Common Care Practices with Mobility

As with any personal care task, supporting a client’s mobility requires skill, professionalism, understanding, and sensitivity. When you help a client move, follow these guidelines:

• Make sure they are as comfortable as possible.
• Do everything you can to maintain their dignity and privacy.
• Listen attentively and incorporate their preferences.
• Speak clearly and respectfully, and explain what you are doing.
• Encourage the client to do what they can and support them at the level of assistance they need.
• Take your time; avoid rushing yourself and the client.
• Use assistive devices correctly and safely.
• Be aware of and address any safety concerns related to the task.

See Common Care Practices and Communication and Client Rights in the Skills Checklist on page 420 for the specific steps for these skills.

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Skill: Assist a Client to Walk

A person may need support while walking for a variety of reasons. Injury, weakness, or other conditions can make walking difficult and maybe even dangerous. Falls are a serious risk for older adults. Assisting a client to stand and walk safely is an essential skill for Home Care Aides.
See Assist a Client to Walk in the Skills Checklists on page 421 for the specific steps of this skill.

Tips for Assisting a Client to Walk

1. Prepare for the walk before you start.

• Communicate with the client and look around the environment to make sure you are both ready. Clarify with the client where they want to go and determine the level of assistance they need.
• Think about what the client is wearing. Long loose clothing like skirts and robes that fall below the ankles can cause tripping. Encourage clients to use their glasses and/ or hearing aids if they have them. Nonslip, good-fitting shoes will also help minimize trips and falls.
• Check the path before starting the walk. Make sure it is clear and free of clutter.

1. Keep the client’s body as straight as possible while assisting the client to stand. If a client has a weak leg, brace your knee against it as the client stands.
2. Once the client is standing, suggest they stand for a few moments and stabilize their balance before walking. Encourage the client to stand straight, look forward, and keep a measured, smooth rhythm.

Never pull on a client’s arms or put your hands under their armpits when helping them stand.

Assisting a Client to Climb Stairs

Climbing stairs can be challenging for a person with limited mobility. Before helping a client up or down stairs, make sure you know the client’s diagnosis and the level of support they need. Use a gait belt for safety. Hold the gait belt in one hand and place your other hand near (but not touching) the shoulder on the client’s weaker side.

When the client is going downstairs, stand to their weaker side (if they have one). They should hold the handrail on their stronger side and step down with their weaker leg first. If the client is using a cane, have them place the cane down first, before stepping down with the weaker leg. The caregiver should keep each foot on a different stair and only take a step when the client is not moving.

When going upstairs, stand slightly behind and to the side of the client’s weaker side (if they have one). The client should hold the handrail nearest their strongest side and step up with their strongest leg first. The caregiver should keep each foot on a different stair and only take a step when the client is not moving.

Encourage the client not to bend too far forward or backward. If the client begins to lose their balance, provide support with your hand on their shoulder, and move toward the client to help brace them. Do not pull the client toward you. If necessary, move with the client to sit them down on the stairs. Tell the client you will assist them in sitting on the stairs. Call for help and report the incident. What could you do to promote a client’s privacy and dignity while assisting them to walk or climb stairs?