12.8.9: Procedure- Helping a Patient to Stand

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Erin O'Hara-Leslie, Amdra C. Wade, Kimberly B. McLain, SUNY Broome

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Before ambulating a patient, Home Health Aides/Personal Care Aides should assist them to a standing position. Allow the patient to stand in place for 1-2 minutes to ensure that they are steady on their feet and to allow their body to adjust to the change in position. Many patients may become dizzy or feel faint when moving from a sitting to a standing position. If dizziness or faintness persists, Home Health Aides/Personal Care Aides should assist the patient back into a sitting position and inform their supervisor. The use of a gait belt is helpful to assist a patient during transfers. It helps to prevent falls and injury. The belt should be applied over the patient’s clothing and around their waist. Never apply a gait belt to bare skin as it could cause skin breakdown.

Explain the procedure to the patient.
Wash your hands and don gloves as needed.
Ensure the bed locks are on and the bed is in its lowest position.
Ensure the patient has on socks and non-skid shoes.
Assist the patient to a sitting position as outlined in the procedure, “Helping the Patient to Sit at the Side of the Bed”.
Face the patient. Place your feet about 12 inches apart, using the strength of your thigh muscles to provide the base of your support. Bend your knees slightly. Keep your hips and back aligned.
Instruct the patient to place their feet firmly on the floor and to push down on the bed with their arms and to lean forward. If they have one weak leg/foot, instruct them to place their strongest foot under them and to use that foot to provide the base of their support to assist them during the stand.
If using a gait belt ensure that the gait belt is secure and over the patient’s clothing.Grasp the gait belt securely in both hands, with one hand on either side of the patient’s waist as you stand in front of them.
If not using a gait belt, stand in front of the patient, place your arms and hands around the patient and place your hand under their shoulder blades. Hold the patient close to your center of gravity. This provides balance and stability. Reassure them as needed. Brace the patient’s knees by placing the inside of your knees against the outside of their knees. If the patient has one weak leg, brace that knee by placing your inner thigh against the inside of their knee. Your other leg should be in front of the patient’s knee, braced against it.
Gently rock the patient backward and forward to provide a propelling motion, and begin to count.
On the count of three (out loud), assist the patient to a standing position. As you assist the patient into a stand, shift your weight onto your rear foot for stability and support.
Support the patient until they are stable.
Stay in front of the patient to ensure they are not experiencing 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 sitting and then lying down position. Immediately inform a supervisor.
If the patient begins to fall during assisting to a standing position, widen your stance. Bring the patient’s body close to you to provide support. Bend your knees and using the strength of your thighs, lower the patient to the floor or to the bed if you can. Immediately report the near fall or any actual falls to a supervisor. If the patient has fallen, do not attempt to get the patient up alone. The agency may require the patient gets evaluated by a nurse before helping the patient back up. Report any injuries or concerns. Home Health Aides/Personal Care Aides will also likely be required to complete an incident report, and should seek direction from their supervisor about completing the incident report.
Remove gloves if wearing and wash your hands.
Document the procedure and any observations or changes in condition.