Saturday, June 26, 2010

Fell On Floor and Can't Get Up, how to help

About Human Kinetics
Human Kinetics, mission is to produce innovative, informative products in all areas of physical activity that help people worldwide lead healthier, more active lives.

Human Kinetics is committed to providing quality informational and educational products in the physical activity and health fields that meet the needs of our diverse customers.
So you or your caring partner fell and is having trouble getting back up.

Here is an edited excerpt from Health Professionals’ Guide to Physical Management of Parkinson’s Disease
found on

"Assisted floor transfer techniques for patients with Parkinson's Disease
By Miriam P. Boelen, PT"

"Assisted Floor Transfer Techniques"

When the caregiver helps the patient up from the floor, both must be kept safe. If this is not possible, additional help such as a medical alert system may be needed. If possible, the gait belt should be snug for better leverage.

Transfers should be coordinated between the patient and caregiver to ensure simultaneous maximal effort and to minimize strain on both. The caregiver can accomplish this by giving instructions such as “On the count of three try rolling onto your hands and knees” or “On the count of three try to stand up.” Because of Parkinsonian symptoms, the patient may not initiate movement at the count of three.

The caregiver should be advised of this possibility so that she or he can delay giving assistance until the patient starts. Coordination of effort will avoid placing excessive strain on the caregiver. Caregivers should be encouraged to use optimal lifting body mechanics. .....

* Assisted side lying to hands-and-knees position. The optimal hand placement of the caregiver is to position one hand under the bottom hip and the other hand under the gait belt. The caregiver pulls up on the patient’s hips as if turning a big wheel (figure 11.6, a and b). The caregiver should flex the knees to facilitate lifting with the legs rather than the back.

* Assisted prone to hands and knees. If the patient has strong arms, the caregiver (with proper body mechanics) can straddle the patient, grab the gait belt, and lean back while pulling up on the belt. At the same time the patient pushes with the arms (figure 11.7). As the patient walks her or his hands backward, the caregiver walks backward and guides the hips into the all-fours position.

* Assisted half kneeling to standing. The caregiver stands on the side of the patient that requires greater support. This positioning allows the patient to assist with his or her strongest side, which reduces difficulties in general. The caregiver places one hand on the gait belt and the other arm under the patient’s axilla (figure 11.8).

What to Do After a Fall

Patients often want to get up from the floor immediately after a fall. This desire may be due to the embarrassment of falling or their concern about their ability to get up. Sometimes patients do not think about the fact that after they have fallen, they cannot fall any farther and should be in no hurry to get up. Bystanders occasionally offer a helping hand, but their help may cause greater destabilization or irritate an already arthritic joint. Educating the patient about how to guide bystanders will help minimize these problems. Here are some general guidelines about what to tell your patient:

1. Do not try to get up right away.

2. Before attempting to get up, mentally note whether any areas feel injured. If you suspect injury, seek medical attention.

3. Attempt to relax for a moment before getting up.

5. Before attempting to get up, someone should bring a chair close to you if needed so that you can use it for support to get up.

6. An additional chair could be placed behind you if you have difficulty turning. After you are standing, you can sit on the chair without having to turn.

This is an brief excerpt from Health Professionals’ Guide to Physical Management of Parkinson’s Disease. found on

A gait belt is a device used to transfer people from one position to another or from one thing to another. For example you would use a gait belt to move a patient from a standing position to a wheelchair. The gait belt is customarily made out of cotton webbing and a durable metal buckle on one end. The gait belt is worn around a patient's waist. The purpose for this is to put less strain on the back of the care giver and to provide support for the patient
Points to Remember: More than one caregiver may be needed. Belts with padded handles are easier to grip and increase security and control. Always transfer to resident's strongest side. Use good body mechanics and a rocking and pulling motion rather than lifting when using a belt. Belts may not be suitable for ambulation of heavy residents or residents with recent abdominal or back surgery, abdominal aneurysm, etc. Should not be used for lifting residents. Ensure belt is securely fastened and cannot be easily undone by the resident during transfer. Ensure a layer of clothing is between residents' skin and the belt to avoid abrasion. Keep resident as close as possible to caregiver during transfer. Lower bedrails, remove arms and foot rests from chairs, and other items that may obstruct the transfer

Tuesday, June 8, 2010

It takes two to tango: email version

It takes two to tango: email version - Knowledge Jolt with Jack
Putting the little elves to work.For people who watch the "personal effectiveness" discussion space, one of the favorite topics is that of dealing with email, usually with a strong focus on one person: ideas like Inbox Zero or methods for processing mail. But there is a bigger issue with email in this person is not the only player: she sends and receives emails from many others, and it is their behavior that affect her just as much as her own actions.

Wednesday, June 2, 2010

The Living Will

The Living WillA Guide To Health Care Decision Making
This copyrighted material may be freely reproduced and distributed (intact with no changes) for personal use only.


Through advances in medical technology, some patients who formerly would have died can now be kept alive by artificial means. Sometimes a patient may desire such treatment because it is a temporary measure potentially leading to the restoration of health. At other times, such treatment may be undesirable because it may only prolong the process of dying rather than restore the patient to an acceptable quality of life. In any case, each person is seen, under the law, as having the personal right to decide whether to institute, continue or terminate such treatment. As long as a patient is mentally competent, he or she can be consulted about desired treatment. When a patient has lost the capacity to communicate, however, the situation is different.

Although New York has no statute on the question, there are state and federal court decisions that have established the right of an incompetent or comatose patient to have his or her wishes respected, as long as those wishes are known. New York law requires clear and convincing evidence of what the patient would want. Of all the various acceptable forms of evidence, a health care declaration (often called a "Living Will") can be the best. It simply documents a person's wishes concerning treatment when those wishes can no longer be personally communicated. Even in New York, such a document is recognized if it is clear, specific and unequivocal.

The following guide will help you prepare such a document if you have wishes you want respected. You should realize that if you do not express your views, treatment to maintain your life, by whatever means available, will probably be provided once you are no longer able to communicate, even if family members object. Therefore, if there are conditions under which you would not want treatment, it is important that you communicate your wishes while you are able to do so. In addition, because it is important that your wishes be documented in the most effective way possible, it is recommended that you consult your attorney in regard to the preparation of a health care declaration.

Prepared by: Jack P. Freer, M.D.
Elizabeth G. Clark, Esq.
Hodgson, Russ, Andrews, Woods & Goodyear
Attorneys At Law COPYRIGHT © 1994 Jack P. Freer, M.D. & Hodgson, Russ, Andrews, Woods & Goodyear

Better Care of the Dying

ABCD-CARING - Americans for Better Care of the Dying - Main Page
Every dying person needs to be able to count on excellent care. Americans for Better Care of the Dying (ABCD) aims to improve end-of-life care

Caring Conversations Workbook, published by the Center for Practical Bioethics

About MidBio
Midwest Bioethics Center was a community-based ethics center, founded in 1984 by a physician, an attorney, and a philosopher. Dedicated to its mission to integrate ethical considerations into healthcare decision-making throughout communities, the Center offered workshops and educational programs for professionals and lay people alike, assisted healthcare providers throughout the country in grappling with ethical issues in clinical work, and assisted administrators in integrating ethics into the organizational structure. MBC was a membership organization for both consumers and professionals.

MBC facilitated four different ethics consortia which met to study ethical issues and prepare policy guidelines.