You’re helping Mr. Henderson get dressed after a stroke, and you notice he cannot move his left arm or leg at all, while his right side is strong. This condition is called hemiplegia, and understanding how to protect and care for residents with this diagnosis is a fundamental skill for your daily rounds.
What is Hemiplegia?
Hemiplegia (hem-ee-PLEE-jah) is total paralysis on one side of the body—either the right side or the left side. It is distinct from hemiparesis, which refers to weakness rather than complete paralysis. This condition is most often caused by a stroke (CVA) or brain injury. It affects the arm, leg, and often the face on the same side, meaning the resident cannot voluntarily move those muscles.
Why Hemiplegia Matters in Your Daily Care
Residents with hemiplegia rely entirely on you for safety because they lack balance and stability on the affected side. They are at high risk for falls and injuries, including shoulder subluxation (partial dislocation) if the paralyzed arm is pulled or handled roughly. Furthermore, many residents experience “neglect,” where they ignore or forget the affected side exists. Your care prevents contractures (stiff joints), maintains dignity, and ensures the paralyzed side is treated with the same respect as the strong side.
What You’ll See During Your Shift
You will encounter residents who cannot use one arm or leg during transfers, dressing, and bathing. The paralyzed limb may feel limp or “floppy” (flaccid) or stiff (spastic). You might notice the resident leaning to their strong side or sitting unevenly in a wheelchair.
“Nurse, I was transferring Mrs. Alvarez from the bed to the wheelchair. Since she has right-sided hemiplegia, I made sure to put her right foot flat on the floor first and protected her right arm across her chest. She felt stable, but I wanted to report her right hand looks a little swollen today.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Pulling on a resident’s paralyzed arm or shoulder to help them move or sit up. This can cause severe pain or dislocation because the muscles are not active to hold the shoulder joint in place.
Pro Tip: Always treat the affected arm like it is precious glass. When dressing or transferring, tuck the paralyzed arm safely into the resident’s shirt or across their chest to support it before you move them.
Memory Aid for Hemiplegia
Think “Hemi = Half.” It affects half of the body.
For dressing, remember the mantra: “Affected First.” When dressing, put the clothes on the weak arm/leg first so you don’t have to reach underneath. When undressing, take the clothes off the strong side first.
State Test Connection
Expect questions on dressing skills and transfers regarding one-sided weakness or paralysis. You will likely be tested on the correct order of dressing a resident with hemiplegia and how to protect the affected side during ambulation.
Related Care Concepts
Hemiplegia is closely linked to CVA (Stroke) recovery, hemiparesis (one-sided weakness), and contracture prevention (the need for Range of Motion exercises). It also relates to neglect (unawareness of the affected side) and body mechanics to protect your back while assisting residents who cannot bear weight equally.
Quick Reference
✓ Key signs: Paralysis on one side of the body (arm, leg, face) ✓ When to report: Sudden onset of weakness (new stroke), redness/swelling on paralyzed side, signs of shoulder pain ✓ Care reminders: • Always use proper body mechanics; the resident cannot help you • Support the paralyzed shoulder during transfers • Use “Affected First” rule for dressing • Perform Range of Motion exercises as ordered • Place the affected limb in a functional position when the resident is in bed or sitting
Bottom line: Residents with hemiplegia depend on your vigilance to keep their weak side safe. By handling that limb with care and using proper techniques, you prevent pain and help them live with dignity.