Ambulation Assistance: Strong Side or Weak Side

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Specializes in being a Credible Source.

Hi there.

I've just finished the first week of my CNA class and found some conflicting information in our book and the videos we watch.

Specifically, on which side of the resident do you stand when assisting ambulation using a gait belt?

The video said to stand on the resident's weak side. This makes sense to me because:

  1. It would keep me clear of a cane which would be used on the solid side
  2. It would allow the resident to grip wall rails with their strong-side hand/arm
  3. The resident seems more likely to fall to their weak side. It's safer for my back if they fall toward me than away from me.

However, our book says to assist from the firm side but doesn't justify it. I asked our instructor, who agreed and said that being on the solid side permitted the resident to support themselves on a wall rail on their weak side. This makes no sense to me because how could they help themselves with a weak-side arm?

So, what do real-world CNAs do, assist from the solid or weak sides?

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Hi there.

I've just finished the first week of my CNA class and found conflicting information in our book and the videos we watch.

Here's a passage from my textbook (Mosby's):

Quote
Stand at the person's weak side while he or she gains balance. [...] Help the person walk. Walk to the side and slightly behind the person on the person's weak side. [...] Encourage the person to use the handrail on his or her strong side.
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You ambulate from the pt's weak side. Your book and instructor are wrong; you are right!

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Specializes in LTC.

You automatically assume the resident will have a cane or wall rails to grip, and I almost always go for the strong side. I place myself behind the resident, one hand on the belt, the other free for the resident to use for support as they need it. So they are using me as the cane/wall rail.

If the resident has an assistive device, I would still stay on the firmer side that way; if they were to start to fall or drop the cane, I'm right there on the better side so they can grab ahold of my arm. When walking these patients, I again place myself behind them, but instead of offering them my second hand, I'll gently place it on their hip so if they start to slip down, I have a hand I can quickly slip up to their underarm.

Think of it this way, if a person starts to fall and you are on their weak side, they can't grab your hand and help you steady them or lower them to the ground. Their lack of help makes them a lot heavier.

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Specializes in Nursing Home ,Dementia Care,Neurology..

You have to do a patient-by-patient M & H assessment for this. Usually, with a stroke patient with some walking aid, I would go on the weak side, but if I am walking with a stroke patient without help, I will go to the strong side as that is the arm they can link with yours when walking. If using a gait belt, I would be on the weaker side but with my arm firmly holding the loop on the firmer side. Usually, however, there are two of us if the patient requires a gait belt.

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Specializes in Peds M/S.
casi said:

You automatically assume the resident will have a cane or wall rails to grip, and I almost always go for the strong side. I place myself behind the resident, one hand on the belt, the other free for the resident to use for support as they need it. So they are using me as the cane/wall rail.

If the resident has an assistive device, I would still stay on the firmer side that way; if they were to start to fall or drop the cane, I'm right there on the better side so they can grab ahold of my arm. When walking these patients, I again place myself behind them, but instead of offering them my second hand, I'll gently place it on their hip so if they start to slip down, I have a hand I can quickly slip up to their underarm.

Think of it this way, if a person starts to fall and you are on their weak side, they can't grab your hand and help you steady them or lower them to the ground. Their lack of help makes them a lot heavier.

This is precisely how our instructor taught us also. She also said that if you stand on their weak side and they fall, most likely they will fall towards their soft side, I.e., toward you. Usually, this will cause you to lose your balance, and you will both fall. If they fall away from you, you can catch them, and it is safer for both of you.

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Our instructor told us to stay on their strong side unless they use a cane - then stay on their weak side. They said that if you remain on their strong side and the patient falls, they will want to grab you for support with their strong side because they really won't be able to with their weaker side.

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Our Fundamentals of the Nursing book (Potter & Perry) says we should be on the weak side, whether or not they have a cane. And that the cane would go on the solid side.

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Specializes in NP student.

OMG, I have a test tomorrow, and this is the only question that I can't answer.

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