How To Use A Gait Belt
- If no contraindications exist, place the gait belt snugly around the patient’s waist while they’re sitting on the edge of the bed. You barely should be able to get your fingers under the belt to provide support.
- After the belt is properly secured, ensure that the patient’s feet are placed flat on the floor. If your patient is short and unable to reach the floor while sitting on the bed, consider a specialized low bed or a stepstool that offers a wide base of support.
- Next, place a walker in front of the patient and ask them to push up from the bed to stand. Instruct the patient not to reach for the walker or to pull up on it and not to grab or pull on you for support.
- When the patient is able to stand for a full minute, ask if they feel light-headed or dizzy. If the answer is yes, help the patient to sit back onto the bed. If all is well, test the patient’s balance by having them step forward and back at least three times.
Transferring A Client Who Struggles To Stand Independently
Assessment
- Assess the client’s capabilities: Can they bear some weight? Do they have a stronger side? Can they follow instructions?
- Assess the environment: Is the transfer area clear of obstacles and slipping hazards?
- Determine if assistance is needed: If the client is very unstable or cannot bear much weight, get help from another person.
Prepare for the Transfer
- Explain the process: Tell the client exactly what you are going to do, step-by-step. This helps them cooperate and feel more secure.
- Ensure proper footwear: The client should wear non-skid socks or shoes for stability.
- Position and secure equipment: Wheelchair (if applicable): Place the wheelchair, if applicable, next to the bed on the client’s stronger side, lock the wheels, and swing away the footrests. If possible, lower the bed so the client’s feet can touch the floor when sitting on the edge.
Sit-to-Stand Pivot Transfer (for clients with some weight-bearing ability):
- Position the client: Help them scoot to the edge of the bed with their feet flat on the floor.
- Apply a gait belt: Secure it snugly around the client’s waist.
- Your stance: Stand facing the client, as close as possible, with your feet shoulder-width apart and one foot slightly forward.
- Initiate the stand: Bend your knees and keep your back straight. Grasp the gait belt firmly from underneath.
- Use momentum: Use a gentle rocking motion and a verbal cue (e.g., “On three, push up with your arms to stand!”) to help the client stand.
- Pivot: Once standing, pivot your whole body (don’t twist at the waist) until the back of the client’s legs touch the chair.
- Lower the client: Have the client reach for the armrests of the chair and lower them gently by bending your knees.
Assisted Standing (if the client needs additional support):
- Two-person assist: If needed, have two caregivers assist with the transfer.
- Using assistive devices: Consider using a walker, cane, or the side rail of the bed if appropriate and if the client has been trained in their use.
Patient Lift (Hoyer Lift):
- If the client cannot bear weight: A patient lift is the safest method.
- Procedure: Follow the instructions for the specific lift being used, including using the sling and properly positioning the client.
Important Safety Tips:
- Don’t try anything unsafe: If you are unsure or feel unsafe, get help.
- Maintain proper body mechanics: Bend your knees, keep your back straight, and avoid twisting.
- Keep the client close: This provides stability.
- Use the gait belt for support, not lifting: The gait belt is for helping to maintain balance and controlling movement, not for lifting the full weight of the client.
- If the client starts to fall, ease them gently to the floor: Do not try to stop the fall, as this can cause injury to both of you.
Post-Transfer:
- Ensure the client is stable and comfortable: Check if they are feeling okay in the chair or bed.
- Ensure they have access to necessary items: Place personal items and the call light within their reach.
- Remember: Always consult with a healthcare professional or physical therapist for specific training and recommendations tailored to the client’s individual needs.
Bed to Wheelchair Transfer
When someone is dependent on a wheelchair, it is important to know how to help them safely get in and out of it. This will help them to be mobile while reducing their risk of injury. For safety’s sake, learn how to help them in and out of the wheelchair. One basic method is shown here.
Sit the person up
- Help the person put on proper footwear before they stand.
- Lock the wheelchair.
- In case of 1-sided weakness, place the wheelchair near the person’s stronger side.
- Help the person turn over onto their side, facing you.
- Put an arm under their upper back with your hand supporting their shoulder. Put your other hand behind their knees.
- Swing their legs over the edge of the bed, helping them to sit up.
- If needed, attach a transfer belt around the person’s waist.
Stand the person up
- Have the person scoot to the edge of the bed.
- Position your legs on the outsides of the person’s legs.
- Put your arms around their chest and clasp your hands behind their back. Do not let them grab or hold you around your neck. Use a transfer belt if needed.
- Help the person shift weight in a rocking motion until they reach a standing position.
Sit the person in the wheelchair
- Once standing, have the person pivot toward the wheelchair, as you continue to hold on. Always transfer toward the person’s stronger side.
- Have the person take a few steps back until they can feel the wheelchair on the back of their legs.
- Ask the person to grasp the arm of the wheelchair and lean forward slightly.
- As the person bends toward you, bend your knees and lower the person into the back of the wheelchair.
- Be sure that they are sitting comfortably in the wheelchair.
Important safety tips
- Organize the steps in your head before you start.
- Explain the steps of the move and ask the person to tell you when they are ready to transfer.
- Keep your knees bent and your back straight.
- Use a transfer belt to provide a firm hold, rather than clasping your hands behind the person’s back.
- Get help when you need it.
- Ask to practice with supervision.