12.8.7: Procedure- Transfer to the Sitting Position in Bed
Patients may require instruction or assistance with sitting up in bed. Sitting up in bed allows a patient to eat, engage in visits with loved ones, or participate in other activities. Some patients may become dizzy or feel faint if they sit up too quickly. Home Health Aides/Personal Care Aides should always watch their patient for signs of dizziness and inquire as to whether they feel faint when changing positions from a lying down to a sitting position. If dizziness or faintness persists once the patient is in a sitting (Fowler’s) position Home Health Aides/Personal Care Aides should , assist them back into a lying down (supine) position and inform their supervisor.
- Explain the procedure to the patient.
- Wash your hands and don gloves as needed.
- Ensure that the locks of the bed are on.
- Raise the height of the bed to a safe working height. Raise the head of the bed. This makes it easier for the patient to rise into a sitting position.
- Remove any pillows that are placed underneath the patient’s body. Fold back the top covers.
- Face the head of the bed. Place your outer foot forward. Your feet should be about 12 inches apart. Keep your hips aligned and slightly bend at the knee.
- For an independent patient who can sit up without assistance : Ask them to bend their knees. Instruct the patient to push down on the mattress with their hands, while also pushing down on the bed with their feet, as they boost themselves up in bed into a sitting position. Provide support and assistance as needed.
- For the patient who requires assistance to sit up : Place one arm (the arm closest to the patient) behind the patient’s shoulders. If it is a particularly frail patient or one who cannot control their neck or head, rest your forearm and hand behind their head. This prevents their head from rolling back. Place your other arm underneath the patient’s thighs.
- Do not hold the patient underneath their axilla (armpit) and do not pull against their clothing or other body part. You could cause them injury if you do so.
- Use a gentle rocking motion to assist the patient to propel forward and up into a sitting position. On the count of 3 (count aloud so the patient knows when they will be moving), help to move the patient to the sitting position by slowly pushing them up. Rock forward and then backward, keeping your back aligned, and shifting your weight from your front to your rear leg. This provides a firm base of support and balance while assisting the patient into a sitting position.
- Place a pillow or two behind the patient’s back and head to keep them in an upright position. Position and cover the patient for comfort.
- Check for any changes in the patient’s condition such as dizziness, weakness, or shortness of breath. Make sure to record and report any conditions observed or statements made the patient to indicate this. If the patient remains dizzy or continues to report feeling weak, return them to a lying down position. Immediately inform a supervisor.
- Remove gloves if wearing, and wash your hands.
- Place the bed back into its lowest level and ensure side rails are raised.
- Document the procedure and any observations or changes in condition.