, and joining support groups.

Caring for an individual who cannot walk requires a thoughtful and comprehensive approach to ensure their physical and emotional well-being. The role can be physically and mentally demanding, but with the right knowledge and tools, it can be a rewarding experience for both the caregiver and the recipient of care.

Creating a Safe and Accessible Environment

Modifying the living space is a critical first step to enhance safety and promote independence. Simple changes can make a significant difference in preventing falls and allowing for easier navigation. Start by assessing the home for potential hazards and accessibility barriers.

• Clear pathways: Remove clutter, loose rugs, and electrical cords from high-traffic areas. Ensure hallways are wide enough for a wheelchair or other mobility device.
• Install grab bars: These are essential in the bathroom, particularly near the toilet and in the shower or tub, to provide stable support.
• Modify the bathroom: A curbless or roll-in shower and a raised toilet seat can dramatically improve accessibility and safety. A shower chair or bench can make bathing easier and safer.
• Consider ramps: For entrances or different levels of the house, installing ramps can make moving between areas much smoother than navigating stairs.
• Adjust furniture: Rearrange furniture to create clear, wide paths for movement. Ensure frequently used items are within easy reach.

Mastering Safe Transfer and Repositioning Techniques

Proper techniques for moving and transferring are vital to protect both the caregiver and the person being cared for from injury. Always communicate each step of the process to the individual to ensure their cooperation and comfort.

Transferring from a bed to a wheelchair

1. Position the wheelchair close to the bed on the individual's strongest side, with brakes locked and footrests out of the way.
2. Help the person move to a sitting position on the side of the bed, with feet flat on the floor.
3. Stand facing the person, with your knees bent and back straight. Use a gait belt securely fastened around their waist.
4. On a coordinated count, use your legs to pivot and help the person stand, moving them towards the wheelchair.
5. Gently lower them into the chair, ensuring their back is against the seat before they sit down fully.

Preventing bedsores

Bedridden individuals are at high risk for pressure ulcers. Regular repositioning is the single most important preventative measure.

• Reposition regularly: Shift the person's position at least every two hours in bed and every hour when seated in a chair.
• Use supportive devices: Utilize specialized mattresses, cushions, and pillows to relieve pressure on bony areas like the tailbone, hips, and heels.
• Maintain skin integrity: Keep the skin clean, dry, and moisturized. Check for any signs of redness, warmth, or swelling during repositioning.

Essential Daily Care and Hygiene

Maintaining personal hygiene is crucial for dignity and preventing infections. It is important to involve the individual in this process as much as possible to give them a sense of control.

• Regular bed baths: Use mild soap and warm water. Wash one section of the body at a time to maintain warmth and privacy.
• Oral care: Help with brushing teeth at least twice a day. Use a soft brush or mouth swabs if needed. Ensure dentures are cleaned properly.
• Nail and hair care: Keep fingernails and toenails trimmed and clean. Regularly wash and comb their hair, as this can be a morale booster.
• Managing incontinence: If adult diapers or other products are used, change them promptly to keep the skin clean and dry. Use barrier creams to protect against irritation.

Comparison of Assistive Transfer Devices

Feature	Gait Belt	Transfer Board	Mechanical Lift (Hoyer Lift)
Best for	Individuals who can bear some weight and need minimal assistance with balance.	Moving between two surfaces (e.g., bed to chair) for individuals with good upper body strength.	Individuals who cannot bear their own weight at all.
Caregiver Effort	Requires moderate physical strength and proper technique to use effectively.	Requires less lifting by the caregiver but good technique to slide the person across.	Minimizes physical strain on the caregiver, using mechanical power for lifting.
Cost	Low	Moderate	High (Often covered by insurance for medical necessity).
Training Required	Minimal; basic instruction from a physical therapist is recommended.	Moderate; requires practice to use safely and efficiently.	Extensive; proper training is essential to prevent injury.
Pros	Affordable, portable, and good for basic support.	Reduces friction during transfers; less strenuous than manual lifting.	Extremely safe for both caregiver and user; requires minimal physical strength.
Cons	Not suitable for lifting; can cause injury if used improperly.	Requires user to have some ability to assist with the transfer.	Expensive, can be bulky, and requires more setup time.

Providing Emotional and Mental Health Support

Losing mobility can be a devastating and isolating experience. A supportive and empathetic approach is key to helping someone navigate the emotional challenges. Remember that patience and understanding go a long way.

• Listen and validate: Acknowledge their feelings of frustration, sadness, or grief. Create an open space for them to express their emotions without judgment.
• Encourage independence: Empower them to make decisions about their daily routine, hobbies, and care. Let them perform tasks they are able to, even if it takes more time.
• Facilitate social engagement: Combat loneliness by arranging for visits from friends and family, using video calls, or connecting with support groups.
• Adapt hobbies: Encourage them to pursue hobbies they enjoy, adapting them to their current abilities. For example, a person who once enjoyed gardening might use raised garden beds.
• Consider professional help: If you notice signs of depression or anxiety, encourage them to speak with a therapist or counselor.

Seeking Professional Assistance and Self-Care for the Caregiver

Caregiving is a demanding role, and it is important to recognize when professional help is needed and to prioritize your own well-being.

• Professional assistance: Services such as in-home caregivers, physical therapists, and occupational therapists can provide valuable support and expertise. A physical therapist can also teach proper lifting techniques to prevent caregiver injury.
• Respite care: Consider short-term relief options, such as adult daycare or respite services, to give yourself a break.
• Join a support group: Connecting with other caregivers can provide emotional support and practical advice from those with shared experiences.
• Maintain your own health: Prioritize your own nutrition, exercise, and sleep. You cannot pour from an empty cup.

Conclusion

Caring for someone who cannot walk is a profound responsibility that touches every aspect of their life, from physical safety to emotional health. By making the home accessible, using safe transfer techniques, maintaining meticulous hygiene, and providing compassionate emotional support, caregivers can significantly improve the quality of life for their loved ones. Utilizing assistive devices and professional resources, while also prioritizing personal well-being, ensures a sustainable and effective caregiving journey. This holistic approach empowers both the individual receiving care and the caregiver, fostering dignity, safety, and a strong sense of connection. For more specific guidance on adaptive equipment, consult resources such as Silverts Adaptive Clothing.

Frequently Asked Questions

How often should you reposition a person who cannot walk?

For individuals who are bedridden, they should be repositioned at least every two hours to prevent pressure ulcers. For those sitting in a wheelchair, repositioning should occur at least every hour.

What is the best way to move someone from a bed to a wheelchair?

Using a gait belt is a safe method. Position the wheelchair near the bed, help the person sit up, attach the belt, and use your leg muscles to pivot them from the bed to the chair. Always use proper body mechanics and communicate your actions.

How can I prevent bedsores for a person with limited mobility?

The most effective methods include regular repositioning, keeping the skin clean and dry, using supportive devices like cushions or special mattresses, and ensuring proper nutrition and hydration.

What kind of home modifications are helpful for someone with no mobility?

Helpful modifications include installing grab bars in bathrooms, widening doorways, building ramps for entrances, and creating a curbless shower. Removing clutter and securing rugs also prevents falls.

How do you provide a bed bath for a bedridden person?

Gather supplies, ensure the room is warm, and use a mild soap with warm water. Wash one body part at a time, covering the rest to maintain warmth and privacy. Pat the skin dry gently and apply moisturizer.

How can I support the mental health of someone who can't walk?

Offer emotional support by listening to their feelings, validating their experiences, and encouraging independence in areas they can still control. Facilitate social engagement and adapt hobbies to their abilities to prevent isolation.

When should a caregiver use a mechanical lift instead of manual transfers?

A mechanical lift (e.g., Hoyer lift) should be used when an individual cannot bear their own weight at all. This protects both the caregiver and the person from injury during transfers, as it requires minimal physical lifting.