Startle reactions are quick and powerful causes of caregiver injuries that usually occur when the caregiver does not wait. Waiting is required to allow the person time to process the information that there is going to be a change in the position of their body. If the person does not have time to expect a change in position, the fear is for their physical safety. The fear is instant, and the reaction is swift. To prevent the fear, waiting after a command or a gesture as well as pauses during transfers are required. The time required to wait and pause is determined by the person's response time, which is usually as long as 20 seconds.
Most startle reactions are triggered by someone moving a part of their body. Being told and not waiting is the same as not being told at all. The person is still in their brain, and that person needs time to process the information.