Quality In-Service for CCC Caregivers
Best Practice:
Assisting with
Repositioning and
Transferring
Compassionate Community Care – Caregiver In-service – Assisting with Repositioning & Transferring
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Assisting with Repositioning
and Transferring
Many people are unable to change their position in bed, or
transfer from bed to chair by themselves. As care givers, you will
often be asked to assist your clients to do this. This requires you
to understand good body alignment in order to ensure the safety
of your clients and yourselves.
Can you describe the best way to lift an something to
protect yourself from harm :
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Can you explain why it is important that your clients are
positioned properly when lying in bed :
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Compassionate Community Care – Caregiver In-service – Assisting with Repositioning & Transferring
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Back Safety
Techniques For Safe Lifting
Safe lifting means keeping your back aligned while you lift, maintaining your
center of balance and letting the strong muscles in your legs do the actual
lifting. By using the following techniques you can learn how to life safely and
save your back from accidental strain and injury.
1. Bend Your Knees
Bend your knees, not your
waist. This helps you keep
your center of balance and
lets the strong muscles in
your legs do the lifting.
2. “Hug” The Load
Try to hold the object as
close to your body as possible,
as you gradually straighten
your legs to a standing position
3. Avoid Twisting
Twisting can overload your spine and lead to serious injury. Make sure
your feet, knees and torso are pointed in the same direction when you
are lifting
The Safe Way to Lift
Before you lift anything think about it. Ask yourself: “Can I lift it alone?”:
“Do I need mechanical help?”; “Is it too awkward for one person to handle?”.
If the life is manageable, follow the steps to lift it safely.
Tips To Remember
In addition to these techniques, remember to make sure that your footing is
firm before you start and that your path is clear. And be sure to use the
same safe techniques when you set down your load. It takes no more time to
do a safe lift than to do an unsafe lift, so why not play it safe and lift right?
Proper lifting technique
Plan your lift and ask for help if you need it.
 Stand close to the object and widen your base of support.
 Bend your knees and keep your back straight.
 Tighten your stomach muscles.
 Lift with your leg muscles.
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Why good body alignment?
Changing position frequestly helps us to stay comfortable while we are
sitting or lying down. It also prevents complications that can result from
spending long periods of time in the same position. Some of your clients may
or may not be able to reposition themselves easily without your help.
Weakness, pain, disability, and coma (a state of unconsciousness) are all
reasons why a person might need help with repositioning. When you are
assisting a person with repositioning, take the opportunity to observe for
signs and symptoms of complications of immobility.
Signs and symptoms of complications of immobility
 Reddened skin, especially over bony areas, that does not return to its
normal color after gentle massage of the surrounding tissue.
 Pale, white, or shiny skin over a bony area.
 Tears, scrapes, or skin that looks burned.
 Hot, reddened, painful areas in the lower legs (do not rub these areas).
 If the client has gone three or more days without a bowel motion.
Promoting good body alignment
Six basic positions are used when a person must remain in bed or seated for
a long period of time. After moving a person into one of these positions, you
must ensure that the person is in good body alignment. Good body alignment:
 Is most comfortable for the client
 Relieves strain on muscles and joints
 Promotes good heart and lung function
 Helps to prevent contractures and pressure ulcers
Some people require extra support to maintain proper body alignment. This
support can be achieved by using pillows; a rolled-up towel, sheet, or blanket;
or a supportive device made especially for this purpose.
Adapted from: Carter, PJ (2007) Lippincott’s Essentials for Nursing Assistants,
Philadelphia: Lippincott Williams & Wilkins, pp 312, 313, 316
Compassionate Community Care – Caregiver In-service – Assisting with Repositioning & Transferring
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Six Basic Positions
SUPINE:
Description
The person is lying on his or her back. The bed is flat and a pillow is under
the head. Pillows may also be placed under the arms and hands, under the
knees, and under the lower back.
Uses: Sleeping; Resting.
FOWLERS:
Description
The person is lying on his or her back. The head of the bed is elevated 45 to
60 degrees. A pillow is placed under the head. Pillows may also be placed
under the arms and under the knees (or the knee gatch may be bent).
Variations:
Semi or low Fowler’s position (30-45 degrees)
High Flower’s position (60-30 degrees)
Uses: Eating in bed; Grooming procedures; Oral care; Resting; Reading;
Watching television; Talking with visitors.
Compassionate Community Care – Caregiver In-service – Assisting with Repositioning & Transferring
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Six Basic Positions (cont)
LATERAL:
Description
The person is lying on his or her side. The lower leg is straight, the upper leg
is bent at the knee. Pillows are placed under the head, lengthwise between
the legs, under the upper arm, and along the back.
Variations:
Left lateral (the person is lying on his or her left side)
Right lateral (the person is lying on his or her right side)
Semi-side-lying position (pillows are placed along the person’s
back and hip or along the front of the body so that the person
lies either a little more forward or a little more toward the
back).
Uses: Resting; Relieving pressure on the spine.
PRONE:
Description
The person is lying on his or her abdomen with head turned to one side. The
arms are bent at the elbows, and the hands are placed on either side of the
head, palms facing down. Small pillows are placed under the head, under the
lower abdomen and pelvis, and under the person’s lower legs.
Uses: Relieving pressure on the hips and spine.
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Six Basic Positions (cont)
SIMS’:
Description
The person is lying on his or her side, almost prone. The head is turned to
one side. The knee on that side is bent sharply and supported by a pillow.
The corresponding arm is bent at the elbow with the hand in front of the
face, palm down. The lower leg is straight, and the lower arm extends out
from the side with the palm turned upward.
Uses: Receiving an enema; Having a rectal temperature taken; Relieving
pressure on the tailbone and hip bone.
SITTING:
Description
The feet are flat on the floor or wheelchair
footrests. The knees are bent approximately
90 degrees. The calves of the legs do not touch
the chair. The buttocks and back rest against
the back of the chair. Pillows are placed under
paralyzed arms and hands.
Uses: Sitting in a chair or wheelchair.
Adapted from: Carter, PJ (2007) Lippincott’s Essentials for Nursing Assistants,
Philadelphia: Lippincott Williams & Wilkins, pp 314-315
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Pressure Area Care
How pressure ulcers form
Many clients are not able to change position
easily due to weakness, disability, or illness.
This inability to change position without help
places the person at high risk for developing
a pressure ulcer. Pressure ulcers form when
pressure points press against a mattress,
chair or other surface. The pressure
squeezes the tissues in between the bone and
the surface the person is lying or sitting on.
As a result, blood flow to the tissues
decreases. The tissues do not receive enough
nutrients and oxygen, and they die. The dead
tissue peels off or breaks open, creating an
open sore or ulcer.
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