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I usually ask him to put his feet under him and make an effort at standing up while I grab under both arms with my right foot planted between his feet. He is getting more sluggish and less helpful so pulling him up off the chair (he weighs almost twice as much as I do) is nearly breaking my back. I am afraid that this will be the cause to have to place him in extended care and have permanent damage to my spine. Any suggestions would be helpful.

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Quick fix for getting him up out of a chair is to buy a chair that lifts him up electronically. My mother has a recliner that puts her into a standing position. Wheelchair is locked and ready for her to transfer to it.
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There is no doubt that what you are trying to do is one of the basic keys to all nurses at the bedside. Safety for both is critical and maybe more practical, for sure, if another assistant were available. But if they were you probably wouldn't be asking the question here. You have definitely got the basics right. Most nurses like the use of gait belts around the waist, on a lift I never used them; only during ambulation would I consider them. Planning your lift is critical. Making sure the subject is ready and understands what is about to happen. The higher the sitting position the better. Encouraging them to use the strength in their legs is very important but often not overly effective as many simply lack the strength, but every bit helps. You can save your back by bending your legs as much as possible. Your back can still be straight even if you are at a 45 degree angle. The position of your feet, as you say seems right to me. Make sure the surface of the floor is secure and doesn't have something in the way. Fluids, dirt or anything that can cause you to slip. If you have a wheelchair as a destination point try not to have it more than one turn away. Meaning if the chair is in back of you, your feet will cross themselves and create instability. Lock the chair. I like to support the pt from under the arms and as much around the back as possible, although most pt. are too large for me to have my hands clasped behind me. Either way, keeping the center of gravity close to me gives me more control and requires less effort upon that initial lift. The initial lift should be a combination of rocking backward and a leg push at the same time. The strength in the lift needs to come from the legs, this takes practice as our natural sense is to use our backs. In order for this to be most effective the height of your head should equal that of the pt. Always announce the lift to the pt so they are ready. Keep a phone close by for back up.
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Dave, I had watched several YouTube videos on how to get a person off the floor. My dad, when he was still walking, was dead weight. His legs couldn't even hold him up. After watching the videos, I decided that it's not possible for me to do that. I'm under 5 feet, and at the time, only weighed about 90-94 lbs. My dad was double my weight. But, I will say it was very helpful to see those videos.
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There are special lifts that can be rented to move a patient from the bed to a chair, etc, They look like a sling and you crank the handle to get the sling to lift up and then it swivels to the spot you would like the person to be placed in. I used one of these for my husband who was in a wheel chair many years ago. I cannot remember which group, either the Lion's club or the American Cancer society, but both of these groups lent me hospital items to use in then home. I hope this helps.
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Many of the comments so far has been from utilizing information without the actual use of a patient lift. I hope the following information will help you. My wife has Parkinsons and dementia and was having trouble getting up and down by herself. She went from walking on her own to using a walker then to a scooter and finally to a wheel chair. She slowly lost her ability to use her legs and I ended up assisting her each time she needed to be transferred to a chair, bed or potty. Eventually I found myself lifting her many times a day which took a toll on my shoulders. I mentioned to her primary doctor of the situation and she sent someone to assess the situation. The suggestion was to get a patient lift. One was ordered through Medicare. There are several types of lifts available. One is for assisting the patient to stand up when it is difficult to go from a sitting position to a standing position. The other lift, which is the one I have, lifts the patient in a sitting position from a chair, bed, wheel chair and transfers to another chair, bed, etc. The lift is hydraulic which has the capability of lifting around 450 lbs, if memory serves me correctly. I have a manual lift which is very is to use. If you have a shoulder or arm injury which prevents you from using a pumping action of about 10 to 15 lbs then a motorized one is available. There several types of slings available. The two prevalent ones are the transfer sling and the toileting sling. Flooring is a consideration. Hard floors work best with the patient lift.
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I would recommend looking for a patient lift. If you can get him to exercise his arms and legs he might retain some ability to transfer. There are transfer boards for a patient to use also but they need some ability to use their arms to move across the board. I found my father could do this in a limited way because by later in the day he was too weak to use it. I found a wheelchair with a drop arm assisted the transfer. There are bedside commodes with drop arms too which can make moving him to the commode especially during the night better. The rising recliners can help if he can participate with the move.
I agree with getting the patient involved with the move. I always started with "Lets move you to X to be more comfortable" "Dad I am thinking we can do this if I do X and can you do Y?" He would repeat what we would try to do together to move him and then we would do it. It made him aware and wanting to help with the move as best he could.
I would have as much equipment in the home as you ever might need to conduct a move. You need options because methods used successfully in July may not work by September etc. The patient's ability to assist will fluctuate.

Be careful. I was able to move my father who was 6'3" without having to place him in a NH. However, you have to work smart. Otherwise you are correct you will injure yourself. Lifts can be a big help as the patient's strength declines. I used them almost exclusively the last year of my father's life. They can be very safe.
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A lifting recliner, also a bed that lifts to a higher level will help your back, and what's helped me the most in lifting is a gait belt. As women are strength is in our legs and hips really, not our arms so much. Men are usually taller, lifting a man up by his arms is difficult. A gait belt would allow you to lift him up and support him at his waist instead, so no tugging on his arms, you'd have more control over moving and lifting him with the belt and you'd have something safer to hang onto in case he starts to fall. You can also use your knees and feet to guide him and even use a knee as extra support while he transfers to keep him from slipping to the floor or falling. I assist my dad with a gait belt, he's 6'1, 170 lbs., I'm 5'6", 110 lbs. You can also get a "triangle" for the bed, so if he can move himself at all, he can pull himself up in bed. It attaches to the side of a bed and then rotates to different positions and heights and you lock it. Good luck.
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Alpha, you have to be very deliberate as you help him stand or transfer. Be very specific about what you're doing, describe what's going to happen, and verbally cue him through each step. Here's how I help my mom get out of bed and transfer to the bedside commode: "Mom, we're going to take both of your feet off the edge of the bed, and then I'm going to prop you up to a sitting position. Then we'll get you up." Then I proceed thru THOSE steps with her help. THEN, I tell her, "Okay, let me put this belt around you so I can help you stand." I do that, and then, "Now, I'm going to help you stand up. You're going to put your hands beside you on the bed..."(I wait until she does that)...and on THREE I'll help you stand." The walker is right there for her to grab onto once she's standing. I remind her to grab onto it. Then I might say, "Okay, mom, now side-step/side-step/side-step. Look at the bedside potty; that's where we're going." Etc. I think you get the idea. Step-by-step. Slow, deliberate and patient.
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Ask doctor to prescribe a Hoyer lift device. It's like an engine hoist...very sturdy and helpful...on wheels too!!! You will compress vertebrae if you do it with just your own strength. Trust me, the last thing you want to hear is the crunch of your own spine! Hope this helps! Susan
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I'm sure many of the suggestions such as lifts, etc, will help. I have one more simple one that can help any of us who still have the ability to stand at all. My mother, a previous exercise teacher and dancer, herself taught me and all her friends this technique to stand from a sitting position. It's really useful for anyone, especially trying to get out of a car! 1) You come as close to the edge of the seat as you can, getting your center of gravity under you. 2) Put your head down toward your knees 3) Lift your rear end up and shift your weight to your legs. 4) Use your legs to lift yourself up. Of course, when it is someone you are helping to rise, you tell them, "Head down, Rear end up!" And you can help as they lift themselves as possible. Hope it helps.
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