How to Properly Position Bed Bound Patients

Properly positioning your loved one in bed will not only make them more comfortable but can help prevent them from developing painful pressure ulcers, also known as pressure injuries or bedsores. Here's how to position someone in a manner that is safe for them—and for you.

Make the Bed Properly

Placing a sheet under the patient makes it easier to position them. A slide sheet, which is specifically designed for this purpose, is made from a material that slides easily along the fitted sheet.

If you don't have one, you can make one from a regular top sheet, called a "drawsheet" when used in this capacity. Simply fold a twin-sized top sheet in half.

To place the sheet correctly, follow these steps:

1. If it is a hospital bed, use the controls to raise the bed to a level that reduces the strain on your back.
2. Make the bed in a flat position, as tolerated by the patient.
3. Roll the patient to one side, then place a half rolled-up slide sheet or draw sheet snugly against the person's back.
4. Roll the patient over the lump onto their other side, grab the rolled up sheet once it is visible, and spread it out flat.
5. Roll the patient back onto their back, making sure the shoulders and hips are on the drawsheet.

Get a Lift Buddy

To move your loved one as safely as possible, you'll need another able-bodied person who can help you lift and position the person. The buddy can be a spouse, a sibling, or a teen, or an adult child. Just make sure this person is reliable and strong enough to carry out the task.

Pulling the Patient Up in Bed

The goal is to gently pull, not lift, the patient toward the head of the bed. Have each person stand on opposite sides of the bed. Then:

1. Grab the slide sheet or draw sheet at the patient's upper back and hips on the side of the bed closest to you.
2. Put one foot forward as you prepare to move the patient. Put your weight on your back leg.
3. On the count of three, move the patient by shifting your weight to your front leg and pulling the sheet toward the head of the bed. You may need to do this more than once to get the person in the right position.
4. If the patient is going to remain on their back, raise the foot of the bed enough to bend the knees. In addition, you can place a pillow under the knees to prop the person up so they don't slide, which can create painful skin sores. Their weight should rest on their buttocks, not their hips or tailbone.
5. Place another pillow under the ankles with the heels "floating" off the end of the pillow to alleviate pressure on the heels.
6. Use pillows as needed to place under the person's head and arms for comfort. If they are unable to let you know if they are comfortable, you'll have to use your judgment. If something doesn't look comfortable, it probably isn't. Adjust as necessary until your loved one looks cozy and content.

Turning the Patient on Their Side

To avoid bedsores, it's important to change the patient's position in the bed on a regular basis. Here's what to do:

1. Stand with your buddy on opposite sides of the bed.
2. Reach over your loved one and grab the drawsheet on the opposite side. Gently pull the drawsheet towards you to help them roll, while your buddy gently pushes the person's hip and shoulder towards you.
3. Place a pillow or a foam wedge under the drawsheet at the person's back. Position the pillow close against the back to help prop them on their side.
4. Place another pillow or a specially designed foam leg wedge between the person's knees. This extra bit of support will add to their comfort by keeping the spine in alignment and easing pressure on the bony areas of the knees and ankles.
5. Use another pillow to prop the person's arms. This technique is done by sight. Nurses have found that most patients are comfortable with the arm on the side they are lying on, propped on a pillow to keep it from being compressed between the body and the bed.
6. Alternate between the back, right side, and left side every two hours while you're awake.

Getting Help

Ideally, a nurse or a physical therapist can train you in positioning a person safely. If you have questions about how to do it properly, or if you see signs of skin injury, contact a healthcare professional to reduce the risks to your loved one's comfort and well-being.