How to properly roll someone in bed? The essential guide for caregivers

According to healthcare professionals, proper patient positioning is critical for preventing bedsores and improving circulation. Learning how to properly roll someone in bed is an essential skill for caregivers, ensuring safety and comfort for everyone involved and reducing the risk of injury.

Quick Summary

Safely rolling a person in bed requires using proper body mechanics, communicating clearly with the patient, and often utilizing a draw sheet to reduce friction and strain for both the caregiver and the individual being moved.

Key Points

• Use a Draw Sheet: Always use a draw sheet for easier and safer repositioning, as it reduces friction and caregiver strain.

• Protect Your Back: Practice good body mechanics by bending your knees and using your leg muscles to roll the patient, not your back.

• Communicate Clearly: Explain the process to the person beforehand, even if they are non-verbal, to reduce anxiety and maintain dignity.

• Reposition Regularly: Turn the patient every two hours to prevent pressure ulcers, which are a serious risk for bedridden individuals.

• Ensure Comfort: Use pillows to support the patient's back, legs, and arms after rolling to maintain proper alignment and alleviate pressure points.

• Never Pull by Limbs: Avoid pulling on the patient's arms or shoulders, which can cause injury. Always use a draw sheet or the person's hips and shoulders for guidance.

Why Is Proper Rolling Important?

Frequent repositioning of bedridden individuals is a crucial part of caregiving. It helps prevent a range of health issues, including pressure ulcers (bedsores), muscle stiffness, and breathing problems. Proper technique also minimizes the risk of back injury for the caregiver. Approaching this task with a clear process, appropriate equipment, and good communication ensures the safety and dignity of the person you are assisting.

Essential Preparations Before You Begin

Before attempting to roll someone, it is vital to prepare the environment and the patient. This prevents last-minute fumbling and reduces the risk of injury.

Preparing the Environment

• Lock the Bed Wheels: Ensure the bed is stable and will not move during the process. If using a hospital bed, make sure all wheel locks are engaged.
• Raise the Bed to a Safe Height: Adjust the bed so that the surface is at a comfortable working height, typically around your waist level. This prevents you from bending at the waist and straining your back.
• Clear the Area: Remove any pillows, blankets, or other items that might obstruct the movement. Make sure any medical equipment, such as IV lines or catheters, has enough slack to move with the patient.

Preparing the Patient

• Communicate Clearly: Always explain what you are about to do. For example, say, "I'm going to help you roll onto your side now." This reduces anxiety and helps the patient participate if they are able.
• Assess Mobility: Gauge the patient's ability to help. If they can move their limbs or push with their feet, this can make the process easier and safer.

Step-by-Step Guide to Rolling with a Draw Sheet

Using a draw sheet—a smaller sheet folded and placed across the bed under the person's back and thighs—is the safest and most effective method. A draw sheet significantly reduces friction and provides a strong handle for maneuvering.

1. Move the Person to One Side of the Bed: Stand on the side of the bed you plan to roll them away from. Tuck the patient's arms across their chest. If they can, ask them to bend the leg closest to you while crossing the other ankle over it.
2. Position Yourself Correctly: Bend your knees and keep your back straight. Grab the rolled-up edge of the draw sheet, one hand near their shoulder and the other near their hip.
3. Roll the Person: On the count of three, pull the draw sheet towards you, gently rolling the person onto their side. Use your body weight and legs to do the work, not your back.
4. Reposition for Comfort and Safety: Once on their side, place pillows for support. A pillow behind the back will keep them from rolling back over. Another pillow between the knees and ankles prevents pressure points and maintains proper spinal alignment. An arm pillow can also increase comfort.

Rolling with Minimal or No Assistance

If you have to manage alone, or the patient has some mobility, you can adapt the process.

1. Shift the Person to the Opposite Edge: Before rolling, help the person scoot towards the side of the bed opposite the direction you intend to roll them. This gives them enough room to complete the turn without getting too close to the edge.
2. Use Momentum: Stand on the side you are rolling towards. Instruct the person to bend their knees (if possible) and push off the bed with their feet. At the same time, ask them to reach across their body with their far arm toward the side rail or bed edge. You can provide gentle guidance at their hip and shoulder.

Rolling with Limited Mobility and No Helper

For individuals who cannot assist, special techniques using assistive equipment are crucial for safety. The single-handed technique with a slide sheet is a common method for trained caregivers.

1. Slide Sheet Placement: Roll the person slightly to one side and place a folded slide sheet beneath them. Then, roll them onto the other side to pull the slide sheet through.
2. Pulling with the Slide Sheet: Stand on the side you intend to roll toward. Grasp the slide sheet firmly at the patient’s shoulders and hips. Gently pull the sheet, using your body weight to guide them onto their side.
3. Final Positioning: Once rolled, arrange supportive pillows as described previously. This ensures stability and prevents pressure injuries.

Key Considerations: Preventing Injury

Caregiver Body Mechanics

• Use Your Legs, Not Your Back: Always bend your knees and hips, keeping your back straight. This transfers the effort to your stronger leg muscles.
• Pivot Your Feet: Instead of twisting your torso, pivot your feet to turn your body. This protects your spine from strain.
• Keep the Person Close: Hold the patient as close to your body as safely possible during the roll. This reduces strain on your arms and shoulders.

Patient Pressure Injury Prevention

• Smooth Surfaces: Ensure the sheets are wrinkle-free. Wrinkles can create pressure points that lead to bedsores.
• Reposition Regularly: Bedridden individuals should be repositioned every two hours to relieve pressure on bony areas like the hips, shoulders, and tailbone. For more information on this, the National Institute on Aging offers extensive resources on preventing pressure injuries.
• Check Skin for Redness: After repositioning, check the skin for any reddened areas that do not blanch (turn white) when pressed. This can be an early sign of a pressure ulcer.

Comparison: Draw Sheet vs. Manual Rolling

Feature	Rolling with a Draw Sheet	Manual Rolling (without sheet)
Safety for Caregiver	Significantly reduces back strain by leveraging body weight.	High risk of back, shoulder, and wrist injury from lifting.
Safety for Patient	Minimizes friction and shear forces on the skin, reducing risk of skin tears and bedsores.	Increases friction and potential for skin damage, especially on fragile skin.
Effort Required	Less physical exertion required from the caregiver.	Requires more strength and can be more difficult for a single person.
Best Used For	Most bedridden individuals, especially heavier or less mobile ones.	Only for individuals with some mobility who can actively assist.
Versatility	Can be used to shift the patient up or down in bed as well as side-to-side.	Primarily for side-to-side repositioning.

Conclusion

Knowing how to properly roll someone in bed is a fundamental skill that safeguards both the patient's well-being and the caregiver's health. By prioritizing preparation, employing proper techniques—especially with the use of a draw sheet—and practicing safe body mechanics, caregivers can perform this essential task with confidence. Regular repositioning, combined with vigilance for skin changes, is key to preventing complications and ensuring a high standard of care for those who are bedridden.

Frequently Asked Questions

How often should you roll someone in bed?

For most bedridden individuals, it is recommended to change their position at least every two hours to prevent the development of pressure sores and improve circulation.

What is the best way to roll a heavy person in bed?

For heavier individuals, it is best to use a draw sheet and have a second person assist. This distributes the weight and reduces the risk of injury to the caregivers. Always use proper lifting techniques and leverage the draw sheet for the roll.

How do you roll a patient on their side without a draw sheet?

To roll someone without a draw sheet, move the patient towards the edge of the bed opposite the direction you're rolling. Position their far arm across their chest and bend their far knee. Gently push at the hip and shoulder to facilitate the roll while pulling them towards you.

What is a draw sheet and why is it important?

A draw sheet is a smaller sheet placed over the fitted sheet that runs from the patient's shoulders to their thighs. It is important because it allows caregivers to roll and reposition the patient with much less friction, protecting the patient's skin and the caregiver's back.

Can rolling a person in bed cause injury?

Improper rolling techniques can cause injury to both the caregiver and the patient. Caregivers risk back and shoulder strain, while patients can experience skin shearing, tears, or shoulder dislocations if not handled correctly. Using proper tools and body mechanics is crucial.

How do you position pillows after rolling someone on their side?

After rolling someone on their side, place a pillow behind their back to prevent them from rolling backward. Place another pillow between their knees and ankles to keep their spine aligned and prevent pressure points. Support the top arm with a pillow as well for comfort.

What are the signs of a pressure sore to watch for?

The initial signs of a pressure sore include a reddened area of skin that does not turn white when you press it. Other signs include swelling, warmth, or a color change in the skin. Early detection and repositioning are key to prevention.