When you turn an older adult in bed, what can they do to assist and help make the role easier?

According to research in geriatric care, encouraging an older adult's active participation in their bed mobility can significantly improve outcomes and enhance comfort. So, when you turn an older adult in bed, what can they do to assist and help make the role easier? Their involvement is a key part of safe and dignified care.

Quick Summary

An older adult can assist with turning in bed by bending their knees, using their arms for leverage, and crossing their arms over their chest to help guide the body. These actions create momentum and stability, making the movement safer and less strenuous for both the senior and the caregiver.

Key Points

• Bend Knees: Bending the knees creates a powerful pivot point that significantly eases the rolling motion and engages the senior's own strength.

• Use Arm Leverage: Encouraging the senior to push gently with their hands provides momentum and reduces caregiver strain.

• Communicate Clearly: Agreeing on a signal, like a count of three, ensures both parties move together, making the turn smoother and more coordinated.

• Cross Arms: Asking the senior to cross their arms prevents awkward positioning and potential shoulder injury during the turn.

• Use a Drawsheet: Even with an active senior, a drawsheet is crucial for minimizing skin friction and ensuring a safer, more controlled turn for everyone involved.

• Respect and Dignity: Active participation promotes a senior's sense of independence and dignity, making the care process a partnership.

The Importance of Active Participation

Repositioning a bed-bound individual is a critical task for preventing complications like pressure sores and ensuring comfort. While it might seem like a passive experience for the senior, their active participation is a game-changer. It reduces the physical strain on the caregiver, promotes the older adult's sense of independence, and fosters a collaborative care dynamic.

Benefits of Senior Involvement

• Prevents Caregiver Injury: Proper assistance from the senior reduces the risk of back strain and other musculoskeletal injuries for the caregiver by lightening the physical load.
• Enhances Senior Comfort: When the senior is involved in the movement, it can feel less jarring and more natural, reducing anxiety and discomfort.
• Maintains Dignity and Independence: Encouraging a senior to help with their own movement preserves their autonomy and can be a small but meaningful way to maintain their physical capabilities.
• Reduces Risk of Skin Damage: Smoother, more controlled movements minimize friction and shear forces on the skin, which are contributing factors to pressure sore development.

Key Actions for the Older Adult to Take

By following a few simple steps, an older adult with some mobility can significantly contribute to the turning process. The caregiver's role is to clearly communicate these steps beforehand and provide gentle guidance.

1. Bend the Knees

One of the most effective actions is for the older adult to bend their knees, keeping their feet flat on the mattress. This action is powerful because it:

• Creates a pivot point, allowing the lower body to roll more easily.
• Redistributes the body's weight, making it less of a dead lift for the caregiver.
• Engages the senior's leg and core muscles, providing strength and stability during the movement.

2. Use Arms for Leverage

With their arms crossed over their chest, the senior can use their hands to push down on the bed surface. This adds valuable momentum to the movement. If they are turning towards a bed rail, they can also reach for it to help pull themselves over. This leverages their upper body strength, making the turn a shared effort rather than a one-person lift.

3. Communicate and Coordinate

Before initiating the turn, the caregiver should explain the process and ask for the senior's assistance. Agree on a signal, such as a count of three, to coordinate the movement. The senior should be asked to look in the direction of the turn, which naturally helps with body alignment and makes the roll easier.

The Caregiver’s Supporting Role

The senior's efforts are most effective when combined with proper caregiver technique and preparation. Here are some best practices for the caregiver:

• Positioning: Stand on the side of the bed toward which the senior will turn. Place your feet shoulder-width apart and bend your knees to protect your back.
• Equipment: Use a drawsheet or turning sheet placed under the senior from shoulders to thighs. This is one of the most effective tools for reducing friction and strain.
• Guidance: Gently place one hand on the senior's far shoulder and the other on the far hip, guiding them during the roll. Never pull the senior by their arms, as this can cause injury.
• Secure Position: Once the turn is complete, use pillows or wedges to secure the new position, providing support behind the back and between the knees.

Comparison of Assisted vs. Unassisted Turning

Feature	Assisted Turning (Senior Helps)	Unassisted Turning (Caregiver Lifts)
Caregiver Strain	Significantly lower.	High, with increased risk of back injury.
Senior Comfort	Increased sense of control and smoother movement.	Can feel more jarring or impersonal.
Risk of Injury	Reduced risk for both caregiver and senior.	Higher risk of caregiver injury and skin shear for the senior.
Equipment Needed	Drawsheet, pillows, communication.	Drawsheet essential, potentially more complex lifting aids.
Dignity	Promotes independence and participation.	Can feel passive or disempowering.

Sample Step-by-Step Turning Routine

This routine assumes the older adult has some ability to help with the movement.

1. Communicate: Inform the senior what you are about to do and explain how they can help. "On the count of three, please bend your knees and push with your hands as I help you turn toward me."
2. Move to the Edge: Have the senior scoot toward the opposite side of the bed, creating room for the turn. Assist them if needed.
3. Prepare: Have the senior bend their knees and cross their arms over their chest. Position the pillows you will use to support them after the turn.
4. Signal and Turn: Stand with proper body mechanics. Count to three together. As you pull the drawsheet, encourage the senior to push with their feet and hands to roll toward you.
5. Secure the Position: Once the senior is on their side, use pillows to support their back, the upper leg, and between their knees to maintain proper spinal alignment.
6. Ensure Comfort: Check with the senior to make sure they are comfortable. Adjust pillows and bedding as needed.

Conclusion

For caregivers and older adults, learning how the senior can assist with turning in bed is a vital skill that promotes safer and more comfortable repositioning. By working as a team, using clear communication, and employing proper techniques with tools like a drawsheet, the process becomes less about heavy lifting and more about collaborative, respectful care. Active participation is not only a physical aid but also a way to preserve the senior's sense of dignity and partnership in their own health and wellness.

For more detailed information on proper positioning, you can consult authoritative health resources like the MedlinePlus Medical Encyclopedia, specifically their guide on Turning patients over in bed.

Frequently Asked Questions

Can an older adult with limited mobility still help when being turned?

Yes, even minimal effort like bending a knee or providing slight resistance can make a significant difference. The caregiver's role is to guide and supplement this effort, not to do all the work alone.

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

Active assistance promotes the older adult's independence, improves their comfort during the movement, and significantly reduces the risk of back strain and injury for the caregiver.

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

If they can't bend their knees, the caregiver can cross one of the senior's ankles over the other in the direction of the turn. This still helps to initiate the rolling motion.

How does a drawsheet help when turning an older adult?

A drawsheet minimizes friction between the person's body and the bed surface. This allows for a smoother, easier turn, which helps prevent skin damage and reduces the physical effort required.

Is it safe for one person to turn a heavy older adult?

It is generally safer and recommended to have two people turn a heavy adult with limited mobility. This prevents injury to both the senior and the caregivers involved. Always assess your capability before attempting alone.

How often should a bedridden older adult be turned?

A bedridden person should typically be turned at least every two hours. This regular repositioning is vital for preventing the development of painful and dangerous pressure injuries, or bedsores.

What if the older adult seems uncomfortable or in pain during turning?

Always communicate with the older adult throughout the process. Watch for any signs of discomfort or pain. If they express any, stop the movement, adjust your technique, and never force a turn. Prioritize their comfort and safety above all else.