In your career as a home health aide perhaps one of the most dangerous skills that you will face is the making of an occupied bed. If your client is totally bedbound, you will need to change their linens on a daily basis with them still lying in the bed. This task is not as easy as it sounds and it not something you should attempt to do the first few times alone.
The Dangers to the Client
The risks that the client faces in this task should be obvious; they could potentially fall of the bed. Most of your home health care clients do not have medical bed with rails on each side. When working in a nursing facility, one advantage to this skill is that some of your residents could hold the rail to brace themselves for their own safety while you make the bed. On a standard bed at home, the rail is not there and you need to come up with a safer method. If your client falls of the bed, they will likely suffer an injury and you and you agency could be held liable for neglect.
How to Properly Change the Occupied Bed
Prior to moving the client, layout and arrange the bottom linens as the would lay on the bed and roll them in unison to form a roll the length of the bed. Allow for half of the roll to layout to make it easier to place.
With your client in the bed, reach over the client and hold on to the draw sheet under them. Use this sheet to gently roll the resident towards you. Use your body as a shield between the client and the floor. Allow the resident to brace themselves with their hands against you if possible to better balance themselves.
Reaching behind the client pull the dirty bottom sheets from the corners and roll it up under the client's body. Place the clean linen behind the client and the remainder of the roll under the client as well. Lay the client flat on their back in the middle of the bed and walk around the other side to roll them over towards you again.
Remove the dirty linens and set them to the foot of the bed and unroll the clean sheets out covering the rest of the bed. With the client safely on their back in the middle of the bed, tuck the corners of the bottom sheet in place and remove the dirty linen. Replace the top sheet for the client as well. When the resident is secured, properly remove the dirty linen from the room.
I will admit that this is usually not how most teachers would advise that you do this task. However as a home health aide that worked solo in home health care for a decade, you learn the difference between the ideal in the book and the reality on the job. This task is a strain on your back for reaching. However, it's better than risking injury to your client.