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Now in this case, we're gonna be covering how to move a person from a sitting position using a gait belt, or a manual lift assist. In this case where we're using a gait belt, please keep in mind that we only move people who have partial strength to assist us. If this person was not strong enough to assist us with their legs or with their arms, we would not be lift-assisting them with a gait belt. Now, certain local protocols and policies may contradict this in your different regions. But as a ergonomic rule, if we have to lift an enormous amount of weight, really, manually, even if the person's only 150 pounds, or 75 kilograms, we're still looking at a lot of substantial weight when we're reaching out beyond ourselves, multiplied by 10, on the lower areas of our back. So, again, remember, if we have to lift all their weight, that's when we use a pneumatic lift-assist device, like a Hoyer lift, Invacare lift, or another pneumatic lifting device, which we're gonna show you at a later point. But again, in this case, we're gonna be talking about the gait belt with a lift assist. Now this person happens to be sitting in a stationary chair and is being moved to a wheelchair. We need to make sure that the brakes are on and that the pedals are moved apart or off completely, depending on the type of wheelchair we're dealing with. If you can remove the arm of the wheelchair that's closest to the person, that's a great idea because now we don't have to move them around any objects. We can just, with a pivot, move and sit, and they don't run the risk of hitting their hip on anything in the way. In this case, we cannot remove that arm of the wheelchair, so we're gonna work around it. It's extremely important to keep note of a couple things. Is the person that we're going to be moving wearing nonslip-soled footwear? Whether that's slippers or shoes, it needs to have something that's going to help prevent this person from slipping on a floor. Secondly, we're going to communicate well with this person to explain what we're going to be doing for them and with them, and we wanna make sure that they understand us quite well. So I'm going to engage this person in speaking to them. Can you understand what I'm saying at this time? - Yup - Okay, great. I see that you're wearing shoes, tennis shoes, with good soles; that's great. Can you make sure to move your feet out just a little bit? There you go, perfect, and then if you could separate your feet a little bit; perfect. This allows me to be able to step with one foot in between their feet in order to get a good knee in placement to adopt the person's body weight as my own as I help them stand up. The second thing I would like you to do is put your arms on my arms, not around my neck, because that could cause me injury, and then I could drop you, and you could get hurt as well, okay? I'm asking them questions and waiting for them to respond, because it's gonna be important that they do understand how we're going to do this technique. Now I'm gonna explain to this person what I have in my hands. Sir, this is a gait belt. Have you ever experienced the use of one of these before? - No. - Okay, how this works is that I'm going to bring it around your back in a moment, and we're simply going to fasten it like a belt. And then I'm going to tighten it just enough so that my fingers can be underneath it, and it's going to let me grab onto it instead of your skin or your trousers, correct? And then on the count of three, when I get ready, we're going to stand together, we're going to pivot, and when you feel on your back of your legs this wheelchair, on the count of three we're going to sit down together. Does that make sense? - Yeah. - Now that I've discussed this with this person and they have a cognitive understanding of what we're going to do, I'm gonna move to the next step and actually prepare for this lift. Sir, if you could, could you please slide yourself to the edge of the seat as best you can and just lean straight up a little bit? Perfect; what I've done is I've tested this person again. I wanna know do they have the strength to assist with this lift? Because if he were to tell me, sure, I can help you, I can stand on my own, but then I ask this person to move forward and they don't have the strength to move forward, they really probably are too weak for me to lift them. And we're setting ourselves up to drop the person and to get hurt ourself. Now, I'm gonna go ahead and use perfect ergonomics to actually get the gait belt on as well, so I'm gonna go down on one knee. Sir, if you could raise your arms up for me, I'm simply going to bring this gait belt around behind you. We wanna do that where we feed the belt behind them. We're never going to throw the belt over this person's head. We run the risk of hitting them in the face with the belt. We also run the risk of scaring this person. There are all kinds of different people with all kinds of different needs. If this person has a mental disability or has a developmental disability, this could really scare them. It could panic them, so we wanna make sure that we're not making any sudden movements but that we're encouraging confidence, and feeding this around their back manually is a great way not to hurt them or scare them. Once this gait belt is in place, I'm going to test the tightness by keeping my fingers on the inside. And then make sure you feed the rest of the belt loop through the rest of the buckle so that this does not slip. Gait belts normally have teeth that will prevent the belt from slipping when it's secured correctly. Now that this is in place, we're ready to go ahead and lift this person. Sir, remember once again, your arms, your hands, will go up on my forearms, I will grab the back of your belt, I'm going to step in, your head is gonna go over my shoulder, and on the count of three, we're going to stand up. Ready? - Yeah. - One of the last things we wanna talk about here, though, is to make sure that if I'm gonna be moving the person to the right, my left foot is in between the person's legs. If I'm moving the person to my left, my right foot will go in between their legs, because once we do this lift, I wanna be able to pivot and not get my feet caught up with their legs and trip and fall. Okay, go ahead and put your arms on my arms. Lean over my shoulder. Notice how I stepped in? My leg is between his legs, I'm squatting, using the strong legs to prepare for this lift. On the count of three, sir, we're gonna stand. One, two, three, up we go. Let this person get their balance. Do you feel comfortable? - Yup. - Now slightly shift your feet until you're in front of the wheelchair, sir. Slide back about two or three steps; there you go. Can you feel the chair behind your legs, sir? - Yup. - Okay, on the count of three we're gonna sit down just like we stood up; ready? One, two, three. I step in, I adopt his weight as mine, using the gait belt for my holding, and now this person is sitting in a chair. I back away, I make sure they're comfortable, and now we can situate them back into the wheelchair, get them belted in properly, and get ready for the next move.
From an ergonomics standpoint, you would only lift assist someone by yourself when the person can support his or her own weight while standing with support. If a person cannot support his or her own weight, you would need at least two people to perform the lift. While performing a lift assist, a gait belt should be used.