Wheel Chair Transfers

WHAT YOU SHOULD KNOW:

A wheelchair transfer means moving a person in to or out of a wheelchair. You may help a person move from their wheelchair to a bed, shower chair, commode (toilet) or into another chair. You may also help them move back into their wheelchair. You may be able to help a person transfer by yourself, or with another person helping you. You may use transfer aids such as a gait belt, a sliding board, or a mechanical lift to help move a person. These transfer aids can help make transfers safer and easier for you and the person that you are moving.

AFTER YOU LEAVE:

Preparing a person for a wheelchair transfer:

  • Talk to the person about what will happen during the transfer. Speak slowly and clearly. Tell him what will happen at each step before you do it. Tell him that you must work together with him during the transfer.

  • Learn about the person's condition, and if he is able to move, talk, and follow commands. Check for catheters, tubes, drainage bags and other items that might need to transfer with the person. Ask the person if he likes being transferred one way more than another way.

  • Make sure that you and the person to be transferred are wearing shoes that will not slip on the floor.

  • Make sure that the wheelchair and the transfer aids that you will be using are working right and not broken. Check material, stitching, straps, chains, and hooks. If the transfer aids look weak or broken, do not use them. Check the brakes on the wheelchair and on the bed to be sure they lock as they should. Make sure you have enough space to make a safe transfer.

Avoiding injury while transferring a person in and out of a wheelchair:

  • Ask for help: Ask someone to help you do the transfer. The person may be heavy, or the place that you are transferring the person to may be too far away. A person may begin to fall while you are moving him. If you have another person with you, they can help you.

  • Transfer the person correctly:

    • Bend your knees while transferring. Move from your hips. Do not move people using your back.

    • Do not leave your feet in place and twist your body at the waist during a transfer.

    • Keep your arms in close to your body rather than stretching them out during a transfer. Place your feet as wide apart as your hips.

    • Keep your back curved rather than holding it straight. Do not bend your head forward during a transfer.

    • Never let the person you are moving hold or hug you around your neck while you are moving them.

    • Stand very close to the person while transferring them.

    • Use your body's momentum (force gained by moving) to move the person.

  • Train for the transfer:

    • Do stretching exercises before and after moving a person. This may prevent back strain or injury.

    • Learn how to correctly transfer a person in and out of a wheelchair.

    • Practice transfers with others who may be helping you.

Making transfers safe:

People who are being transferred may get dizzy and faint. Have the person slowly sit up from lying down. Slowly move people from place to place to help avoid this. To help avoid slipping and falling on the floor, wear non-slip footwear, such as running shoes. Be sure the person that you are moving is also wearing non-slip footwear. Holding on to a person the wrong way can hurt their shoulders and other body areas. Hold on to people correctly as you move them. People can get skin bruises and their skin can tear as you are moving them. Transfer people carefully, watching that they do not bump into anything, or tear their skin as you move them.

Avoiding injury to another person while transferring him in and out of a wheelchair:

  • Learn which transfer aid is best for the person that you are moving, and learn how to use it correctly. Never leave a person alone while he is in a mechanical lift.

  • Park the wheelchair as close as possible to the area where you will be transferring the person to or from. Park the wheelchair so that the person's stronger side of their body is the side that the transfer will be done on.

  • Lock the wheels of the wheelchair to keep it from moving before doing every transfer. Lock the wheels on the bed before every transfer from or to the bed. When moving a person from a bed to a wheelchair raise the head of the bed as much as possible before moving the person out of the bed. Put the bed in the lowest position, so that it is as close to the floor as possible.

  • Talk to the person who will be helping you with the transfer. Decide how to do the transfer, and talk about the transfer as you are doing it. Move together smoothly as you do the transfer. Ask the person that you are moving to help you do the transfer as much as they can. Explain each step before it happens.

  • Before every transfer from or to a wheelchair, raise or remove the footrests. Have the persons feet set in the correct position, flat on the floor. Remove the armrest that is closest to the side that you are moving the person to, or moving him from. Be sure the patient will not fall out of the chair after you remove the footrests and arm rest, and before you do the transfer.

  • Always put the footrests and armrest back on the wheelchair in the correct position after you have transferred a patient into the wheelchair. If the person cannot move an arm or leg, move it into the correct position for them after a transfer.

  • If the person you are moving begins to fall during a transfer, bend your knees and lower him slowly to the nearest safe surface, or to the floor. Call for help. Never grab or hold on to a persons clothing while moving them.

Transferring a person using a gait belt:

A gait or transfer belt is a device that is placed around the person's waist or lower body. It may be used to help move a person to and from a wheelchair. It is used for persons who can stand, but need help getting up from a chair or bed to the standing position.

  • Supplies:

    • Gait or transfer belt.

    • Wheelchair.

  • Moving a person from a chair or bed into a wheelchair:

    • Prepare the wheelchair and the person for the transfer.

    • Fasten the gait belt securely around the person's waist. Ask the person to hold on to you if they can. Bend forward at the waist and bend your knees. Grab the belt or its handles around the back of the person.

    • Rock gently back and forth about three times with the person. On the third time, help the person up to a standing position.

    • Turn with small steps until the person's back is in front of the wheelchair. Ask the person to help by reaching for the wheelchair behind him. This may make it easier for the person to sit down in the wheelchair.

    • Bend forward while bending your knees, and lower the person so that he is sitting in the wheelchair.

    • Check that the wheelchair is safe, and the person is comfortable.

  • To move a person out of his wheelchair using a gait belt, follow the same steps as when you moved him into the wheelchair.

Transferring a person using a mechanical lift:

A mechanical lift is equipment that is used to move a person. The lift has slings and straps, and can be electric or hand-powered. The lift can be attached to the floor, wall, or ceiling, or you may be able to move it from place to place where it is needed. A lift can be used for people who cannot stand up by themselves. A lift can be used for a person who is heavy and cannot be lifted easily. It may also be used for a person who cannot think clearly and are unable to help with the move. A lift is used to move a person over short distance, such as from a bed to a wheelchair.

  • Moving a person into a wheelchair:

    • Roll the person onto their side. Slide the sling underneath him. Roll the person onto the other side and spread the sling evenly under him.

    • If the person is lying down, raise the head of the bed so he will be sitting up.

    • Correctly attach the sling's hooks, straps, or chains to the lift. Lift the person by pumping or plugging in the lift. Ask the person to keep still while he is being lifted up.

    • Move the lift until the person is over the wheelchair. Slowly lower him into it. Move the person into a position so that he is comfortable.

    • Unhook the sling from the lift. You may leave the sling under the person in case you need to transfer him again.

  • Moving a person out of a wheelchair:

    • Lift one side of the person's body up slightly, or tilt him to one side. Slide the sling underneath his buttocks.

    • Lift or tilt the person to the other side, and spread the sling evenly under him.

    • Attach the sling to the mechanical lift. Raise the person by pumping the lift manually or by turning the lift on. Ask the person to stay still during the lift.

    • Move the lift until the person is over the bed, or the place where he is being transferred to. Slowly lower him down until he is seated. Move the person into a position so that he is comfortable.

    • Unhook the sling from the lift. Leave the sling under the person if you will need to transfer him again.

Transferring a person using a sliding board:

A sliding board is flat surface that can be used as a bridge between two areas. It is used when the person can move, but is too weak to transfer himself. It may also be used if the person is heavy. A sliding board may be used with a gait belt.

  • Supplies:

    • Gait belt.

    • Sliding board.

    • Wheelchair.

  • Moving a person into a wheelchair:

    • Place the gait belt around the person's hips and buttocks, then place one end of the sliding board under his buttocks. The sliding board should form a bridge between the place he is transferring from (such as the bed), and the wheelchair.

    • Put one of your knees between the person's knees. Hold the gait belt or its handles. Slowly slide the patient across the board to the wheelchair. Ask the person to help by pushing his palms on the board and moving towards the wheelchair.

    • Remove the board once the person is seated in the wheelchair.

  • To move a person out of his wheelchair using a sliding board, follow the same steps as when you moved him into the wheelchair.

Transferring a person using a sitting transfer:

You may use a sitting transfer if the person that you are moving cannot use his legs. This can also be used for people who cannot lift their body weight up using their arms.

  • Supplies:

    • Gait belt.

    • Wheelchair.

  • Moving a person into a wheelchair:

    • Place the gait or transfer belt around the person's hips and buttocks.

    • Slowly move the person to the edge of the bed or chair that he is transferring from. Ask the person to lean forward.

    • Hold the belt or its handles, then bend from your hips and knees. Holding the person close to your body, lift him up, and then lower him into the wheelchair. Move the person's arms and legs so that they are comfortable.

  • To move a person out of his wheelchair using a sitting transfer, follow the same steps as when you moved him into the wheelchair.

Transferring a person using a pivot transfer:

This transfer is also called the assisted standing transfer. This transfer may be used for people who are weak on one side of their body, such as a person who has had a stroke.

  • Supplies:

    • Gait belt.

    • Wheelchair.

  • Moving a person into a wheelchair:

    • Place the wheelchair at an angle on the person's strong side. Lock the brakes of the wheelchair. Raise or remove the footrests, and remove the armrest closer to him.

    • Put the transfer belt around the person's waist. Ask the person to put his arms on your hips or at his side. Put one of your knees between the person's knees.

    • Grip the belt or its handles. Bend your knees and rock using forward and backward motions. Ask the person to help by pushing up with his strong arm or leg.

    • Take small steps and turn both your body and the other person's body together. Have the person that you are moving take small steps with you. Step together until the person's back is in front of the wheelchair. If possible, ask the person to reach back for the armrest on the wheelchair behind him. This may bring the wheelchair closer and may make it easier for the person to sit down.

    • Bend forward to lower the person onto the wheelchair.

    • Put the wheelchair's footrests and armrest back to their place.

  • To move a person out of his wheelchair using the pivot transfer, follow the same steps as when you moved him into the wheelchair.

Transferring a person using a scoot transfer:

  • Supplies:

    • Gait belt.

    • Wheelchair.

  • Moving a person into a wheelchair:

    • Place the wheelchair at an angle on the person's strong side. Lock the brakes of the wheelchair. Raise or remove the footrests, and remove the armrest closer to him.

    • Put the transfer belt around the person's waist. Ask the person to put his arms on your hips or at his side. Put one of your knees between the person's knees. Keep your shoulders and chest up, instead of leaning forward.

    • Ask the person to lean forward and put some of his weight on you. Lean back slightly. Grip the belt or its handles. Bend your knees and rock forward and backward. Lift the person slightly up and move him each time. Rock 2 to 4 more times, until you have moved (scooted) the person to the wheelchair.

  • To move a person out of his wheelchair using the scoot transfer, follow the same steps as when you moved him into the wheelchair.

Transferring a person using a two-person transfer:

This transfer is done with another person helping you. If possible, choose someone who is near the same size and height as you to help. This transfer may be used if the person you are moving is heavy.

  • Supplies:

    • Gait belt.

    • Wheelchair.

  • Moving a person into a wheelchair:

    • Put the transfer belt around the person's waist. Have the person cross his arms across his chest if possible.

    • Stand behind the person with your arms placed under the person's arms. Hold both of his wrists. Have your helper put his arms under the thighs of the person.

    • At the count of three, gently lift the person up, working together as a team.

    • Working together, carefully lower the person into the wheelchair.

  • To move a person out of his wheelchair using the two-person transfer, follow the same steps as when you moved him into the wheelchair.

CONTACT A CAREGIVER IF:

  • The skin on the person that you are moving has torn.

  • The shoulder, arm, or another body area on the person that you are moving looks out of place or different after you have moved him.

  • The person that you have moved complains of new pain after you have moved him.

  • You see one or more new sores on the skin of the person that you are moving.

SEEK CARE IMMEDIATELY IF:

  • The person that you are moving has fainted and cannot be woken up.

  • The person that you are moving has fallen down and looks like he is hurt.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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