Dwellness • Safe Body Dynamics

Safe Body Dynamics

Dwellness customization for:

Your Patient

General Principles

[NOTE: Before you undertake this routine, please study and practice the principles of Safe Body Dynamics for your patient’s transfers and ambulation.]

→ Breathe! Never hold your breath and bear down when exerting yourself ←
→ Stretching helps prevent injury… stretch before work, and stretch every day ←
→ Keep a low center of gravity during transferring or lifting ←
→ When not transferring or lifting, stand and walk fully erect with abdominals engaged ←
→ Think carefully about each move you make ←
→ Prompt your patient's movements, prepare, and wait for a response before moving yourself ←
→ When in doubt, pause and reconsider your next move ←
→ If your patient decides to go down to the floor, do not resist; gently lower your patient ←

Principles in Practice

Standing up from floor
  • Keep in mind all the general principles of Safe Body Dynamics
  • Your patient loves to move on your patient's own in your patient's room
  • Your patient's room is padded completely, so your patient can crawl, roll, climb, and tumble for proprioceptive and vestibular input
    1. When your patient reaches up, take both of your patient's hands
    2. Do not pull your patient's arms, but just hold steady so your patient knows to initiate standing up
    3. When your patient initiates, tilt a little to your left so your patient can put the left foot forward
    4. Your patient will push with the left leg and come to standing
    5. [NOTE: About 10% of the time, your patient may have a neurological physical "stutter" with your patient's left foot. When your patient initiates your patient's left foot to step so your patient can stand up, your patient's left foot does a slight spasm and your patient can’t place it squarely on the floor. Your patient usually moves it back in place under your patient, and immediately tries again. The second time almost always works well and your patient stands up. This does not change anything you should do, except keep a steady hold and encourage your patient to try again.]

    6. Still just holding your patient's hands, allow your patient to hold your patient's own weight
    7. Transfer your position to from in front of your patient to in back of your patient
Walking ("The Safe Walk")
  • The Safe Walk has been designed to protect the caregiver and your patient, while enabling your patient to use your patient's gross motor abilities in the best possible ways
  • Walking is not just a forward movement, but a side-to-side movement in the process. While walking your patient, be sure to imitate that movement by alternating a left and right tilt with each step
    1. From behind your patient, reach around your patient and let your patient hold onto your open hands
    2. Be ready to hold your patient's hand if your patient doesn’t seem to hold on tight enough
    3. Wait until your patient initiates the first step
    4. Whichever foot your patient uses first, tilt slightly toward the other side so your patient's step is encouraged
    5. [NOTE: About 10% of the time, your patient may have a neurological physical "stutter" with your patient's left foot. When your patient initiates your patient's left foot to step so your patient can stand up, your patient's left foot does a slight spasm and your patient can’t place it squarely on the floor. Your patient usually moves it back in place under your patient, and immediately tries again. The second time almost always works well and your patient stands up. This does not change anything you should do, except keep a steady hold and encourage your patient to try again.]

Pivoting
  • Pivoting carefully when you change directions, transfer to a chair, or transfer into bed is key to keeping everyone safe
    1. Do not twist while standing on one leg — twisting can cause stress on the joints
      • Make small steps to change the direction you’re facing
    2. If you are feeling unstable or uncertain, pause and evaluate your position
    3. Always be aware of each move, and analyze any way to make it easier and safer
      • Communicate your experiences and your needs
Difficult behaviors in the open
  • If your patient goes to floor and does not want to cooperate, stay calm
    1. Start by just observing and keeping your patient safe
      • Keep your patient clear of hard surfaces or hard objects
      • Calmly and patiently encourage your patient to tell you what your patient wants
      • Calmly and patiently encourage your patient to stand up and move to a different location, or to get into a chair
    2. If necessary, lift your patient to standing
      • Squat behind your patient
      • Hold your patient's elbows and press your patient's arms to your patient's sides (shoulder stability)
      • Lift with your legs, and your patient will take a step when you’re halfway up
      • Move your patient along to your goal location

[NOTE: I am right-handed. If you are left-handed, you may choose to reverse the steps in any physical process. Do what is most comfortable for you.]


HPCA Input

Dwellness input from HPCA and family caregivers can serve to improve the ongoing support system. Feel free to speak up!