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Wheelchair Transfers After Spinal Cord Injury

WHAT YOU SHOULD KNOW:

Wheelchair Transfers After Spinal Cord Injury (Discharge Care) Care Guide

After a spinal cord injury (SCI), you may need a wheelchair to move from place to place. Caregivers will teach you how to transfer (move) to and from your wheelchair. These transfers may be used when moving to and from your bed, the commode (toilet), the bathtub, or anywhere that you would like to sit. Whether you can transfer without help depends on where on your spinal cord the injury happened. Caregivers will work with you to build up your upper body strength. Then they will see if you have the strength and balance to do transfers without help.

AFTER YOU LEAVE:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

How do I move from my bed or commode to my wheelchair without help?

  • Position yourself at the edge of the bed or commode in a sitting position. Keep your feet flat on the floor.

  • Place your wheelchair as close to your bed as possible. Lock the wheels. Remove the arm and leg rest that are closest to the bed.

  • Put one edge of the transfer board under your buttock (hip) and the other edge on the wheelchair seat. The transfer board will bridge the gap between the other surface and the wheelchair.

  • Put your hands on the bed or commode seat, tighten your elbows, and push yourself up off the surface. Move yourself over the board in sections until you are completely on the wheelchair. Do not drag yourself across the board. Doing this can tear or scratch your skin.

  • Remove the transfer board and position yourself in the middle of your chair.

  • Replace the arm and leg rest.

How do I move from my bed or commode to my wheelchair if I cannot do it myself?

There are several ways to transfer to your wheelchair from your bed or commode if you need help.

  • Using a transfer board:

    • Have your assistant help you sit up on the edge of your bed or the commode seat. Make sure your feet are flat on the floor.

    • Have the assistant place your wheelchair as close to your bed or commode as possible. Lock the wheels. Have your assistant remove the arm and leg rests that are closest to the bed or commode.

    • The assistant then places one edge of the transfer board under your buttock (hip). They will place the other edge on the wheelchair seat. The board will bridge the gap between your bed and the wheelchair.

    • The assistant stands in front of you with his knees pressing against your knees to keep them stable. The assistant also stabilizes your shoulders to keep you from falling.

    • Put your arms around the assistant's shoulders. You may also cross your arms over your chest or put your hands in your lap.

    • The assistant holds you under your buttocks as you lean forward toward him.

    • The assistant will lift your buttocks off the bed, and pivot toward your chair. He may set you down on the transfer board half way through the turn, if needed. He should make sure not to drag you across. Doing this can tear or scratch your skin.

    • The assistant then removes the transfer board. The assistant should make sure that you are positioned in the middle of the chair.

    • The assistant will replace the arm and leg rest.

  • Using the stand-pivot-sit method: This method can only be used if your assistant is strong enough to help you stand and turn. It also can only be used when it is OK with caregivers for you to put weight on your legs. Make sure you wear non-skid shoes when using this type of transfer.

    • Have your assistant help you sit on the edge of your bed or commode seat. Make sure your feet are flat on the floor.

    • Have the assistant place your wheelchair as close to your bed or commode as possible. Lock the wheels. Your assistant will remove the arm and leg rests that are closest to the bed or commode.

    • The assistant then places one edge of the transfer board under your buttock (hip). The assistant places the other edge on the wheelchair seat. The transfer board will bridge the gap between your bed and the wheelchair.

    • The assistant stands in front of you with his knees pressing against your knees to keep them stable. The assistant also stabilizes your shoulders to keep you from falling.

    • Put your arms around the assistant's shoulders. You may also cross your arms across your chest, or put your hands in your lap.

    • The assistant holds you under your buttocks or around your waist as you lean forward toward him.

    • The assistant will move and lift you to a standing position. At the same time, the assistant presses his knees firmly against yours to lock your knees in the straight position.

    • The assistant will pivot you toward your chair.

    • The assistant will then remove the transfer board. He makes sure that you are positioned in the middle of the chair.

    • The assistant will replace the arm and leg rests.

How do I transfer from my wheelchair to the commode in the front-on position?

  • Remove the leg rests and move the wheelchair close to the front of the commode.

  • Put your feet flat on the ground in front of you. Lock the wheelchair.

  • Move to the edge of your wheelchair. Slide your pants and underwear down to your ankles. Remove the clothes from one ankle so that you can spread your legs apart.

  • Put your feet flat on the floor next to the sides of the commode. Spread your knees and ankles wider than the commode.

  • Grab the safety bars next to and behind the commode. Facing the wall behind the toilet, lift yourself up.

  • Holding and using the safety bars, turn and lower yourself onto the commode.

  • After you have finished and transferred back to your wheelchair, replace the arm and leg rests.

Safety tips for getting into and out of a bathtub:

  • Use a bathtub seat that fits well across the bathtub.

  • Always transfer into a dry bathtub to keep from slipping.

  • Make sure the non-skid mats on the bathtub floor are not too rough for your skin.

  • Put your towel close to the bathtub so that you can reach it easily.

  • You may want to put a towel onto the floor of the bathtub for safety.

  • Empty the water before you transfer out of the bathtub.

  • Dry off while you are waiting for the water to drain out of the bathtub.

  • Dry your feet last to make sure you do not slip when transferring back to your chair.

  • Put bath powder or a dry towel under you and on the transfer board to keep from sticking while transferring out of the bathtub.

How do I get into and out of a bathtub without help?

  • Remove the arm and leg rest that are closest to the bathtub. Keep your feet flat on the floor.

  • Place your wheelchair as close to the bathtub as possible, facing it rather than beside it.

  • Lift your legs into the bathtub. Then move the wheelchair up against the bathtub.

  • Lock the wheels. Move to the edge of your wheelchair.

  • Put one edge of the transfer board under your upper legs and buttocks and the other edge on the bathtub. The transfer board will bridge the gap between the bathtub and the wheelchair.

  • Put your hands on the edges of the wheelchair seat and tighten your elbows. Push yourself up off the wheelchair seat and onto the transfer board. Scoot over the board in sections until you are completely on the edge of the bathtub. Do not drag yourself across the board. Doing this can tear or scratch your skin.

  • Pivot onto the bathtub seat.

  • To get out of the bathtub, follow the same steps.

How do I get in and out of the bathtub if I cannot do it myself?

  • Have your assistant help you sit up on the edge of your wheelchair. Make sure your feet are flat on the floor.

  • Have the assistant place your wheelchair as close to the bathtub as possible. Lock the wheels. The assistant will remove the arm and leg rest that are closest to the bathtub.

  • The assistant then places one edge of the transfer board under your buttock (hip). He places the other edge on the edge of the bathtub. This way it bridges the gap between your bed and the wheelchair.

  • The assistant stands in front of you with his knees pressing against your knees to keep them stable. The assistant also stabilizes your shoulders to keep you from falling.

  • Put your arms around the assistant's shoulders. You may also cross your arms over your chest or put your hands in your lap.

  • The assistant holds you under your buttocks or around your waist as you lean forward toward him.

  • The assistant will move you to a standing position. At the same time, the assistant presses his knees firmly against yours to lock your knees in the straight position.

  • The assistant pivots you onto the bathtub seat.

  • The assistant helps stabilize you while he lifts your legs over the side of the bathtub.

  • He then removes the transfer board. He makes sure that you are positioned in the middle of the bathtub seat.

  • To get out of the bathtub, follow the same steps.

Where can I go for support?

  • Having a spinal cord injury is life changing for you and your family. Accepting that you have a spinal cord injury is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with a spinal cord injury.

  • You may want to join a support group. This is a group of people who also have spinal cord injuries. Ask your caregiver for the names and numbers of support groups in your town. You can contact one of the following national organizations for more information.
    • Paralyzed Veterans of America
      801 Eighteenth Street NW
      Washington, DC , 20006
      Phone: 1- 800 - 424-8200
      Web Address: www.pva.org
    • National Spinal Cord Injury Association
      1 Church Street, Suite 600
      Rockville , MD 20850
      Phone: 1- 800 - 962-9629
      Web Address: www.spinalcord.org
    • American Spinal Cord Association
      2020 Peachtree Road, NW
      Atlanta, Georgia , 30309-1402
      Phone: 1- 404 - 355-9772
      Web Address: www.asia-spinalinjury.org

CONTACT A CAREGIVER IF:

  • You feel you cannot make transfers by yourself and need help.

  • You do not understand how to do a transfer.

  • Your skin has been scratched or torn during a transfer.

© 2013 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.

Learn more about Wheelchair Transfers After Spinal Cord Injury (Discharge Care)

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