Dementia fall prevention includes learning to properly transfer your family member. Transferring, as one of the ADLs (activities of daily living) is the act of getting up or moving from one place of sitting or lying to another. Common points of transfer are from the bed to a wheelchair (or wheelchair to bed), from chair to toilet (or toilet to chair), from the floor to a chair (after a person falls), and from one chair to another.
Independence with transferring becomes more difficult as dementia progresses. Your family member loses muscular coordination. The body slows and becomes weaker. They become increasingly unstable and more likely to lose their balance and fall. Your family member will require personal assistance, particularly in the middle and late stages of dementia.
Dementia Fall Prevention: Tips and body mechanics
These tips are good to remember, as they will assist you to make the most of transferring with the least amount of worry and physical stress:
- Observe for falls; the likelihood for falls and need for assistance with transferring increases in later dementia stages
- Be gentle during transferring; the skin of elderly people is often quite fragile and tears easily
- Use a gait belt or other assistive device as needed
- A Hoyer lift can be used to help transfer the large person or those fully bedbound (commonly used in long-term care settings)
More on dementia fall prevention…
Good body mechanics can minimize the risk of injury to yourself or your family member:
- hold your family member close to you, to keep the center of gravity close, lowering the strain on your lower back
- keep your feet at least shoulder width apart (a wide base of support is far more stable than a stance that keeps your feet close together
- use your stronger muscle groups to lift (legs, arms, and shoulders)
- although it is not possible to keep perfectly straight when squatting or stooping, be conscious of your body position and keep your back as straight as you can, using your stronger thigh muscles (quadriceps) to raise up
- when arising from a stooped or squatting position, first take a few deep breaths, leaning your head forward (helps keep you from getting dizzy)
- do not underestimate the effort needed to transfer
- make eye contact with your family member. Tell your family member what you plan to do and how they may be able to help. Speak slowly, using one word commands.
- don’t rush the transfer and allow your family member to help, if practical (helps prevent injury)
- get assistance from others as needed
Transferring can be one of the most physically challenging of ADLs, for both you and the family member with dementia. One of the most important things to remember about successful transferring bears repeating – go slow and carefully. Back injury is the most common caregiver injury, due mainly to tugging, pulling, lifting, and other types of physical exertion.
Dementia fall prevention starts in the early stages of dementia. As with most ADLs, transferring is usually not an issue in the beginning stages of dementia. You should be concerned, though, if your family member has increasing falls, increasing confusion, or is becoming physically weaker. Using proper body mechanics techniques will help save your back and your family member from injury.
I have many primary caregivers work very hard to keep their family members at home. When falls start to occur, there are times when you may be alone and need assistance. Never hesitate to call for help. There are many first responders that are used to these type of calls. Remember, if you hurt your back, you will not be able to continue to provide care at home. Get help and take care of yourself as well.