Planning for Unpredictable Clients during Transfers Including Dead Weight Mobility Status

Have you been in a situation where you had to lift someone from the sofa, bed or car after they dozed off? Probably yes. Your experience of lifting an unconscious fellow human would have made you notice one important fact: they seem to be heavier than usual. You might have had a similar experience when handling someone with a medical condition that caused them to lose complete or partial strength and movement.

It is undoubtedly difficult to pick up a person when they are in the unconscious or semi-conscious state. But the question is ‘why’? How can someone suddenly become heavier? The truth is that the person hasn’t really become heavier; it is just harder to lift them because they are no longer in the state to use their own muscles and hold their bodies together. They cannot even take the support of the helper because they are physically and/or mentally incapable of performing the task.

In other words, the person becomes a ‘dead weight’, with their arms, legs, and head hanging down. Think about how you would lift a box of closely packed books that weighs nearly 30 pounds. It would be heavy, but, you would be able to manage to lift it much more easily than a cloth laundry bag carrying the same number of books.

Differences in mobility statuses of patients

Cognitive impairment is one of the primary reasons that cause an individual to become incapable of exercising mental and physical strength and makes them ‘dead weight’. Professional caregivers are often appointed to help such patients through their daily activities, whether at home or in a hospital or medical facility.

The following terms are used in the clinical setting to describe such patients:

• Active patients: These patients are independent patients and can contribute to movement and function.
• Passive patients: These patients are absolutely 'dead weight' and non-functioning.
• Negative-acting patients: These patients are combative.

Below is a further division of the above two categories:

• Independent – Requires zero assistance.
• Minimal assistance (Min) – Requires the assistance of one (X1) or 2 (X2) caregiver/s.
• Moderate assistance (Mod) – Requires the assistance of one (X1) or 2 (X2) caregiver/s.
• Maximum assistance – Requires the assistance of one (X1) or 2 (X2) caregiver/s.
• Dependent – Requires assistance with any kind of activity.

Caregivers and nursing assistants usually use special equipment/tools to aid X1 and above category patients. Maximum assistance and dependent patients would typically require either a floor lift or a ceiling lift. Following are a few such special equipment/tools:

Belts 

Ergonomic belts such as FlexiBelt are designed especially to aid the transfer of passive/negative acting patients from the sitting to the standing position (usually from a car, wheelchair or toilet seat to a couch or bed). This type of belt is also helpful in offering support whenever the patient is walking or standing. FlexiBelt is tied around the hips or waist of the patient and has several sturdy handles (horizontal and vertical). These handles provide the right amount of grip to the caregiver in different situations.

The latest version of FlexiBelt is ‘FlexiBelt Hug’. It features an advanced innovative design with multiple horizontal handles which can slide easily in loops. This means that the belt hugs the patient rather than sliding up and down during transfers. FlexiBelt Hug allows caregivers to provide even greater support to the patient with minimal effort. The product also has a woven label that is placed on the belt-tightening lip. It carries the use instructions. The size of the belt can be modified as per the comfort of the patient.

Rehabilitation and Transfer Devices

Transfer support equipment such as ReTurn7400 is a highly effective and user-friendly assisting device that facilitates a natural and comfortable transfer from the sitting to the standing position. ReTurn7400 allows for the safe transfer of passive/negative acting patients from/to the wheelchair, toiler or bed and can also help in adjusting or repositioning the patient while he/she is sitting in a wheelchair or chair.

Caregivers can use ReTurn to avoid lifting heavy weights, thereby reducing the risk of injuring their back or other body parts. If the patient still has some strength, this device can trigger the natural movement pattern while they are being transferred from sitting to the standing position. It also helps in strengthening muscles and the overall functional ability.

Back and Pelvic Support Devices

EasySlide, available in three different sizes, works as a brilliant aid for passive/negative acting patients who still have strength in their body. It is designed to help with the movement in bed (for example, turning, moving up, and so on) This device can also facilitate smooth transfers from a bed to a wheelchair.

EasySlide is a highly compact ergonomic device that stimulates activation. With this device, the caregiver does not have to assist the patient in all positioning and also reduces the amount of lifting in transfers. EasySlide works as an excellent aid for assisting pregnant women who have back and pelvic pain.

Tips to ensure easy transfer

Here are a few basic guidelines that can help caregivers help transfer passive/negative acting patients more easily, and planning for unpredictable clients during transfers:

• Tighten the muscles of your stomach during transfer. This will keep your spine protected.
• Bend your hips and knees so that your abdominal muscles and upper legs are at work, not the spine.
• Maintain a distance of approximately 10 to 12 inches and keep one foot in front of the other (not too apart). This is a good position to transfer the patient and will help distribute the dead weight.
• Make use of transfer devices (if possible) for pushing, pulling, and sliding rather than physical lifting. This will protect you from injury.
• Be equipment ready. Keep the walker or other transfer equipment at a close distance. If using a wheelchair, ensure that the wheels are locked. Try and remove/swing away the leg and armrest as a part of transfer preparation. Make sure there is no clutter in the area to protect the patient from tripping.