How should people get up out of a chair or bed to prevent falling?

According to the CDC, over one in four older adults falls each year. Understanding how should people get up out of a chair or bed to prevent falling is a critical skill for maintaining independence and safety in your home. By mastering simple, deliberate movements, you can significantly reduce your risk of injury and gain confidence in your daily activities.

Quick Summary

To prevent a fall when rising, shift to the edge of your seat or bed, lean forward with your nose over your toes, and use your leg muscles to push up slowly. Pause to ensure your balance is stable, especially after prolonged sitting or lying down, before you begin walking. Practicing these deliberate movements can significantly improve stability and reduce fall risk.

Key Points

• Nose Over Toes: Align your nose over your feet to shift your center of gravity forward, making it easier and safer to stand up from a chair.

• Take Your Time: Stand up slowly from sitting or lying down and pause to allow your blood pressure to regulate, preventing dizziness.

• Prepare Your Surroundings: Remove tripping hazards like clutter and loose rugs, ensuring a clear path for transfers.

• Strengthen Your Core and Legs: Engage in regular, gentle exercises to improve the muscle strength and balance needed for safe transfers.

• Utilize Assistive Devices: Use bed rails, sturdy chair armrests, and installed grab bars to provide stable support during transfers.

• Stay Hydrated: Drink plenty of fluids throughout the day, as dehydration can contribute to orthostatic hypotension and instability.

• Foot Positioning: Ensure your feet are flat on the floor, shoulder-width apart, and slightly behind your knees for a stable base when standing.

The Science of Safe Standing

When you transition from a lying or sitting position to standing, your body's cardiovascular system must adjust quickly to maintain blood pressure and adequate blood flow to the brain. This response can become less efficient with age, certain medications, or conditions like dehydration. This common phenomenon, known as orthostatic hypotension or postural hypotension, can cause dizziness, lightheadedness, and instability, increasing the risk of a fall. The techniques outlined below are designed to counteract these effects by promoting a slow, deliberate transition that gives your body time to adjust.

How to Get Up From a Chair Safely

Mastering the sit-to-stand movement is crucial for daily independence. The key is to use proper body mechanics and your strongest muscles, primarily your legs, rather than relying on upper body strength alone.

1. Prepare the environment. Ensure the path is clear. Check that the chair is stable and not at risk of sliding. Place any assistive devices, like a walker or cane, within easy reach but not so close that you trip over them.
2. Move to the edge. Scoot your bottom forward to the edge of the chair. This shifts your center of gravity forward and positions your feet for a powerful push-off.
3. Position your feet. Place your feet flat on the floor, shoulder-width apart, and slightly behind your knees. This stance provides a stable base of support.
4. Lean forward. The core principle is "nose over toes". By leaning your upper body forward, you bring your nose over your feet, which helps propel you forward and upward.
5. Use armrests for support. If available, place your hands on the chair's armrests. Avoid pulling on unsteady surfaces like tables or walkers. Push down on the armrests to assist your legs in the lift.
6. Push with your legs. Drive your legs through the floor, straightening your hips and knees to rise. Focus on using your glutes and thigh muscles. This is a controlled, deliberate motion, not a sudden jerk.
7. Stand and pause. Once standing, pause for a moment to ensure you are steady and not dizzy. Wait until any head rush passes before you begin walking.

How to Get Out of Bed Safely

Getting out of bed, especially in the morning after being in a horizontal position for a long period, requires a careful, methodical approach.

1. Move to the edge of the bed. Roll onto your side, facing the side of the bed where you will exit. Bring your knees toward your chest.
2. Push up with your arms. Use the elbow of the arm that is on the bed and the hand of your other arm to push your torso up to a seated position.
3. Pivot your legs. As you push up with your arms, simultaneously swing your legs off the side of the bed. Your legs and feet should swing to the floor.
4. Sit on the edge and wait. Take a moment to sit on the edge of the bed with your feet flat on the floor. Take a few deep breaths and let your blood pressure normalize. This is a critical step to prevent lightheadedness.
5. Position your hands. Once you feel steady, place your hands on the bed or an adjacent sturdy surface, like a bed rail.
6. Stand slowly. Using the "nose over toes" technique, lean forward and push up with your legs to stand. Again, pause to confirm your balance before taking your first step.

Assistive Devices for Standing Up

Assistive devices can significantly enhance safety and independence. The right device depends on your individual needs and the specific situation.

Comparison of Standing Assistive Devices

Device	Primary Use	Key Features	Best For	Considerations
Grab Bars	Bathrooms, stairs	Permanent, sturdy installation; provides leverage	Bathroom safety, stair navigation	Requires professional installation; not portable
Bed Rails	Bed transfers	Attaches to bed frame; provides handhold for sitting and standing	Bed mobility	Works with most traditional beds; check compatibility
Couch Cane/Chair Lift	Chair transfers	Stable handle frame that slides under the furniture's feet	Transfers from couches and chairs	Can be a less obtrusive option than a full lift chair
Walker/Cane	General mobility	Provides support while walking and standing	Individuals needing constant mobility support	Ensure it is stable before leaning on it for standing
Sit-to-Stand Lifts	Heavy assistance	Powered or manual lift to assist from sitting to standing	Individuals with very limited mobility	Requires significant investment and space
Handy Handle	Portable assistance	Ergonomic grip provides leverage when standing	Getting out of cars or other low surfaces	Highly portable; offers a comfortable, secure grip

Essential Home Modifications

Beyond proper technique, modifying your living space is vital for fall prevention.

• Improve Lighting: Ensure all rooms, hallways, and stairs are well-lit. Use nightlights in bedrooms and bathrooms. Install motion-sensor lights where applicable.
• Clear Clutter: Remove loose boxes, newspapers, and electrical cords from walkways.
• Secure Rugs: Use non-slip backing or double-faced tape on area rugs, or remove them entirely if they pose a tripping hazard.
• Add Grab Bars: Install grab bars in the bathroom, particularly near the toilet and inside the shower or tub.
• Install Handrails: Ensure sturdy handrails are available on both sides of staircases.
• Store Items Within Reach: Keep frequently used items on lower shelves to avoid the need for step stools or reaching overhead.

Exercises for Improved Mobility

Regular exercise builds the strength and balance needed for safe transfers. Consult a physical therapist for a personalized plan, but some general exercises include:

• Sit-to-Stand Practice: Repeatedly and slowly stand up and sit down from a sturdy chair. This strengthens your leg and core muscles.
• Gluteal Squeezes: While sitting or lying down, squeeze your buttocks muscles and hold for a few seconds. This helps strengthen the muscles essential for pushing up.
• Ankle Pumps: Move your ankles up and down while sitting to improve circulation and reduce swelling in the legs.
• Balance Training: With support nearby, practice standing on one foot or walking heel-to-toe to improve balance and coordination.

When to Seek Professional Help

Sometimes, a fall prevention plan requires more than just technique and home modifications. A physical therapist can provide an expert assessment of your gait, balance, and strength, and help you develop a personalized exercise program. They can also recommend appropriate assistive devices and train you on their safe and effective use. If you have experienced a fall, have a fear of falling, or have difficulty with transfers despite practicing safe techniques, it is essential to consult a healthcare provider for a thorough evaluation.

The Importance of a Slow and Steady Pace

Moving too quickly is a primary contributor to falls during transfers. Rushing increases the likelihood of dizziness and reduces the time your body has to react to a loss of balance. It is important to treat every transfer as a deliberate, thoughtful action. Before you even begin to move, pause and plan. Assess your environment, confirm your grip on assistive devices, and ensure you have a clear path. By slowing down and focusing on the process, you can maintain control and dramatically decrease your risk of falling. Taking a deep breath before and after each transfer can also help your body manage the change in blood pressure and prevent lightheadedness.

Conclusion: Prioritizing Safety in Daily Movements

Mastering safe transfers from a chair or bed is a fundamental part of healthy aging and senior care. It involves a combination of proper technique, strategic home modifications, and consistent practice. By adopting the "nose over toes" method for standing and the slow, methodical approach for getting out of bed, you can minimize the risk of falls and protect your independence. The use of appropriate assistive devices and regular exercise can further enhance your stability. Prioritizing these steps will help ensure that you or your loved ones can navigate daily life with greater confidence and safety. For more information on creating a safe environment, visit CDC's Guide to Fall Prevention.

Frequently Asked Questions

What is orthostatic hypotension and how does it relate to falling?

Orthostatic hypotension, or postural hypotension, is a form of low blood pressure that happens when you stand up from sitting or lying down. It can cause dizziness and lightheadedness, which significantly increases your risk of falling. Getting up slowly and pausing to let your body adjust helps to counteract this.

How can I tell if a chair is safe to use for getting up?

A safe chair should be stable, with firm armrests and a height that allows your feet to be flat on the floor when seated. Avoid chairs that are too low, recline, or have wheels that don't lock, as these can make transfers unstable. Consider a couch cane for additional support.

What exercises can help me stand up more easily?

Simple exercises can build strength. Try practicing the sit-to-stand movement repeatedly, performing gluteal squeezes while seated, and doing balance training like standing on one foot while holding onto a stable surface. Always consult a physical therapist for a personalized routine.

Should I use a walker or a cane to help me stand?

Assistive devices like walkers and canes are primarily for support while walking, not for pulling yourself up. Rely on stable surfaces like sturdy armrests, grab bars, or bed rails to stand. Once you are fully standing and balanced, you can then use your walker or cane.

How do I get out of bed safely if I have bad knees?

To protect your knees, focus on using your core and upper body strength to initiate the movement. Roll to your side first, use your arms to push your torso up, and swing your legs off the bed simultaneously. This reduces strain on your knees. Using a bed rail can also provide a stable grip.

What home modifications are most important for fall prevention?

Crucial modifications include installing grab bars in the bathroom, adding handrails to both sides of staircases, improving lighting, securing all loose rugs, and removing clutter from walkways. These changes address the most common areas where falls occur.

What is a transfer belt and how is it used?

A transfer or gait belt is a safety device worn around a person's waist during transfers. It provides caregivers with a firm and secure way to hold and guide the individual, ensuring safety for both the caregiver and the person being assisted.