Caring for the Caregiver – How to Avoid Back Injury

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Bond-and-his GrandieDarn. I did it again. That familiar twinge at the small of my back, this time a little to the right. All I did was lower my son into his wheelchair. I’ve done this transfer a million times. I know the proper body mechanics. Lift with the thighs; keep his body weight close to my center. And then, with no warning, bang. More like pop. Twinge. Cringe. Darn.

Anyone who provides care for a person using a wheelchair is well aware of the need to protect against back injuries. But how? Back braces are dubious. In my experience, they provide a false sense of security, encouraging me to forget my own trunk stabilization and to lift more than I should. In fact, NIOSH (National Institute for Occupational Safety and Health) not only agrees, but “does not recommend the use of back belts to prevent injuries.” Just to be sure I wasn’t missing something, I did some research. The Nursing Assistant Education website suggests exercise, rest, warming up. Check. Check. Check. They also list these tips:

  1. Get help if you need it.
  2. Use a mechanical lifting device whenever you can.
  3. Stay as close as possible to the person you are about to lift.
  4. Face the person you are about to lift.
  5. Keep your head, neck, and back straight up and down, and tuck your chin in.
  6. Keep your feet wide apart so that you have a wide base of support.
  7. Pivot on your feet in the direction of the move.
  8. Make sure that you have a good grip on the object you are about to lift.
  9. Use the long, strong muscles of your legs. Do NOT use your back muscles to lift.
  10. Use smooth and slow motions. Do NOT hurry. Take your time.

I’m pretty good at adhering to most of these recommendations. It’s those first two that I trip up on. Fortunately, I have a ceiling track lift installed in my home, so mechanical assistance is available.  When we’re at home. Unfortunately, such assistance is absent virtually anywhere else my son goes: school, clinics. And public places like restaurants or stores? Forget about it.

Yes, I need to be better about asking for help. Not just help with an individual lift or transfer, but also help with assuring that the appropriate assistive equipment is available. And not just for me.

Hoyer Lift used with Armedica Jumbo Hi Lo Changing Table
Armedica 150 Jumbo Hi Lo Changing Table adapted for Hoyer Lift

The instructional aides in his special education class lift and move him several times a day for diapering and position changes without benefit of any mechanical assistance. They compensate by team-lifting, so two staff members are required to accomplish a task that would only require one if the proper equipment was available. And the class is understaffed as it is. I have great respect for the hard-working, caring, patient personnel in my son’s class. The penny-wise, pound-foolish decision makers who fear the expense of a thoroughly outfitted special needs’ classroom? Not so much.

Then again, maybe I’m just grouchy.  After all, my back hurts.