Mobility and Positioning
What to know
Body mechanics protect you and the resident. Wide base of support, knees bent, back straight, load close to your body, pivot with your feet instead of twisting, and get help or use equipment for heavy residents. Use a gait belt for transfers. Never lift a resident by the underarms or pull them by the arms.
Reposition immobile residents at least every two hours, more often if skin is fragile. Know the standard positions: supine, lateral (side-lying with a pillow between the knees and behind the back), Sims, prone, and Fowler's or high Fowler's for breathing and eating. Support the heels and arms to prevent pressure and contractures. Perform range-of-motion exercises gently, within the resident's limits, and stop if there is pain.
Ambulation: the cane goes on the stronger side and moves with the weaker leg; a walker is moved forward first, then the resident steps into it. Encourage residents to do what they can - mobility maintained is mobility preserved.
Traps
'Cane on the weak side' - wrong. 'Pull the resident up by the arms' - wrong. 'Leave the bed high after care' - wrong. 'Skip repositioning because the resident is asleep' - wrong.
Rule of thumb
Before every transfer: gait belt on, bed at the right height, wheels locked, call light in reach, and the resident's shoes on.
Worked example
A resident with weakness on the left wants to walk. Place the cane in the right hand, stand on the resident's weak side, apply the gait belt, and walk slightly behind and to the side - close enough to guard, not so close you block them.