Peter’s story: Reducing risk in transfers

Description of case:

Forty-nine-year-old Peter has acquired a brain injury following a road traffic accident. Peter is unable to mobilise himself and is dependent on a self-propelled wheelchair for all mobility. Peter transfers between furniture by sliding from one piece of furniture to the other, at a 90-degree angle. Peter is able to follow basic instruction, however, he does require support to ensure he is able to carry out most of his daily living tasks safely, as he can be impulsive and has poor risk awareness.

Main issues:

When transferring into bed, Peter slides with minimal difficulty from the wheelchair to sit on the edge of the bed but experiences significant problems getting his legs onto the bed, using his whole body weight to try and swing his legs into bed. This was a very uncontrolled movement and placed him at particular risk of injuring himself on the bed rails or falling out of bed on the other side if the bed rails were not in use. Several interventions have been trialled, including a powered leg lifter, a monkey pole, carer support and a low profiling bed of 200 mm. Unfortunately, none of these interventions proved successful, so Peter continued to place himself at risk.

Intervention:

Using a FloorBed Peter is able to slide from the wheelchair onto the edge of the bed and lower the bed to the floor. He no longer requires the leverage of his full body weight to get his legs onto the bed. Peter now leans on the backrest and ‘walks’ his feet round to the foot end of the bed, where he slides his legs onto the bed.

Outcomes:

The floor height of the bed enables Peter to bring his legs onto the bed in a much more controlled manner, significantly reducing the likelihood of injury. In addition, the bed rails have been removed, since the floor height lessens the risk of injury in the event of a bed fall.