Assisting the Resident to Dangle 

Purpose: 

• To reposition a resident from a horizontal to a vertical position, allowing for gradual adjustment in blood pressure to minimize dizziness and weakness. 

Equipment: 

• Resident’s bathrobe 

• Slippers 

• Chair 

• Bath blanket 

• Footstool 

• Pillow 

Procedure: 

1. Preparation: 

• Check the resident’s pulse and blood pressure before moving them if ordered. 

• Ensure the resident is covered with a bath blanket if necessary. Fanfold the covers to the foot of the bed. 

2. Positioning: 

• Gradually elevate the head of the bed. 

• Slide the resident to the edge of the bed. 

• Place one arm around the resident’s shoulders and the other under their knees. Turn the resident toward you, allowing their legs to hang over the side of the bed. 

• Ensure the resident is wearing their slippers. 

3. Dangling: 

• Instruct the resident to swing their legs gently to and fro, ensuring they do not tire. 

• If desired, place a footstool to support the feet for a few minutes. 

• Allow the resident to dangle for the time ordered or instructed. 

4. Monitoring: 

• Observe the resident for any signs of dizziness or faintness. If the resident becomes dizzy or faint, return them to bed immediately. 

• Check the resident's pulse and report any concerns to the charge nurse immediately. 

• Check blood pressure if ordered. 

5. Returning to Bed: 

• Slowly and gently return the resident to bed. 

• Lower the head of the bed to a comfortable position. 

• Place the call bell within reach. 

6. Post-Procedure: 

• Document the procedure, including the resident’s response, in their medical record. 

• Note any observations related to the resident’s pulse, blood pressure, and any signs of dizziness or weakness. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Ensure that all procedures are documented accurately in the resident’s care plan. 

• Regularly review and update techniques for assisting residents to dangle according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on the correct procedures for assisting residents to dangle to ensure resident safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.