Smart caregivers use a gait belt!

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Smart people DO use a gait belt! What makes them smart? They know that misfortune does not always happen to the other person. They know that one more mishap or fall for their loved one could mean a slow, painful death. They also know that when they use a gait belt, they reduce injury to themselves.

God bless careless but we can get lazy about safety. We think if we've done it a hundred times just fine, we'll be fine for the next hundred times.

Did you know that using a gait belt correctly tends to help patients do better? Having that extra bit of security allows them to relax a bit and actually get up more now that they feel more secure.

When you use a gait belt, you inspire others, respect them and your body, and you may even sleep better knowing that you are not cutting corners to safety.

Yes, but...

...but what? I've heard all the excuses in the world... so, let's cover a few of them...

  • It's time consuming to put on and take off all day long

  • It just hangs there around their waist

  • I could never catch them with that!

  • I can't tighten it once it's on

  • It's uncomfortable for them

  • It gets in the way

  • They don't want to wear it

You might be able to add your own. Before we address these issues and make life easier and safer for everyone, I'll talk about the simple steps and ways you can cash in on this piece of canvass.

Use a gait belt right or don't use it at all.

Safety MUST come first... would you agree? Remember when your children were babies... the pains you took to put them in their car seats checking the connections 3 and 4 times? How about the pains you went through selecting the BEST car seat?

What's changed? Safety is a basic human right. Unfortunately, disability's render many helpless, hoping that others will provide the human right of safety.

Let me suggest that nothing should have changed. The use of a gait belt is like checking the car seat 3 times. It must be used correctly and checked for it to do it's job.

Several types of gait belts

There are many types of gait belts out there. Basically, they are 2-3" canvass with a metal buckle, a quick release buckle or velcro secured.

Some gait belts are plane with one buckle, others have grab loops around the entire belt. I'm not a fan of grab loops but some swear by them.

Metal buckle canvas gait belt. Canvas belts with metal buckles provide the best safety in home health physical therapy for elderly. This is my personal favorite for using a gait belt. A 2-3 inch canvass belt (length can vary depending on size needs) with a metal buckle at the end.

Canvas gait belts are great but plastic buckles can break over time causing risk of falls Plastic buckle canvas gait belt. This gait belt is still the 2-3 inch canvass. The big difference is the plastic quick release buckle vs the sturdier metal buckle.

I've been in the home care industry for 16 years now and I will use my own gait belt before I use a plastic one for these reasons:

  • Quick release gait belts, when secured snuggly, are uncomfortable to wear all day. Adjusting this kind is very difficult.

  • Quick release belts are either on or off but can awkward trying to get on and snapped into the buckle

  • When I use a gait belt, I almost always have to tighten it a bit more when the patient stands... this is not easily done with a quick release belt.

  • At times, quick release belts can sound like they click but can malfunction especially when you can't see what you are doing very well due to obesity issues.

Gait Belt with grip loops. gait belt with multiple side looks gives caregivers various loops to grab in a hurry This gait belt features "convenient" (but safe?) grab loops. There are some sturdier versions of these today but be cautious about using the older ones that were flimsy plastic.

When you use a gait belt, anything in a pinch will do but when you use one consistently you begin to become attached to it. Some love this type of gait belt with loops on it to grab onto. Personally, I don't trust sewed on loops. It's not what's holding the patient, the belt is. The loops appear convenient but I just don't trust them. A 3' piece of canvass is not going to rip during a catch or fall break. A floppy 1/2 inch grab loop might.

It's my opinion but a very strong one at that. Remember as far as safety goes, nothing's changed... You wouldn't buy a car seat with 1/2 harness straps would you? Use a gait belt that is sturdy and undamaged.

Uni thigh strap. A uni thigh strap gait belt keeps the gait belt from sliding up the waistline but can be just as uncomfortable for the trade off An alternative to fighting a gait belt that is constantly sliding up is the above pictured Uni Thigh Strap. These (2) straps secure around the thighs and attach to the gait belt to prevent slippage. More features to this "remedy" are:

  • The gait belt and Universal Thigh Strap can be left in place if the patient is requires frequent transfers.

  • This product is adjustable

  • Protects gait belt from sliding

  • Less effort is required by the careless to transfer a patient

  • Makes your existing gait belt more effective

  • Can be left on the patient if future transfers are required

SafetySure transfer belt. A soft, comfortable gait belt offering increased feeling of security for both patient and user This transfer belt is a thick padded belt with hand grips that allows care givers to easily lock and unlock. They are first transfer belts and then can double into a gait belt. These belts tend to work better on larger people since the belt itself is wider. Some have no slip inner surface to avoid slippage when helping a patient up and down or while assisting them with walking. A better option than the older plastic versions that I've seen. These have hand grips on each side for easy access and better 'ergonomically correct' assist with patients. Some company's claim that these gait belts prevent care giver back injuries. Back injuries are prevented with good posture and lifting techniques, and "Use a gait belt!" If those two forms are faulty, NO gait belt will prevent back injuries.

Gait belt sizes

The most common length for gait belts are (in inches): 48, 54, 60 and 72. For longer gait belts, it is very simple to buckle two gait belts together. I have only done this with my favorite metal buckle belts and have had good success for larger patients. A 72 inch gait belt will likely fit your need, however, at times you may only have two shorter belts. By attaching them, you can accomplish "bigger" goals.

Use a Gait Belt with A Metal Buckle (My humble opinion!)

But fastening it can be tricky till you learn how... here are the simple steps.

Step 1

Bring the ends of the belt together so that the teeth are pointed out - begin threading the belt through the teeth end first - this way the teeth 'bite' down on the gait belt as it is tightened.

Step 2

Thread the end with the metal tip through the open end of the buckle angling it if need be.

Step 3

Keep threading the metal tip through the teeth end and then through the opposite open side of the buckle.

Step 4

Tighten by pulling the metal tip completely through the buckle.

Snug the belt up around the patients waist being sure to avoid any feeding tubes, breast tissue or sutures. Be sure you can slip about 2 finger widths between the belt and the body. Keep in mind, this will still be quite snug.

Help the patient to their feet with the simple verbal trick of 'nose over toes.' Once standing, quickly yet efficiently snug the belt up by repeating step 4 and then step 3 etc until you have a snug fit.

Now, as you walk with your patient, put your hand flat on their back over the gait belt slipping only your thumb under the belt. This allows for your hand to monitor movements that your vision my miss. This also allows for you to grab the belt in the event that it is necessary.

Some careless prefer to completely grasp the belt palm up or palm down as necessary. This can tend to a subconscious pulling up on the gait belt when it's not needed. Remember when you use a gait belt, it's generally being used to steady someone, not to drag them around. Any unnecessary, unintentional force from you can disrupt an already fragile balance system.

When you are done walking with your patient, simply loosen the belt back as shown in step 3. This allows comfort to your patient yet adverts the temptation for you to take it off (and leave it off!) That's way to tight! This is by far the biggest complaint that I hear from patients and careless alike! Albeit... it can be too snug in some cases where there is abdominal pain, feeding tubes, breast tissue etc getting in the way (and sometimes you just can't use a gait belt).

However you must remember that if you are breaking a fall - a sloppy gait belt will simply slide up into armpits before anything grabs.

A note about falls when you use a gait belt - Patients fall for two reasons:

  • The lose their balance, get dizzy and topple

  • Their legs or hip or back "gives out" causing a fall

Gait belts prevent falls

So, remember that no matter how the fall is happening, your job is not to try to prevent the fall necessarily - but to break the fall with, of course the use of a gait belt. I've used a gait belt over and over again to break a fall and even to steer the patient back into the chair or away from hitting furniture.

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