As you walk into Mr. Henderson’s room to help him with breakfast, you notice his stroke-affected hand is resting comfortably on a pillow, cupped around a soft foam cylinder. That isn’t just a pillow; it’s a hand roll, a simple but vital tool keeping his hand functional and safe from injury.
What is a Hand Roll?
A hand roll is a cylindrical positioning device usually made of foam, gel, or rolled towels. Its job is to maintain the hand in a slight, natural curve—known as the functional position—with the fingers slightly flexed and the thumb positioned opposite the fingers. Think of it as a brace that holds the hand in a relaxed “C” shape rather than letting it flatten out or curl into a tight fist.
Why Hand Roll Matters in Your Daily Care
Without proper support, a paralyzed or immobile hand can quickly develop contractures—permanent tightening of the muscles and tendons that makes the hand claw-like and unusable. A hand roll prevents this, keeps the palm open for hygiene (so you can clean it properly), and reduces the risk of pressure sores. Using it correctly preserves the resident’s dignity and comfort, ensuring their hand doesn’t become a source of pain or infection.
What You’ll See During Your Shift
You will use hand rolls frequently for residents who have had a stroke, are recovering from surgery, or have limited mobility. You’ll place them in the palm during bed baths, repositioning, or when the resident is sitting up. You might notice a resident’s fingers looking stiff or swollen if the roll has been removed or forgotten.
“Nurse Jamie, I was repositioning Mr. Henderson and noticed his fingers looked really tight when I took the hand roll out for his bath. His skin looks good, but he has a hard time straightening them. I put the roll back in to support his wrist, but I wanted you to see the stiffness.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Leaving the hand roll out for “just a minute” while you gather supplies, or letting it fall onto the floor. In that short time, the fingers can hyperextend backward or the wrist can drop, leading to pain and stiffness that is hard to reverse.
Pro Tip: Always keep a spare hand roll or washcloth nearby if you need to remove the device for care. When placing it, ensure the thumb is opposing the fingers (like holding a ball) rather than tucked inside the fist. Check the skin under the roll every shift for redness or pressure marks.
Memory Aid for Hand Roll
Think “C is for Care”: The hand roll forms a Curve.
Or: “No Flat Hands”: If the hand is lying flat on the mattress, it needs a roll. A flat hand leads to a tight claw; a curved hand stays loose.
State Test Connection
You will likely see this on the clinical skills exam under “Positioning a Resident in Side-Lying” or “Providing Passive Range of Motion.” Examiners look for proper placement to ensure safety and comfort.
Related Care Concepts
Using a hand roll directly prevents contractures and muscle atrophy. It connects closely to Range of Motion (ROM) exercises, as the roll maintains the gains made during exercise. It also relates to peripheral edema management, as proper elevation of the hand on the roll helps reduce swelling.
Quick Reference
✓ Key steps: Place roll in palm, maintain slight wrist extension, keep thumb opposite fingers ✓ When to report: Fingers becoming stiff, redness under the device, swelling, or pain ✓ Care reminders: • Never leave the hand flat on the bed surface • Remove briefly to check skin integrity during baths • Do not wrap tape too tightly around the device • Ensure the roll isn’t too hard (causing pressure) or too soft (offering no support)
Keeping a resident’s hand in that natural, relaxed curve is one of the best ways to protect their mobility and comfort long-term.