There are many reasons why a person needs to use a wheelchair ranging from a recent orthopedic injury to having difficulty in walking for a long period of time. For some, using a wheelchair can be managed on their own, while for others assistance is required. It is important to know the right way to support the user with their mobility and safety as moving in and out of a wheelchair requires strength and coordination.
A wheelchair user would need to transfer in and out of the wheelchair for various reasons such as while waking up in the morning, to go to the bathroom, dressing up, to go to the car or to perform several other activities of daily living. The goal of a successful wheelchair transfer is for the user to move himself/herself independently as physically possible as well as to prevent any falls or injury to the wheelchair user and to the caregiver supporting the transfer.
It is always best to know the wheelchair user’s needs and understand the wheelchair you will be dealing with. Consult with a physician before attempting a wheelchair transfer. The following basics typically apply:
- Determining the wheelchair user’s needs: Start by asking them about their preferred transfer method, their ability to help and always check for any medical condition that you need to be aware of.
- Preparing and positioning: Prepare where the patient will be transferring from and to. If you are moving the person from a medical bed, ensure that the head of the bed is raised and the bed is lowered appropriately. Position the wheelchair parallel to the transfer point. Always park the wheelchair as close as possible to the place to which the user will be moved to. Make sure to lock the wheels and move the arm and foot rests before any transfer.
- Use a belt: A transfer belt, called Gait belt, is securely tied around the person’s waist and is used to help those who need help getting up from a seated position. It gives the caregiver something to hold on to instead of the wheelchair user’s clothing which can slip and create an unsafe transfer.
- The weak side: The caregiver should assess the weak side of the user to know the side that he/she is more likely to lean or fall over. Based on that, the caregiver can position their knees in between the user’s legs with ready support, just in case.
- Getting out of bed: Have the person roll on his/her side and use their upper body to push to an upright position as his/her legs slide over the side of the bed and then help stand and pivot. Using transfer devices such as trapeze bars, mechanical patient transfer hoists and slings can provide smooth transfer from any area to a wheelchair and back.
- Getting out of a chair: Bring the user to lean towards the front of the chair. With their arms positioned on the armrest and feet leveled with the ground, the user should push themselves upwards with the assistance of the caregiver. The caregiver must stand as close as possible, with stable footing, slowly move the user onto the desired transfer point. Proper shoes are recommended as they provide safer support to avoid any slips.
- Navigating the stairs: When helping someone climb up stairs, it’s best to walk next to or behind the user as it is easier to position him/her forward, if they try to fall. While descending, it is better to stand in front of him/her to keep balance. Extra care and precaution should be taken while moving an occupied wheelchair up and down the stairs. Installing a stair lift which can be fitted for either straight or curved stairs is the safest way for the person to move along the stairs.
- Transfers to/from the toilet: Bathroom surfaces are slippery, so when attempting a transfer, the caregiver should be extra careful. For Wheelchair Transfers to the toilet, it is recommended to have bathroom safety devices such as grab bars and raised toilet seats with arms as this gives the user extra safety as they have something to hold on to.
- Keep communicating: Ask the person you are transferring if they are comfortable and explain how you plan to do the transfer before you start. Reduce their anxiety by announcing each step of the transfer before it takes place.
- Preventing Pressure Ulcers: Check the various pressure points on the body for pressures sores that develop as a result of long contact of the user’s skin with the wheelchair. Call for immediate attention if you notice any.
- In case of a fall: Bend your knees and lower the person slowly to the nearest surface and never try to pull up the person by their clothing. Call for help immediately.
- Caring for the caregiver: It is easy for the caregiver to hurt themselves especially their back. So it is important to remember to protect the back by bending the knees instead of from the waist, keeping the back straight. Ask the wheelchair user to use the wheelchair arms or toilet seat arms for support wherever possible. Transfer aids such as the gait belt, sliding board, mechanical lifts, vehicle lifts and seat turny can help make transfers safer and easier for you and the person that you are moving.
People with limited mobility still need to retain their independence and should be able to move to places as they like. However, physically lifting and assisting someone can be exhausting and unsafe. Therefore, transfer devices should be installed for greatly safety, timeliness and increased independence.
Remember to always seek professional help from a trained professional regarding the wheelchair transfer process.