4.2.3 Assisting to Rise from Bed
When a client is unable to get out of bed without assistance, you must help them to exit their bed by completing three steps. Note that you may skip the first step, or steps one and two, depending on the degree of assistance that the client requires.
1. Log-rolling
Since the client is in bed, they may need to roll to the correct side to get out of bed. The log-rolling manoeuvre involves turning the client to the side using two or three people to keep the spine and neck straight, or using a turning/slider sheet (a slippery sheet made to reduce the friction of moving clients to prevent injuries). One person steadies the head, one the torso, and the other the legs). The client is turned so they can be assisted to a sitting position.
This video, “How to Apply a Slide Sheet Using the Log Roll Technique,” shows the method of log-rolling and the use of the turning/slider sheet.
Click here for a video transcript in .docx format: Video Transcript
2. Dangling
The dangling method refers to the practice of assisting the client to sit on the edge of the bed for a few minutes prior to rising to reduce the chance of dizziness. When you are assisting a client to get out of bed, you must ensure that the bed is in the low position; the head of the bed may be raised to assist in the process. Then, complete these steps:
- Stand next to the client’s waist on the side of the bed.
- Assist the client to sit up, using a wide base of support stance and slowly lowering the client’s legs down over the side as the client’s head is raised. If the client is not dizzy, after a few minutes you may proceed. If the client is dizzy, allow them to lay back and try again when the dizziness resolves.
- Provide shoes to client prior to having them stand.
This “Dangle and Transfer” video shows the method of assisting to sit on the bed.
Click here for a video transcript in .docx format: Video Transcript
3. Assisting the client to stand
Remember to refer back to the general guidelines listed above before assisting a client to stand and become ambulatory. Then, talk to the client, making sure they understand how you are going to assist them to stand, and confirming that they are able to weight-bear, which refers to the ability of part of the body to resist or support weight (“Weight-bearing,” n.d.).
The care plan will state how the client is able to get up.
If a client is able to stand with minimal assistance, you will work through the following steps:
- Stand slightly to their weakest side (if there is one), and present your hand face up to their weakest side’s hand to indicate your willingness to assist them.
- Ask the client to place their feet flat and shoulder-width apart on the floor directly under the knees, and then scoot to the edge of the bed.
- Place your other hand at the middle of their back.
- Ask them to stand on the count of three.
- Assist them to move their shoulders forward as they are standing.
Below is a video of the process: “Sit To Stand – Patient Moving & Handling”:
Click here for a video transcript in .docx format: Video Transcript
This second video, “Two Assist – Sit To Stand,” is the sitting-to-standing movement when two people are needed to assist the client:
Click here for a video transcript in .docx format: Video Transcript
What did you notice about the way the carers were standing and moving in this video? They were using the lunge/stride stance which is standing with feet shoulder-width apart, with one foot a length ahead of the other. This stance allows the base of support to widen, and increases stability during movement.
Practice Makes Perfect
Now, try to answer the following questions about the second video without any guidance:
- Were the carers standing close to the client or at arm’s length away? Why do you think they were using that stance with the client?
- Why did they not use an under-the-armpit lift?
If you like, practice this lift method with a volunteer to become used to assisting in the process.
