Hands-On Skills for Caregivers

By Family Caregiver Alliance

When you’re a caregiver, finding time to take care of your own physical needs is difficult enough, but taking care of the physical needs of someone else is even more challenging. Assisting someone else to dress, bathe, sit, or stand when they are upset, agitated, or combative—often the case when caring for someone with a brain disorder such as Alzheimer’s disease—requires special strategies. The following five techniques can make taking care of a loved one’s physical needs easier.

Approach from the front and retain eye contact
When assisting someone physically, do not approach him/her from behind or from the side. This can startle and confuse the person in your care, leading to increased levels of agitation and/or paranoia. Instead, approach from the front. Touch the care recipient on the shoulder, upper arm or hand, and tell them what’s going on. Use a calm voice to walk him/her through the whole process. For example, “Okay, let’s stand up. Good. Next, we are going to… .” Retain eye contact throughout the duration of the activity.

Elicit your loved one’s help
Even when frail, your loved one might be able to shift his/her weight or move his/her arms or legs to make physically assisting them easier. Some examples are: “We’re getting ready to stand now, Mom, so lean forward as far as you can,” or, “Can you move your leg, honey, so I can change the sheet?” A little help from them means a lot less work for you.

Allow the person to finish what they’re doing
If, as a caregiver, you are running late, the tendency is to hurry your loved one, too. However, this rushed atmosphere is very difficult for care recipients, especially those who suffer from memory loss or brain impairment. Though you may try to sound calm and encouraging, it’s easy for loved ones to pick up our “anxious vibes.” So, even if running late, allow some time to finish the current activity before moving onto the next. For example, “Mom, after you finish that last bite of cereal, we’re going to get you dressed and ready to see your friends.”

Utilize the major muscle groups
When physically assisting a loved one, pulling or supporting them by their hands or arms is not only difficult, but may lead to injury for you and them. Instead, utilize the major muscle groups.

For example, when taking someone for a walk, stand directly behind and to the left of him or her. Place your left hand on their left shoulder, and your right hand on their right shoulder. In this way you are walking with your loved one in a comforting hug rather than pulling or pushing them. And when turning someone in a bed, contract your abdominals to maintain your back straight, while using your shoulder and leg muscles. Pull them toward you with your right hand over their hip or at the knee, and your left hand at their shoulder. Finally, when pulling someone to a standing position, it’s best to use a transfer belt (one can be purchased at any medical supply store for around twenty dollars).

Once they are sitting at the edge of the bed or chair, pull up on the transfer belt, “hugging” your loved one close, again, utilizing their large muscle groups in the shoulders and the back. Remember to keep your back straight and to always change position by moving your feet, rather than twisting at the waist. And before going home from your next doctor’s appointment, ask for a referral to an occupational therapist who can help you develop your transferring skills.

Allow for their reality
Remember to accept your loved one’s reality, even when assisting with a physical task. If, for example, your spouse becomes shy because he/she thinks that you are a sibling and doesn’t want to get undressed in front of you, don’t force the situation. Try leaving the room and coming back in a couple of minutes. Perhaps on a second or third attempt your spouse will recognize you and be amenable to your care. If all else fails, consider the situation. Is it an emergency? Changing a loved one’s soiled garments cannot be delayed. However, if a care recipient is being difficult and doesn’t want to take a bath or wash his/her hair on a particular day, that’s okay. Plan on doing it at a later time that day or the next day, when your loved one may accept your help.

Finally, don’t try to physically assist with caregiving unless you can. Injuring yourself will not help the situation, and will often make your caregiving responsibilities that much more difficult. If you find yourself in a nonemergency situation where you are unable to physically assist your loved one (for example, after he/she slides from their chair to the floor) call your local fire department and request a “fireman’s assist.” They will come to your house and help you. If it is an emergency situation (where either you or your loved one are injured), contact the paramedics by calling 911.