3. Practical advice and tips for carers > Moving and handling

Moving and handling

3) Standing from sitting

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If the person you care for can stand for short periods, you should have been shown the safest method to do this. In this film we see John and two people assisting him to stand from sitting in a wheelchair. Notice how he adjusts his balance before sitting again and the position of the carer’s hands when they are assisting him.

Therapist:

“Joanne we are going to help John to stand up from his wheelchair.” “So first of all we just check the brakes are on the wheelchair.” “Is your brake on?”

Joanne:

“Yes”

Therapist:

“Mine isn’t so I’ll put this one on.” “And also John, we need to make sure your feet are in the right position.” “So get your feet under your knees, around about a shoulder distance apart.” “So when you stand up you feel balanced on your feet.” “Also, having your heels down so you can push down through your heels as you’re standing up.” “Now John is going to assist a little bit by pushing away with his good arm.” “And we are going to help him get forward so he can get his weight forward over his legs.” “Now we’ve got our arms quite far down his back.” “Up in to standing.” “We’ll just give John a second or two to get his balance.” “Can you bring your weight forward a little more John if you can?” “Try and bring your tummy forward.” “While he’s standing, if we can support him with our hands on his chest at the front and round about his shoulder blade level at the back.” “Avoiding his shoulders, especially his weaker arm.” “We don’t want to grab his arms at all in case we cause any injury.” “Do you feel reasonably balanced there John?”

John:

“No.” “I feel like I’m falling backwards.”

Therapist:

“You’re falling backwards?” “Can you bring your weight forward a wee bit more?” “How’s that, a little bit better?”

John:

“Not bad, that’s better.”

Therapist:

“OK, so your weight’s well forward over your feet.” “To get that balanced feeling isn’t it?”

John:

“Aye”

Therapist:

“Yep”

Therapist:

“So John we’re going to sit down again nice and slowly.” “So if you can feel for the arm of the chair with your left hand.” “Bend in the middle.” “Slowly, slowly down.” “Well done.” “Just make sure your arm is OK.” “Right and again going down Joanne, we had our hands in the same position.” “On his chest at the front and his shoulder blade at the back so we could guide that sitting down.” “He wasn’t falling backwards.” “He was keeping his weight forward as he sat down.”

Here are some points to consider when helping someone from sitting to standing.

  • Check the wheelchair brakes are on.
  • Check feet position. The person should stand with their feet about a shoulder width apart to help with balance.
  • Keep weight forward. Leading with the head over the knees will help to keep the person’s weight forward as they move their weight over the feet. Ask the person to use their unaffected hand to push up from the chair.
  • Avoid pulling the arms. Place your hands on the upper chest and the shoulder blade.
  • Is the person balanced? If they feel unsafe or unsteady, ask them to make small adjustments aiming to keep their weight evenly over both feet. Some people may push over to one side of the body or like John they may feel they are falling back.
  • Keep all movements controlled.

Other points to consider when moving and handling at home.

  • If the person needs support, keep as close as possible. If you are carrying a heavy object keep the weight as close to your body as possible with you back straight but not rigid.
  • Think about how and where you are going to hold the person. If you grab too firmly they may tense up and be more difficult to move. The person needs to feel supported but not restricted.
  • If you have to bend, start to bend from the knees keeping your back as straight as possible but not rigid. This will restrict your ability to move smoothly.
  • Lead with your head and look towards the direction you are going to move to. If possible get the person to do the same. If they have their head down they may not be in a balanced position when you start to move.
  • Consider the persons eyesight and sensation. If they cannot see well or cannot  feel when objects are close by they will need extra guidance to locate where they are in relation to where they are going.
  • Never pull the person towards you. This position may put both of you off balance and increase risk of injury.
  • Never allow the person to hold you around your neck when moving. Instead the person should hold on to your waist , shoulders or arm if they require less support.
  • Do not attempt to lift heavy objects above shoulder height.
  • Do not over reach for heavy items. This makes your body position top heavy and unstable.
  • Use the furniture to help you. Push up from the chair arms or if the bed  is adjustable raise the height to make it easier to get into a standing position.
  • If you have been supplied with moving and handling equipment use it. If you are unsure of the technique of how to use it safely or if circumstances have changed and you need advice contact the hospital ( only if still an inpatient ) or local authority social services. You are entitled to a carer needs assessment. If your circumstances have changed it may not be safe for you to continue moving and handling on your own. Alternative help or equipment may be needed.
  • There may be training courses locally run by voluntary organisations such as the The Carers Trust specifically for moving and handling. Basic moving and handling courses are also offered by St.Andrews First Aid centers across Scotland.

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