Caregiving: How to Turn Someone in Bed

Overview

People sometimes have to stay in bed for long periods of time. They may be very sick, in pain, or very weak and not be able to move themselves into different positions. It's very important that your loved one changes positions. Lying in one position for a long time can cause pressure injuries (also called pressure sores).

Pressure injuries are damage to the skin. They can range from red areas on the surface of the skin to severe tissue damage that goes deep into muscle and bone. These problems are hard to treat and slow to heal. When pressure injuries don't heal well, they can cause problems such as bone, blood, and skin infections.

Pressure injuries usually occur over bony areas, such as the hips, lower back, elbows, heels, and shoulders. They can also occur in places where the skin folds over on itself.

You can help your loved one avoid pressure injuries by helping them turn and change position in bed. A drawsheet can help.

Turning someone in bed

Before getting started, tell your loved one that you want them to roll into another position. If your loved one has any drains, tubes, or other medical equipment, adjust these so they don't get in the way.

If your loved one can help

• You may need to help your loved one scoot toward the opposite side of the bed so that there will be room to roll.
• Go to the side of the bed you want your love one to roll toward.
• Ask your loved one to lie on their back with their knees bent. Have them place their arms across their body.
• Ask your loved one to roll toward you while keeping the knees bent. If you have a rail on the bed, have your loved one reach toward the rail.
• Help your loved one as needed. Gently place your hands on the shoulders and hips, and guide them toward you.

If your loved one can't help

It is best to turn your loved one every 2 hours. If your loved one cannot move or finds it very hard, you can use a drawsheet.

Have a family member or friend help you. It is easier for two people to turn someone, and it can be dangerous for one person to do it.

Position your loved one

• One person stands on each side of the bed. If your loved one is in a hospital bed, lower the height of the bed. This will make it easier to turn the person.
• Untuck the drawsheet on both sides of the bed. Each person gathers up one side so you both almost have a "handle" to grab. You may also need to make sure your loved one is high enough up in the bed. If not, lift them toward the head of the bed.
• Agree on a count, and then lift and move your loved one to the side of the bed you're going to roll away from.
• Tuck in the drawsheet on the side of the bed that your loved one will roll toward.

Move your loved one

When you and your assistant are ready:

• Help your loved one lie on their back with their knees bent. If your loved one can't bend their knees, cross one ankle over the other in the direction of the turn. Position your loved one's arms across their body.
• Stand on opposite sides of the bed. One person will pull and the other push. Be sure that you and your assistant have your feet shoulder-width apart. This will help you avoid straining your back.
  • If you're pulling your loved one toward you, lean from your hips (don't bend your back), reach over your loved one, and grab the drawsheet at your loved one's hip and shoulder areas. Slowly pull the drawsheet toward you to roll your loved one over.
  • If you're rolling your loved one away from you, slowly push at the hip and shoulder areas.

Moving someone in bed is best as a two-person job. If your loved one can help, even a little, you may be able to do it yourself. But do all you can to find someone to help you.

Getting someone comfortable in bed

You can use pillows to help your loved one get comfortable and avoid pressure injuries.

If your loved one is on his or her side:

• Place pillows in front of your loved one, at chest level, with the top arm draped over a pillow.
• If needed, tuck one edge of a pillow under the buttock, lengthwise. Then fold the pillow under and tuck the other edge under the first edge. That creates a "roll" that stays in place better and helps keep your loved one from rolling back.
• Place a pillow between your loved one's knees, with the legs slightly bent.
• Put the top leg a little in front of the bottom leg. This takes pressure off the bottom leg.
• Put a pillow under the bottom leg so that the bottom ankle is off the bed.

If your loved one is on his or her back:

• Put a pillow under your loved one's legs between the knees and ankles.
• Do not put anything under the heels.
• If you have a hospital bed, don't adjust the top end above 30 degrees. This helps prevent your loved one from sliding down.

When you are finished, smooth out the drawsheet in its original position and tuck it in.