How to Safely Reposition Your Bed or Chair-Bound Loved One

As providers of the most trusted Phoenix senior care the area has to offer, we know working with bed-bound seniors and chair-bound seniors requires much care and attention, and one of the most critical components is repositioning. The primary purpose of repositioning is to improve circulation to the skin and other organs, relieving pressure and preventing skin breakdown. Repositioning also helps in providing comfort to your loved one and ensures movement of the joints and muscles. Although many bed-bound patients often resist turning and will tell you they just want to be left alone, turning will improve comfort over the course of the day and night, and will also give you opportunity to inspect the skin.

To help you keep both yourself and an older loved one safe, we’ve answered some of the top questions related to repositioning here:

How often should I reposition a bed-bound loved one?
The common guideline is every two hours. However, repositioning an elderly loved one should be individualized based on tissue tolerance, medical condition, activity level/bed mobility, comfort, skin condition, and overall treatment goals. Chair-bound individuals generally need repositioning even more frequently.

What is “tissue tolerance,” and how do I check it?
Tissue tolerance is how long skin can safely tolerate pressure over bony areas (hips, ankles, shoulders). Observe how long it takes for redness to appear, then set your schedule to 30 minutes less than that interval, with a maximum of two hours between turns.

What positions are safest when I reposition in bed?
Alternate between the back, right side, and left side on the schedule that fits the person’s tolerance. Avoid positioning directly over areas that redden easily and always relieve or redistribute pressure.

What are the basics of safe bed mobility?

• Never lift more than you can manage—get help when needed.

• Explain what you’re doing and how the person can help.

• Raise the bed to a safe working height and lock the brakes.

• Do not pull by the arms or drag the person; use a drawsheet to slide, not lift.

Why is a drawsheet so important, and how do I place one?
A drawsheet reduces friction and skin injury during repositioning in bed. To place it: roll the person to one side, set the half-rolled sheet perpendicular to the bed (head to knees), roll the person back onto it, unroll flat, then tuck and smooth both sides.

How to turn a patient in bed (step-by-step):

1. Move the person to the center of the bed.

2. Ask them to look toward you; place the nearer arm outstretched toward you and the far arm across the chest.

3. Place a pillow on the opposite side for support.

4. Use the drawsheet to gently roll the person toward you; slide the pillow/wedge snugly behind the back.

5. Align head/neck with the spine; keep ankles, knees, and elbows from resting on each other.

6. Add pillows: behind the back, under the top arm, and between the knees.

How do I move someone up in bed without injuring skin?
Use a two-person assist with a drawsheet (or slide sheets). Ask the person to tuck their chin, fold arms, and bend knees. On a count of three, both helpers shift weight forward and slide (do not lift) the person up. Reposition the pillow and, if staying on the back, elevate the foot of the bed or place a pillow under the knees to reduce shear.

What equipment helps with bed mobility and skin protection?
Talk with the healthcare team about: hospital bed with rails, trapeze (if upper-body strength allows), Hoyer lift, drawsheets/bedpads, slide sheets, wedges/pillows, low air-loss mattress, wheelchair cushion, geri-chair, and heel/elbow protectors or contracture rolls.

How should I address repositioning an elderly loved one who is chair-bound?
They should shift weight every 15 minutes if able; if not, reposition at least hourly using a drawsheet or sling under the hips to shift side-to-side. Always use a pressure-redistribution cushion.

What else affects the right schedule for my family member?
Nutrition, overall medical status, current skin condition, and tissue tolerance all matter. Ask the healthcare team to tailor a plan for how to reposition a patient in bed and in a chair based on these factors.

What are quick safety “don’ts” when turning or sliding in bed?
Don’t lift beyond your ability, don’t pull by the arms, and don’t try to move someone without a drawsheet. These mistakes increase risk of skin tears and caregiver injury.

Where can I get expert help with bed mobility and routine repositioning?
If you’re unsure about how to turn a patient in bed or need hands-on support, trained in-home professionals can coach you on technique, suggest equipment, set a custom schedule, and help protect skin health day to day.

To ensure your loved one is safe from injury – as well as yourself! – call on Nightingale Homecare, providers of the most trusted Phoenix senior care the area has to offer. We can assist with a full range of both skilled and non-medical services for seniors in the home, based on each person’s individual needs. Call us at (602) 504-1555 to learn more.