In this film we will give guidelines for some basic moving and handling for carers.

Each person is an individual and they may have different moving and handling needs. Sometimes the person may be able to assist more than at other times, such as when they are tired. How you are feeling as the carer is just as important when you are moving and handling someone. If you have any individual concerns about moving and handling the person you care for or your own ability to do this safely, please ask to see a physiotherapist, occupational therapist or stroke nurse for individual advice.

John is a stroke patient; he is working with his physiotherapist and his carer.

Therapist:

“OK Joanne we are going to be transferring John on to the bed.” “It’s just worth remembering that the bed should be as good a height as possible for transferring somebody.” “Ideally we are looking at a bed height for transferring a patient on it should be about 19 inches from the floor.” “In this situation the bed is a bit higher because we’ve got a special bed with a special mattress which is making it slightly higher.” “So really all we can do is get it as low as possible and just take extra care when we are transferring John on to the bed.” “So I’m just going to alter the bed to go as low as we can first of all.” “Just get that out of the way.” “We’ve got the pillows organised.” “We put the last pillow so we get an armchair of pillows to give John a little bit of support there.” “Bearing in mind that it’s his right side we need to give more support than his left side.” “So if you can position the wheelchair almost at right angles to the bed as far up the bed as you can.” “So that when John is transferred in to the bed, or on to the bed, his bottom is as high up the bed as possible.” “ So when we turn him round, and assist him to get into bed, he’s not coming too far down the bed because normally what you find is when somebody transfers on to the bed, they slip down a little bit.” “So you really need to go as high up as you possibly can.” “Now John’s transferring with a patient turner.” “So what we need to do is get his feet off the footplates to begin with.” “Just actually remove these.” “Just give him a little bit of help with his right leg.” “Clear these out of the way so they are not in the way.” “Make sure the brakes are both on.” “OK and we’ll just position the patient turner in front of John.” “Now John, are you going to manage to help a little bit?” “With these turners it is important that you don’t lift them because they are very heavy pieces of equipment.” “So although you can push them on their wheels to a certain extent, when you come to position it underneath somebody’s feet, you have to actually just walk them in underneath the person’s feet.” “You must not lift them.” “Now if you can come and stand in front to counter balance the turner.” “John, just make sure your right foot is properly on.” “John is going to pull himself up and I’m just going to guide him forward from behind and give him a little but of position, a bit of stability in his leg as well.” “Got to make sure he’s nice and steady in standing.” “Which I think you are.” “OK, so we are going to turn the turner round.” “Maybe just move the wheelchair out of the way there actually.”

Joanne:

“Do you want me to move it?”

Therapist:

“OK that’s fine.” “If you can stand with John, I’m just going to move the bed in a little bit.” “Just going to move this bed a little bit closer to John.” “To make sure that he sits exactly where we want him.” “Always remembering to put brakes on before you move someone on to something that’s got brakes.” “Now will I go in front and counter balance the front of the turner again.” “If you can assist John with your hands on his upper trunk.” “And just sit down nice and slowly John.” “OK ““Now Joanne if you stay with John there to make sure he is nice and steady.” “I’ll gently remove this from under his feet.” “Again, just sliding it out.” “Just get that foot back there.” “Then we can roll it away.” “Now because John has got quite long legs, the height is not an issue with this bed at all.” “OK if you were a shorter person you might find that your feet were dangling a wee bit.” “So we would just have to take more care for getting him into bed.” “So what we are going to do is we’re going to help you in to bed OK.” “Joanne is going to help you down with your top half OK.” “Making sure this arm is looked after as you transfer as well and I am going to help you get your legs up on to the bed John.” “OK. “ “So we are going to do it nice and gently.” “If you can start to lean towards your left side and I’ll help you lift your legs up.” “Just bring his shoulders over Joanne.” “OK now if I help you bend this knee up John, just one second.” “Ok have you got your hand?” “Now first of all I think what we’ll do.” “Can you manage to hold on to your hand for me?” “Can you manage to lift your bottom over in to the centre of the bed?” “OK” “Now stay there for just a second while we put the height of the bed up a little bit.” “Just so we can actually reach you easier.” “OK” “I’ll be round this side.” “So you are assisting someone to move their bottom it’s really important that both knees are bent up.” “From a rehab point of view and from a functional point of view so he is managing to get a better effort to move his bottom across the bed.” “So now you’ve got your knees bent up, can you manage to lift your bottom over?” “OK hold on.” “Just let this leg come down.” “This one down as well.” “So Joanne if we just gently help John bring his shoulder across in to the centre.” “Just get that pillow there.” “Now can you manage to let go of your hand now?” “You should be reasonably comfortable there John.”

John:

”Aye that’s alright”

Therapist:

“Is that alright there?”

John:

“Aye”

Here are some points to consider

• Check the height of the bed. (Is it adjustable? Is it at the correct height for the person? If it is not adjustable could it be raised or lowered to a more suitable height by using bed raise blocks or removing castors.)
• Correctly position the wheelchair. (Apply the brakes, allow enough room for each person to move, you may have to try to make more space.)
• Correctly position the turner. (Do not lift the turner, use the wheels until you are close to the person and then walk or shuffle the turner into position.)
• Remember to apply brakes. (the bed may also be on wheels and these brakes should also be applied before moving.)
• Sit near the pillows. ( By sitting near the top of the bed the person will be in the correct position when lying down.)
• Ask the person to help you. (Some people will be able to help themselves and you if the movements can be coordinated and smooth. Even holding on to their affected arm can help.)
• Take your time. (Make sure you are not rushed. Think and plan what you are going to do before you attempt the move.)
• Is everyone ready? (One person usually takes the lead so that everyone knows exactly what they are going to do and when to start the movement. The lead person could sometimes be the person themselves giving the carer instructions.)