Correct positioning - tips and tricks for relatives

Storing, positioning, embedding. What is that? Why are you doing this? And above all, how do you do it right? In the following article, I will give you some tips and tricks that really help me as a caregiver in practice to position people in need of care correctly.

 

Positioning - Why is it important?

Imagine lying in your bed and sleeping until the early hours. Have you ever noticed that you lie differently when you go to bed than when you wake up?

 

Why is that? When you go to sleep, you assume a position in bed that is comfortable for you and feels good. During the night, you then automatically turn yourself from one side to the other.

 

Now imagine that you are restricted by an operation, injury, illness or simply age from getting yourself into a comfortable position so freely. You are now dependent on the support of others to help you find a comfortable position.

 

 

Why is it so important that you change your position regularly? There are many reasons. On the one hand, certain positioning can damage the can promote sleep and breathing, on the other hand, they can give you security and help you to perceive your body boundaries.

 

In addition, timely positioning represents a prophylaxis against pressure ulcers, contractures and pneumonia. For a person in need of care, it is particularly important to regularly to be repositioned, as mobility may be restricted.

 

Decubitus prophylaxis:

Wondering what a pressure ulcer is? Imagine lying or sitting in exactly the same place for several hours. When you look at yourself in the mirror afterwards, you will notice that the areas of your body on which you have been lying or sitting are reddened. This may already be a sign of an incipient pressure sore.

 

A pressure ulcer occurs when pressure is exerted on an area for too long. This squeezes the arteries and veins, disrupting blood circulation and causing skin damage. In severe cases, wounds can develop that allow you to see all the way to the bone. Regular repositioning is therefore very important. What does regular mean in this context?

 

In care facilities and hospitals, patients are positioned every two hours. This is intended to ensure decubitus formation can be prevented. If you or a relative needs to be positioned at home, you can also use the two hours as a guideline. Over time, you will notice how quickly your grandma becomes reddened and whether you need to position more often or even every three hours would be enough.

 

Contracture prophylaxis:

A contracture means a stiffening of the joint. This means that you can only move your joint to a limited extent. You can prevent a contracture by moving your joints actively or passively. You can also counteract a contracture in the ankle joint when positioning yourself by placing a cushion in front of your legs and feet so that your toes are pointing vertically upwards

 

Pneumonia prophylaxis:

Pneumonia is the technical term for pneumonia. Are you wondering what this has to do with positioning? If you always lie there in the same position, then not every area of the lungs will be sufficiently filled with air, which can cause can cause pneumonia. Special positioning, such as keeping the upper body up, can prevent pneumonia.

 

General tips and tricks for correct positioning

Are there general tips that you can apply to any storage? Yes, there are. And I'll also list the most important ones here so that you can position your granny correctly.

 

• It's important that you make sure that no shear forces occur during positioning. What are shear forces? Shear forces are forces that exert pressure. For example, you can see this when you have your heels on the mattress for a few hours. When you lift them, what do you see? Exactly, the heels have turned red. This is due to the pressure exerted by the mattress on the heels.

   

• Therefore, it is important that you make sure that your grandmother's heels are always stored freely. What does free storage mean again? Free support means that the heels are not touching anything. The best way to do this is to place a cushion or towel under your grandmother's ankle. This way, the heels are not resting on the mattress but are free in the air.

 

• When positioning, that no body part "sags". Can't imagine what that means? Then let me explain it to you using an example. If you put a cushion under your grandmother's thigh and another under her lower leg, your grandmother's knee will float freely in the air because there is no cushion underneath.

 

• To prevent the knee from sagging, you should also place a cushion underneath. This will be more pleasant and comfortable for your grandma.

 

• In most cases, it is advisable to position the upper body slightly elevated. Why do this? Lie completely flat on your bed. Now sit up so that your upper body is at the same height. Finally, sit on the edge of your bed. Observe your breathing. What do you notice?

 

• Exactly, the higher your upper body is, the better you can breathe and the better you can breathe. An elevated upper body is also a prophylaxis for pneumonia.

 

• Be sure to check this, that your grandma does as much as possible herself. This means, for example, that you only give her a little push and she then turns to the side herself, rather than you taking over everything. Why is this important? Imagine you have a sequence of numbers in front of you and memorize them. If you keep repeating it, you will memorize it.

   

   

   

• However, if you stop actively memorizing the sequence of numbers, you will forget them. It's the same with the movement patterns. If you no longer actively perform them, your body will forget how to do something. In addition, your grandma's muscles will then break down, leaving her with no strength and far too weak to lift her foot herself.

 

• Every time, when you have moved your grandmother to the head of the bed and put the bed in a sitting position so that she can eat, she slides down to the end of the bed. What can you do about this?

 

• If the bed is still in the lying position and your grandma is already at the top, then make a slip brake. What is a slide brake and how do you do it?

 

• A slide brake can be made very easily. Your grandma puts her legs up. Then place a cushion or towel under her buttocks. Make sure that the cushion is really firmly under the buttocks. If you now bring the bed into a sitting position, the cushion will slow your grandma down. This means that she won't slide down so quickly and can enjoy her meal with peace of mind.

 

• After you have positioned your grandma, please take another close look at the positioning. Does it look physiological? If not, then change what you don't like. An example of this would be that your grandma is lying straight in bed, but her hips are turned outwards. This not only looks strange, but is also uncomfortable for her.

 

Tips and tricks on how to protect your back while positioning

       

• The most important thing, what you must always keep in mind: You may still be young, but you only have one "cross" that you absolutely have to take care of.Therefore, always place your grandma's bed at a height at which you can work comfortably without having to bend down. Your grandma doesn't have a height-adjustable bed? You can buy or borrow such beds.

 

• Various organizations offer you the opportunity to return the bed as soon as your grandma no longer needs it. Which organizations are involved? You can either search the Internet or contact a mobile care organization directly. Are you worried that caring for your grandma will be too expensive? Then take a look at our article "Tips for saving money".

 

• If you want to turn your grandma sideways, have her put her legs up first. This will give her a lot more room to move her hips, allowing her to turn better. You won't need as much strength and can save your resources.

 

• Do you want to turn your grandma to the side now? It is important that you grab the shoulder and the hip bone. Because there is a bone underneath these areas, you can grab them easily and turn your grandmother over skillfully.

 

• If you were to tackle the upper arms or thighs, you will quickly notice that the fatty tissue, but not your grandma, will move more. As a result, you would need more strength, which is strenuous and goes into your back.

 

• When your grandmother has slid all the way to the bottom of the bed, you have to move her back to the top of the bed. There are also a few tricks for this. First, your grandma should put her legs up again to make it easier to move up.

   

  If she can still move up easily on her own, then hold her feet against the mattress so that she can push herself off and her feet don't slip away. If your grandmother can no longer slide up on her own, you will need to help or even take over.

   

  How do you do this when you are alone? To do this, turn your grandma on her side. For example, if she is now lying on her right side, gently move her left hip bone and left shoulder upwards.

   

  While you do this, have your grandma lie down on her back again. If you now look at your grandmother, you will notice that the left side is slightly higher than the right.

   

  To move your grandma to the top, repeat this process a few times on each page in turn. It will take some time, as each side can only be moved up a few centimetres, but it is the gentlest on your body as you are working with your granny's natural resources and not using your own physical strength.

   
  If there are two of you, set up your grandma's legs again. Because the legs are up, there is not so much weight on the mattress that needs to be lifted up. Now reach under the shoulder blade with one hand and under the buttocks with the other.

   

  Then make sure that your grandma puts her chin towards her chest so that the back of her head is raised. This prevents the head from slowing down and you can lift your grandma up easily.

   

How to know that positioning is correct

What tips and tricks are there to help you know if you've done everything right?

 

• When you position your grandma, this positioning should also be comfortable for them. So how do you know if it's comfortable for your grandmother? Simple: just ask her. If something is not right, she can tell you and she can also make it clear what is not comfortable.

 

• If your grandma can't speak, watch her facial expressions and look at the positioning again. Does she look physiological? Would she look comfortable to you too?

 

• The best positioning succeeds, when you try to actively involve your grandmother. What do I mean by that? You should use her resources. This means that you should make sure that your grandma does the movements that she can do herself.

 

• This may take some time, but it will encourage activity and independence from your grandma. So give her the time she needs so that she doesn't forget this independence.

 

• You shall look, that your grandmother can breathe well in her position. This means that the airways should be clear. The best way to ensure this is to keep the upper body slightly elevated.

 

• It is extremely important that you pay attention, that no shear forces arise in the new position. The ears, rump, ischial tuberosities and heels are particularly vulnerable to pressure. Therefore, change the position regularly so that the pressure is distributed and not always just on the same spot.

 

• You should also pay attention, which positioning is prohibited due to the clinical picture. For example, people who have just had a hip operation may only bend their upper body to certain degrees.

 

• So if this is the case with your grandma, please pay attention. This will allow your grandmother to recover well from the operation and you won't create any disadvantages for her.

 

• It is best to discuss the optimal positioning with the nursing staff at the hospital. They will tell you which positions you should avoid and which are suitable.

 

• ask your grandma too, which position she likes best. This way, you can position her in her favorite position, which is very likely to be tolerated and is also very comfortable.

 

• The positioning should be changed at regular intervals. Over time, you will get a feel for how quickly your grandma turns red in a certain spot because too much pressure has been applied to this one spot for too long. Your grandma should never lie in the same position all day!

 

Nora's conclusion

 

In the beginning, positioning can overwhelm you. But don't let this discourage you, because as we all know, practice makes perfect. You will gain experience and self-confidence with every positioning session. You will see that with time, correct positioning will become child's play for you and your grandma will be grateful for every new comfortable position.

 

You have now read and tried out the tips and tricks, but are afraid of doing something wrong? Would you rather let "professionals" get to work to ensure that everything is done correctly? Then you can also look for a caregiver who positions your grandma regularly.

 

This guarantees your grandmother the right care from second one. If you are now interested, you can register with noracares register, where you can choose your nurse yourself.

 

Positioning care recipients correctly can be challenging at first, but with time you will become more confident and experienced.

 

All the best,

Nora