Declining strength with ageing
Several factors dictate our capacity to function on a physical level, and our ability to stay active and independent as we grow older. As we age, we lose muscular strength. This decline is gradual and may affect us in small ways which are barely noticeable in our 40s and 50s. However, the decline in strength often becomes more obvious as we move into our 60s. If you are over 60 years, perhaps you find it more of an effort to carry the grocery bags from the car to the kitchen. Or, you have difficulty standing up from low-set chairs. Conversely, you may be in the role of a caregiver, tasked with guiding, coaching, and helping someone to stand.
Benefits of independence
The ability to stand up from a chair without assistance is a critical factor to maintaining independence.
Many older people who experience muscle weakness in their legs require the use of their arms to push from a chair into standing. Occasionally, they may need the assistance of others to complete this task. Once a person is reliant on ‘assistance’ to get out of a chair, they will sit for longer than they want or need. This sedentary behaviour accelerates the loss of muscle strength and eventually loss of independence. This is a stark reminder for us all to maintain our strength as we grow older.
Helping someone to safely stand up from a chair will also help them to maintain a higher level of independence. It will encourage them to use their own body efficiently, thus improving the strength of their leg muscles. Additionally, clear instructions will also help reduce a carer’s risk of injuring themselves in the process of helping someone out of a chair.
Our previous blog provided general guidelines on how to be a smart and safe caregiver. The following tips are specific to helping others to stand and get out of a chair. This advice ensures the person who needs assistance is safe, while protecting the person who is assisting from injury as well.
Grab a chair and test yourself
How do you help someone to stand without injuring yourself? What is the most effective way of instructing and helping someone to stand when they are having trouble getting out of a chair and to ensure the caregiver is protected from injury?
An ideal place to start is to understand what are the most important factors involved when standing up from a chair.
Try this exercise yourself to help you understand:
- Sit in a chair with your buttocks set well back into the seat.
- Place your feet on the floor but slightly away from the chair.
- Keep your feet firmly in the same position, and without using your arms to push off, try to stand up.
Difficult? Yes, very, especially if the seat is low.
To stand up, you need to manoeuvre yourself into a good biomechanical position for your legs to work efficiently and perform the task. This involves shuffling your buttocks forward, bringing your feet further back under the chair and leaning your trunk far enough forward so your ‘nose is over your toes’. Now you should be able to stand up – and if not, try pushing off with your arms on the arm rest of the chair. The job becomes much easier.
Help others help themselves
When guiding and helping someone to stand from a seated position, provide a few key instructions. In turn, these can make a significant difference so they can manage to do most of the work themselves. This not only assists them to be more independent, but it also encourages them to be using their own leg muscles rather than your lower back and shoulder muscles.
Use this method when helping someone to stand:
GUIDE FROM SIT TO STAND- getting out of a chair:
- If the person uses a walker, place it in front of the seated person.
- Position the persons feet for standing, asking them to move their feet back on the floor behind the line of their knees. They may need some assistance to help their feet go back far enough. Be mindful of stiff and painful knees when assisting.
- Ask them to shuffle or slide forward towards the edge of the chair.
- Stand to the side of the chair and place your own foot in front of their foot to block and prevent their foot slipping or moving forward.
- Ask and assist them to place their hands on the arms of the chair. (Many people will instinctively reach for the walker in front).
- Ask them to lean their trunk forward so their ‘nose is over their toes’. Then, push up on the arm rests to a standing position.
- Once in standing they can place their hands on the walker to release the brakes. Then walk forward as needed.
A reminder- always encourage someone to push from the chair- not pull on the walking frame. Most frames will not have the stability to help someone to stand and the frame ends up on their lap. Additionally, they lose the biomechanical advantage of pushing off with their arms.
GUIDE FROM STAND TO SIT – getting back safely into a chair:
- Approach the chair and ask the person you are guiding to feel the chair at the back of their legs. This reduces their chance of falling on the floor. Many people will not feel for the chair and end up falling on the floor in front of the chair. This is because they have misjudged the distance in their haste to sit down.
- If there is a walker, place the brakes on and ask them to reach back for the arm-rests of the chair. This will help to control their movement as they sit – rather than flopping into the chair.
- Instruct the person to bend their knees and hips as they control themselves into sitting.
Looking after your own health as a carer is just as important as having the right words and technique to help someone to stand and sit safely. One effective way to help your own wellbeing and reduce your risk of injury, is to participate in a strengthening program.
Refer to our previous SimpliMove.health blogs for strengthening exercises that focus on your core, buttocks, legs, arms and shoulders.