By physiotherapist Peter Maindal
June 2014
There is no definite answer to what good positioning is. It will always be determined by the situation. So the question is what do you want to achieve with the positioning?
In the previous articles it is stated that positioning can be used in many situations, such as pressure or pain relief, to create safety and comfort in connection with i.e. examination or hygiene situations.
A fundamental premise for feeling safe and comfortable is the experience of stability. For example, try standing on one leg with closed eyes on a soft surface. Most people will experience insecurity and a lack of safety and comfort. Simultaneously, the feeling of being tense and very concentrated will be dominating. You will focus on staying in balance since the body is not stable.
The moment you use both legs for support, the stability is increased and the body will be less tense. If you then place yourself in the walking / stride standing position the support surface is increased, leading to greater stability.
If you then sit in a chair with armrests and a backrest the support surface and stability is further increased. That way you achieve basis for even better comfort, safety and relaxation.
The exact same situation applies when lying down. Try lying on the floor with your arms along your side. It is experienced as stable and safe. Then turn to your side with your legs stretched and attempt to continue holding your arms at your side. Most will experience this as unstable, insecure and not very comfortable.
If the shoulder blade facing the floor is pulled forward, the stability is increased a bit, and the comfort considerably. If the legs are then bent the stability is increased considerably and the position is experienced as far more comfortable and safe. This is first and foremost because the support surface and stability is increased.
" Stability is secured by creating a support surface as large as possible. "
So the basis for good positioning is creating stability for bedridden people. Stability is secured by creating a support surface as large as possible. This is achieved by the way the bedridden person is positioned and by using appropriate positioning cushions.
When you position a bedridden person stably, you create the basis for the person to feel safe. If the person feels safe, he/she will also feel more relaxed. If the person is feeling relaxed, the tone and arousal is reduced, which again creates the basis for better rest and sleep.
Positioning is unfortunately often turned into something special and difficult. This is unfortunate, as that approch contributes to positioning not becoming a natural part of the care.
If you focus on creating stability and a large support surface, you will in the majority of cases be able to create a good, safe and successful position for the bedridden person.
When working with good and suitable positioning cushions, positioning becomes easier and you could make a great difference for the bedridden person you are taking care of.
It does not need to be very advanced. Focusing on stability will get you very far.
" You will be able to make a great difference for the bedridden person. "
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