When a PT stands close to you or holds onto your hips when you walk so you don’t fall, that’s called guarding.  PTs don’t like it when their patient falls, that means a lot of paperwork and paperwork sucks.  So I had dinner with my friend tonight and she uses a walker when she walks.  Her dad follows closely behind her when she’s walking.  He was guarding(holding) her on the shoulder.  Wrong.  When you’re guarding someone when they walk, you hold the hips, or keep your hands close to the hips.  Not at the waist, at the hips.  At the hips you can control the motion of the entire body.  If you’re holding onto the shoulders and their legs go out from under them, down they go.  But if you’re holding at the hips you can prevent the fall, usually.  When guarding on stairs you should always be below the patient.  If the person is going down the stairs you should be in front of them going down backwards – ready to catch them if they fall.  If the person is going up stairs you should be behind them – ready to catch them if they fall.

Categories: Rehab, Stroke stuff

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17 replies

  1. One of the first things I was taught was how to hold onto a belt or sash and guide a patient to the floor. I don’t try to catch them as much as limit the amount of injuries incurred by a fall.

    Even today, m being post stroke, I will establish balance in my husband’s unstable stance with a guiding hand on his hip or lower back.

  2. I’m passing your post on to my husband since he’s the one guarding me most often these days. Very informative – thanks!

  3. When a friend lived with us and helped me most of the time, we called it “spotting,” as in gymnastics. She was afraid of difficult stairways, so would always try to talk me into bumping down on my butt; I refused and insisted that she go down in front of me. She would go forward and keep on the step one ahead of me (too close for me to see my next step), which was only going to help if I stumbled and landed on her – there was no way she could catch me. She considered herself the expert, though, and did what she wanted even when it was more dangerous for both of us. I was so grateful she was helping me that I went along with even her bad decisions.

  4. And if PT schools ever enter the current world they will realize that the fall prevention by the patient is the way to go. If you never are allowed to recognize what you did wrong prior to the fall you will never be able to correct it. Never mind me, I’m just an uneducated fool.

    • Oh Dean, you’re no fool…

    • Yes, Dean, it was the post-fall analysis that let me know that I should not twist and reach at the same time. If someone had pushed me upright at the time I’m sure I wouldn’t have believed I would have fallen to the ground without catching myself. And there’s nothing like the out-of-control feeling of falling to convince you that you RELLY don’t want to fall.

  5. Amy, I am forever awed at the knowledge you have. Thank you for teaching us these important lessons.

    I love the memories of me being “guarded” for the first time. I was learning to take my first steps and the PT had my hips and gait belt. My husband had our baby girl by the armpits. We took those amazing steps together. We took our first steps on the same day in that hospital hallway.


  1. Falls – mycerebellarstrokerecovery

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