Mobility, Positioning, and Restorative Care
Move with your legs, position with your brain
Reposition bedbound residents at least every two hours and per the care plan, using a 30-degree lateral tilt with pillows between the knees, behind the back, and under the arms. Keep heels off the mattress, keep the head of the bed as low as tolerated, and never drag a resident - use a draw sheet and enough help.
Body mechanics protect your back as much as the resident's skin: wide base of support, bend at the knees, keep the load close, and do not twist. Raise the bed to working height for care and lower it before you leave.
For transfers, apply a gait belt, put the bed at the right height, and use a stand-pivot motion toward the resident's stronger side. Mechanical lifts require trained staff and two caregivers per policy. During ambulation, the cane goes in the stronger hand and moves with the weaker leg; a walker is picked up and placed ahead. Encourage weight bearing and self-care even when it is slower.
Restorative care means consistent practice: range of motion (active when the resident can do it, passive when they cannot), splints and positioning devices as ordered, and encouragement at every meal and bath. Contractures and pressure injuries are prevented by small, repeated efforts. Never skip repositioning because the resident is sleeping unless the care plan or nurse directs otherwise.
Traps: putting the cane in the weak hand, pulling a resident up by the arms, or doing all the work instead of prompting the resident.
Rule of thumb: cane in the strong hand, gait belt on, and reposition every two hours.