Transfer And Assistive Devices

Front 1

Walker

Back 1

Walkers are extremely light, movable devices.
• The client holds the handgrips on the upper bars, takes a step, moves
the walker forward, and takes another step.
• A walker requires a client to lift the device up and forward.

Front 2

Walker

Back 2

Client should hold the handgrips evenly on each side.
• Take a step forward.
• Move the walker forward.
• Take another step.

Front 3

Cane

Back 3

Canes are lightweight, easily movable devices and are made of wood or
metal.
• They provide less support than a walker and are less stable.
• The single straight-legged cane is most common and is used to support
and balance a client with decreased leg strength.
• Have the client keep the cane on the stronger side of the body.

Front 4

Cane

Back 4

For maximum support, the client places the cane forward 6 to 10 inches,
keeping the body weight on both legs.
• The weaker leg is moved forward to the cane so that body weight is
divided between the cane and the stronger leg.
• The stronger leg is then advanced past the cane so that the weaker leg
and the body weight are supported by the cane and weaker leg.
• During walking, the client continually repeats these three steps.

Front 5

Crutch

Back 5

Crutches are often needed to increase
mobility.
• A crutch is wooden or a metal staff.
• When crutches are fitted, the length of
the crutch should be from three to four
finger widths from the axilla to a point 6
inches lateral to the client’s heel.

Front 6

Crutch

Back 6

The handgrips should be positioned so
that the axillae are not supporting the
client’s body weight.
• Determine correct position of the
handgrips with the client upright,
supporting weight by the handgrips with
elbows slightly flexed at 30°.

Front 7

Basic crutch stance

Back 7

Tripod position.
• Crutches placed 6 inches in front and 6 inches to the side of each foot.
• Head and neck should be erect, with vertebrae straight, and hips and
knees extended.
• The axillae should not bear any weight.
• The tripod position should be assumed before crutch walking

Front 8

Four-Point Gait

Back 8

Each leg is moved alternately with each opposing crutch
so that three points of support are on the floor at all times.

Front 9

Three-point gait

Back 9

Requires the client to bear all weight on one foot.
• The client bears weight on both crutches and then on the
uninvolved leg, repeating the sequence.
• The affected leg does not touch the ground during the
early phase of the three point gait.
• Gradually, the client progresses to touchdown and fill
weight bearing on the affected leg.

Front 10

Two point gait

Back 10

Requires at least partial weight-bearing on each foot.
• The client moves a crutch at the same time as the
opposing leg, so that the crutch movements are similar
to arm motion during normal walking.

Front 11

Swing through gait

Back 11

Paraplegic clients who wear weight-supporting braces on their
legs frequently use the swing-through gait.
• With weight placed on the supported legs, the client places the
crutches one stride in front and then swings through to or
through the crutches while they support the client’s weight.

Front 12

Crutch Walking on Stairs

Back 12

When ascending stairs on crutches, the client usually uses a modified
three-point gait.
• Standing at the bottom of the stairs, the client transfers body weight to
the crutches.
• The unaffected leg is advances between the crutches and the stairs.
• The client then shifts weight from the crutches to the unaffected leg.
• The client aligns both crutches on the stairs

Front 13

Crutch walking on stairs

Back 13

When descending the stairs, the client transfers the body weight to the
unaffected leg.
• The crutches are placed on the stairs, and the client begins to transfer
weight to the crutches, moving the affected leg forward.
• The unaffected leg is moved to the stairs with the crutches

Front 14

Crutch Safety

Back 14

The nurse should show the client
how to routinely inspect crutch tips.
– When tips are worn, they need
to be replaced.
– Rubber crutch tips increase
surface friction and help prevent
slipping.
• Clients should be educated to keep
crutch tips dry.
– Water decreases surface
friction and increases the risk of
slipping.
• Cracks in a wooden crutch
decrease ability to support clients.
– Bends in an aluminum crutch
can alter body alignment.

Front 15

Transfer devices

Back 15

A safe transfer is the first priority.
• Always ask the client to help to the fullest extent possible.
• If a nurse is required to life more than 35 lb of a client’s weight,
assistive devices should be used.
– Follow the manufacturers recommendations on use and safety.
– Follow agency policy on device as well.

Front 16

Bed to chair transfer

Back 16

After moving obstacles out of the way and placing the chair next to the
bed with the chair back in the same place as the head of the bed, the
nurse should determine if the client can bear weight.
• If the client can partially bear weight and is cooperative, the transfer
requires one caregiver.
• Two caregivers and a full body sling are needed for transferring
uncooperative clients who can bear partial weight and for clients who
cannot bear weight and are either uncooperative or do not have upper
body strength.

Front 17

Bed to chair transfer

Back 17

A seated transfer aid, such as a friction reducing lateral assist device, is
used with or without a gait belt for clients who cannot bear weight be who
are cooperative and have sufficient upper body strength to complete the
transfer.
• Clients who have partial weight-bearing should be transferred toward
their stronger side.

Front 18

Bed to stretcher transfer

Back 18

Assess whether the client can assist with the transfer.
• Use a friction-reducing device for clients who weigh less than 200 lb.
• If a client weighs 200 lb or more, use a friction-reducing device (such as
a slide board) and three caregivers.
• Use caution when moving a client with suspected spinal cord trauma.
– If you have to move the client, place a transfer board under the client
to maintain spinal alignment.