Mobility, Positioning, and Restorative Care
Protect your back and the resident
Use good body mechanics every time, even for small moves: feet apart for a wide base, bend your knees, keep the load close, tighten your stomach, and never twist while lifting. Raise the bed to working height and lower it afterward. Use a gait belt for transfers and ambulation, and get help - a second aide or a mechanical lift - when the resident cannot bear weight. Never lift a resident by the arms or under the armpits, and never pull on a weak arm.
Positioning
Turn and reposition an immobile resident at least every two hours, more often if skin is fragile. Support the body in alignment with pillows: head and neck in line, arms supported, hips and knees slightly flexed, heels floated off the mattress. Know the common positions - supine, lateral (side-lying), Sims', prone, Fowler's (upright 45–60 degrees) and semi-Fowler's - and why each is used, for example Fowler's for eating or shortness of breath.
Restorative care
The goal is function, not dependence. Encourage the resident to do as much as possible: brushing teeth, feeding, washing, pushing up during a transfer. Do range-of-motion exercises as ordered, gently and within the point of pain, and use splints or hand rolls as ordered to prevent contractures. Document what the resident actually did.
Ambulation and devices
- Cane: held on the stronger side, moved with the weaker leg.
- Walker: picked up and set down ahead, one step at a time.
- Stand on the weaker side unless told otherwise, and stay behind and to the side with a gait belt.
Traps
- Grabbing the gait belt around the ribs, or pulling the resident's arm.
- Turning a resident by pulling a limb instead of using a draw sheet.
- Skipping repositioning because the resident is sleeping comfortably.
Rule of thumb
Two hours, alignment, and let the resident do the part they can do.