How a plus size person feels being repositioned by carers in a clinical setting

"I have worked as a plus size demonstration model for medical equipment and education companies for almost twenty years. Over the years, I have had the chance to experience numerous methods of manual handling and being transferred and I have developed fairly definite views on my preferences.

Plus size blog 2

Weighing around 200kg, there are a selection of methods and equipment that can be used to transfer and reposition me, including ceiling hoists, mobile gantry systems and floor lifters, slings of numerous designs, transfer sheets, electric profiling beds and turn assist mattress to name but a few.

Happily, on each occasion I have been transferred I was fit, well, and fully able to voice my thoughts during the process. Having awareness of the techniques and confidence in the equipment helps with the anxiety but despite all my experience, I can still find the process unpleasant. Being transferred can be uncomfortable, undignified and disorientating. My skin integrity and muscle tone are good and I am usually wearing robust clothes rather than minimal nightwear. I am also very aware that I am in a very privileged position compared to real patients / residents, who may be in pain, and unable or unwilling to self-advocate.

My preference in being repositioned always favours technological solutions rather than hands on methods. Being moved by manual means at 200kg requires a large team of people, and the success depends on constant, effective communication between all the people involved. The voice of the person being moved becomes less and less prominent and runs the risk of being completely drowned out.

The process of having so many hands on your person feels invasive and disabling, and can be embarrassing and undignified. There is guilt associated with needing a team of six or even eight people to participate leading to questions regarding the client creating a disproportionate burden on a busy care team. A further factor is the fear that a well-intentioned member of the care team might injure themselves, which creates fear and anxiety. While I can see the need for manual moves in emergency situations, it can never be my preference.

So, what works better? Using technology immediately reduces the number of care staff that are required to safely facilitate a transfer. Immediately the communication process between the care team and the client is improved when only one or two staff are needed. The anxiety surrounding someone hurting themselves while trying to assist me is immediately diminished.

A surprising factor that can affect the individuals’ comfort can be related to sound. Equipment should be as near to silent in operation as possible. A larger client can interpret any noise as the equipment being under stress and can incorrectly suggest that a failure might be imminent. Ensuring that sound levels are kept low reduces this stress and ensures the individual being moved remains confident in the process.

With all transfers asking the person involved to participate, even in the most minor ways, can be useful. Asking them to assist by turning their head, bending a joint, or using the hand control ensures they feel part of the process and helps to promote a valuable sense of independence. Facilitating the client to maintain and if possible develop further their range of movement promotes well-being and helps morale.

The range of technological solutions now available is very exciting. Anything that can be done to promote the independence and comfort of the client, while reducing their anxiety is valuable and creates better outcomes. Reductions in the time taken to accomplish moves leads to lower staff requirements, and reductions in the potential risk of staff injuries. The progress I have seen over my time as a model has been really impressive and I would recommend everyone to keep up to date with the new developments that are being brought to the market."

Tracey Carr

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