American Medical Association Family Medical Guide - American Medical Association [145]
An immobile person who is confined to bed should not remain in the same position for longer than 2 hours while the caregiver is awake. Move the person from his or her side, onto his or her back, and onto the other side every 2 hours. When the immobile person is on his or her back, position a pillow under each arm and on the side of each thigh to prevent outward hip rotation. Also, place a small pillow under the knees and a footboard at the foot of the bed to keep the person’s feet positioned at a right angle to the mattress. This positioning will prevent the development of footdrop (a condition in which the foot hangs limply from the ankle) and keep the person from sliding down the bed.
Do not tuck sheets and blankets tightly around the person’s feet and legs; keep blankets and other coverings elevated with a bed or foot cradle (a tentlike device placed at the foot of the bed). Keep bottom sheets taut to prevent them from wrinkling or gathering under the person’s body, which could cause pressure sores.
When feeding a person in bed, elevate the head of the bed at least 30 degrees to prevent choking, and keep the bed raised for at least an hour after eating. This positioning helps prevent the person from regurgitating food, which can cause him or her to accidentally breathe food into the lungs and choke. Breathing foreign particles into the lungs can lead to pneumonia.
Moving an Immobile Person
When moving an immobile person to a chair, wheelchair, or commode, wear sturdy shoes with nonskid soles, and make sure that the person you are moving is also wearing sturdy, nonskid shoes or slippers. To prevent falls, do not attempt to move a person who is barefoot or wearing only socks. You may need to use a transfer belt, a specially designed belt that is placed around the person’s waist. The belt provides leverage and makes it easier to firmly grip the person when you help him or her to a standing or sitting position. Your doctor, nurse, or home health aide can teach you how to use a transfer belt properly. You can purchase one from a medical supply company.
WARNING!
Transfer Belts
Never use a regular belt as a transfer belt when moving an immobile person or you could cause serious injury to the person.
Before you move the person:
• Talk about each step with the person.
• If you are moving the person from a hospital bed, lock the bed’s brakes.
• If you are moving the person to a wheelchair, lock the wheelchair’s brakes.
• If needed, put a transfer belt on the person.
To move an immobile person:
1. Carefully help the person to a sitting position on the side of the bed, with his or her feet on the floor. If the person has been confined to bed for a long time, allow him or her to rest on the edge of the bed until he or she feels secure. Stand directly in front of the person, and brace his or her knees with your knees. Carefully slide the person’s hips toward you.
2. Help the person to a standing position, using the transfer belt if necessary, to firmly hold him or her around the waist.
3. Slowly pivot the person around until his or her back is directly in front of the chair, wheelchair, or commode; have the person feel the seat of the chair or commode with the back of his or her legs before attempting to sit.
4. Slowly lower the person to a sitting position. Once he or she is securely seated, remove the transfer belt.
To help the person back into bed, perform the steps described above in reverse order. Be sure to lock the brakes on the bed and wheelchair before you begin, and use the transfer belt. If you are using a hospital bed, don’t forget to raise the bed rails after the person is back in bed.
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