How do you get an elderly person out of bed? A caregiver's guide to safe transfers

According to the CDC, over 36 million falls are reported among older adults each year, and many of these occur during transfers. Knowing how to get an elderly person out of bed safely is crucial for preventing injuries to both the senior and the caregiver. This guide provides step-by-step instructions and important safety precautions to make the process as smooth and secure as possible.

Quick Summary

This resource provides comprehensive instructions on how to safely assist an elderly individual out of bed, covering preparation, proper body mechanics, and using assistive devices. Learn essential techniques like the pivot transfer to minimize injury risk and enhance confidence for both caregiver and senior.

Key Points

• Assessment is the first step: Always evaluate the senior's mobility and weight-bearing ability before a transfer to choose the safest method.

• Use proper body mechanics: Protect your back by bending your knees, keeping your back straight, and lifting with your legs, not your back.

• Incorporate assistive devices: Tools like a gait belt, transfer board, or mechanical lift are crucial for safe transfers and reducing caregiver strain.

• Prepare the environment: Clear clutter, lock wheels, and ensure good lighting to create a safe path for the transfer.

• Communicate clearly and effectively: Explain each step to the senior and provide cues to coordinate movements, making them feel secure and involved.

• Allow rest after sitting up: Always let the elderly person sit on the edge of the bed for a moment before standing to prevent dizziness and falls.

• Consider the 'strong' side: When possible, position yourself and the destination on the senior's stronger side for better leverage and stability.

• Never lift beyond your capacity: If the senior is too heavy or unable to assist, use a mechanical lift or ask for a second person to help.

Essential preparation for a safe transfer

Before attempting any transfer, thorough preparation is key to ensuring safety and reducing strain. A little time spent on preparation can prevent accidents and make the process much smoother for everyone involved.

Assess the senior’s mobility

Understanding the senior's abilities is the first step. Can they bear weight on their legs? Can they follow simple instructions? Are they stronger on one side? Knowing these factors helps you determine the right level of assistance required. If the person is non-weight-bearing, a mechanical lift is the safest option.

Prepare the environment

Next, optimize the transfer space. Clear any clutter, loose rugs, or electrical cords from the path between the bed and the destination chair. Lock the wheels on the bed and any mobility aids, like a wheelchair, to prevent shifting during the transfer. Ensure adequate lighting in the room to prevent trips.

Gather necessary equipment

Gather any assistive devices that will be used, such as a gait belt, transfer board, or wheelchair. A gait belt, or transfer belt, is a simple but effective tool worn by the senior to give the caregiver a secure place to grip. Using a gait belt prevents grabbing the senior's clothing or arms, which can cause injury.

Communicate clearly

Throughout the process, explain each step clearly and concisely to the elderly person. This helps them feel more secure and encourages their participation. For instance, say "On the count of three, we'll stand up," to coordinate your movements.

The sit-to-stand pivot transfer technique

For an elderly person who can bear some weight, the sit-to-stand pivot transfer is a common and effective method. It requires using proper body mechanics to protect both the caregiver and the senior from injury.

Here are the steps for a standing pivot transfer:

1. Assist to a seated position: Help the senior roll onto their side, facing the direction of the transfer. Place one hand under their shoulders and the other behind their knees. As you swing their legs off the side of the bed, help them push up with their arms to a seated position on the edge of the bed.
2. Allow for balance adjustment: Let the senior sit for a moment to regain their balance and prevent dizziness from changing positions too quickly.
3. Position for transfer: Ensure the senior's feet are flat on the floor and slightly apart, and that they are wearing sturdy, non-slip footwear. A gait belt should be fitted securely around their waist.
4. Caregiver's stance: Stand directly in front of the senior, with your feet shoulder-width apart and knees bent. Place your feet outside theirs for a solid base of support. Keep your back straight, tightening your core muscles.
5. Engage the transfer: Ask the senior to place their hands on the bed's edge or on your shoulders (not around your neck). Grip the gait belt firmly on both sides. On the count of three, use your legs to push up into a standing position, pivoting your feet towards the wheelchair.
6. Lower into the chair: When the senior's back touches the chair, guide them to sit down slowly by bending your knees. Ensure they are seated securely before releasing the gait belt and repositioning their limbs.

Transferring with additional assistance or devices

For individuals with very limited mobility, or when extra support is needed, mechanical lifts and other aids are essential for safety.

Using a mechanical lift (Hoyer lift)

A mechanical lift is the safest option for transferring a senior who cannot bear any weight. The process involves placing a sling under the person while they are in bed, attaching it to the lift, and using the lift's mechanism to hoist and move them.

Utilizing a transfer board

A transfer board is used to create a bridge between two surfaces, like a bed and a wheelchair. The senior must be able to sit up and slide their buttocks across the board with assistance. This method requires proper technique to avoid skin shearing and caregiver strain.

The two-person transfer

If the senior is too heavy for one caregiver, or if they require more stability, a two-person transfer is necessary. Caregivers should coordinate their movements, with one at the senior's upper body and the other at their lower body, to perform a controlled lift. This reduces the risk of injury for both the senior and the caregivers.

Comparison of transfer techniques

Technique	Mobility Level Required	Caregiver Effort	Equipment Needed	Primary Benefit
Standing Pivot Transfer	Can bear some weight, can follow instructions.	Moderate	Gait belt, non-slip shoes.	Promotes independence, builds confidence.
Mechanical Lift	Very limited or no mobility.	Minimal	Mechanical lift (Hoyer), sling.	High safety for non-weight-bearing seniors, minimal caregiver strain.
Transfer Board	Can sit up, can assist with sliding.	Moderate	Transfer board, gait belt.	Efficient for sliding between surfaces, reduces lifting.
Two-Person Transfer	Requires significant assistance, heavy individual.	Significant	Gait belt (optional).	Ensures stability and safety for heavier seniors.

Conclusion

Knowing how to get an elderly person out of bed safely is an essential skill for any caregiver. By properly assessing their mobility, preparing the environment, and utilizing the right techniques and equipment, you can perform transfers with confidence and minimize the risk of falls and injuries. The sit-to-stand pivot, mechanical lifts, and transfer boards each offer tailored solutions depending on the individual's needs. Clear communication and a focus on proper body mechanics are paramount to protecting both the senior and yourself throughout the process. For those providing home care, consulting with a physical therapist or healthcare professional can provide specific training to ensure the safest practices are followed.

Authoritative resource

• Source: MedlinePlus.gov
• URL: https://medlineplus.gov/ency/patientinstructions/000428.htm

Frequently Asked Questions

What is the safest way to get a heavy elderly person out of bed?

The safest way to move a heavy elderly person, especially if they cannot assist, is by using a mechanical lift, such as a Hoyer lift, which uses a sling to securely transfer them with minimal physical strain on the caregiver.

How do you use a gait belt to help an elderly person stand up?

To use a gait belt, wrap it snugly around the person's waist, over their clothes. The caregiver then holds the belt, bends their knees, and uses their legs to assist the person into a standing position, pivoting towards the destination.

What should I do if an elderly person gets dizzy while sitting up?

If an elderly person gets dizzy while sitting up, have them sit on the edge of the bed for a few minutes. Make sure their feet are flat on the floor and provide support until the dizziness passes before proceeding with the transfer.

What equipment is available to help get a senior out of bed?

Key assistive devices include gait belts, transfer boards, mechanical lifts (Hoyer lifts), and hospital beds with adjustable heights and built-in rails. The right equipment depends on the senior's specific mobility needs.

How do you transfer a senior with limited mobility from bed to a wheelchair?

To transfer from bed to a wheelchair, position the wheelchair at a 45-degree angle to the bed, lock the brakes, and ensure the senior's feet are flat on the floor. Use a gait belt and proper pivot technique, lifting with your legs as the senior helps push up.

How can I prevent back injury as a caregiver?

To prevent back injury, always lift with your legs, keep your back straight, and avoid twisting at the waist. Keep the person you are moving close to your body and use proper assistive devices like a gait belt to maintain control.

Is it safe for a senior to put their arms around my neck during a transfer?

No, it is not safe. The senior should be instructed to hold onto a gait belt or place their hands on your shoulders. Allowing them to wrap their arms around your neck can cause serious injury to you during the lift.