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Step by Step: Assisting Older Adults with Mobility, Transfers & Mechanical Lifts

This is a multi-part series to help caregivers learn how to assist a senior with their personal care. Activities of Daily Living, or ADLs, are basic self-care tasks. In Part 5, we will focus on assisting older adults with mobility, transfers and repositioning. When helping with mobility, always wash your hands before and after the task and provide privacy as much as possible. Explain clearly what you are going to do so the older adult knows what to expect and allow the person you are assisting to do as much as possible.

Proper & Safe Body Mechanics

Good body mechanics are necessary to reduce the risk of you hurting yourself (such as injuring your back) while caring for an older adult. Allow the person you are assisting to do as much of the moving as possible. Hold your head up, shoulders back, chest high and back straight. Your feet should be hip width apart, with one foot in front of the other. Keep your knees bent and lift using your leg muscles rather than pulling with your arms. Pulling with your upper body is likely to cause injury to yourself. Do not turn from the waist and do not reach out when lifting. Moving an Older Adult up in Bed Remove pillows from under the older adult’s head; then have the older adult bend both legs and put their feet on the bed.  Ask the older adult to push down with their hands and feet and help move their body up toward the top of the bed on the count of three. As always, allow the older adult to do all or most of the work. Ensure that the older adult has enough room to roll. If needed have them bend both legs and put feet on bed to allow them to assist with scooting over. Ask the older adult to help perform the roll by reaching in the direction of the roll. If the older adult’s legs are bent it will assist to make the roll easier. Put one hand under the older adult’s shoulder. Put the other hand on the older adult’s hip then gently roll the older adult toward the other side of the bed. Finally, make sure the older adult is comfortable. Assisting Older Adults with Transfers The basics of transferring are the same whether you are moving an older adult from a bed to a chair, wheelchair or commode. First, bring the chair close to the bed, position it so that the older adult’s stronger side is closer to the chair, then fold the footrests out of the way. When transferring them back from the chair, wheelchair or commode into bed, ask the older adult to push up from the chair on the count of three. Ensure the older adult uses their gait device (eg. cane, walker) as part of the transfer. Here is a great tip: a gait belt or pants belt will give you the most control while assisting an older adult to stand. Pulling on arms during a transfer may cause injury to the older adult. Using a Mechanical Lift The most important thing about using a lift is to make sure to have a therapist or equipment company demonstrate the specific lift to you first so that you will understand the safety steps involved. However in general, position the wheelchair so that there is room to turn and move the lift. Ensure that the wheelchair’s brakes are locked and always look for obstacles or objects which could cause injury by bumping into them. Explain what you are going to do so that the older adult knows what to expect. Lastly, move slowly while turning an adult in a lift to minimize risk and allow time to spot potential hazards.  Assisting Older Adults with Walking Most importantly ensure that supportive footwear is in place; slip on shoes or slippers are less preferred. If the older adult is not steady, use a gait belt or pants belt. Position yourself alongside the older adult’s weaker side as walking.  Make sure the older adult turns fully and backs up before attempting to sit back down. Encourage the older adult to reach back with one or both arms before sitting. Assisting Older Adults to Get Up After a Fall First, make sure that no injury has occurred. If you believe that an injury has occurred, do not move the older adult and call for help. Pull a chair up close to the older adult. Ask them to grasp the chair with their arms so that they can help lift their upper body. You can put a gait belt on or use their pants belt to hold onto and help to lift them as they rise. As always, do not pull on their arms. To learn more about helping after and even preventing falls with older adults, take CareAcademy’s online course. If you’re an eldercare agency, register for a demonstration and free class from Care Academy by going to our site and clicking Request a Demo.

Dr. Reddy is a specialist in Internal Medicine & Geriatric Medicine. She holds appointments at Harvard Medical School & Hebrew SeniorLife in Boston, MA. She has seen the struggles that families and caregivers go through when caring for adults. Through CareAcademy, she intends to improve people's lives. Dr. Reddy's research is published as journal articles and book chapters. She has also authored a book for family caregivers.

Madhuri ReddyStep by Step: Assisting Older Adults with Mobility, Transfers & Mechanical Lifts

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