How to assist elderly out of chair? A comprehensive guide for safe transfers

According to the CDC, falls are a leading cause of injury among older adults. Learning how to assist elderly out of chair safely is critical for preventing these injuries, protecting their dignity, and ensuring your own physical safety as a caregiver.

Quick Summary

Safely assisting an elderly person from a chair involves proper positioning, communication, and using your legs, not your back, to create forward momentum. This guide details the correct methods and assistive devices to ensure a safe, dignified transfer, reducing the risk of falls for both parties.

Key Points

• Communicate Clearly: Before starting, explain each step of the transfer process calmly to the elderly person to ensure cooperation and reduce anxiety.

• Position Correctly: Have the person scoot to the edge of the seat, with feet flat on the floor and slightly behind their knees, to shift their center of gravity forward.

• Use Proper Body Mechanics: As a caregiver, stand in a wide, stable stance, bend your knees, and lift with your legs to prevent back injury.

• Leverage Assistive Devices: Utilize tools like gait belts, lift chairs, or stand assist frames for additional stability and to reduce physical strain.

• Prioritize Safety First: Always check the environment for hazards and ensure a clear path for the transfer. If the person is too heavy, seek professional assistance to avoid injury.

• Encourage Forward Momentum: Instruct the person to lean their "nose over their toes," as this simple action helps create the necessary momentum for standing.

• Allow Time to Balance: After standing, give the person a moment to regain their balance before beginning to walk, reducing the risk of a fall.

Understanding the Biomechanics of Standing

Getting out of a chair requires a complex series of movements involving shifting weight, muscle strength, and balance. For older adults, this process can be difficult due to age-related changes like muscle weakness (sarcopenia), joint stiffness, and balance issues. Caregivers must understand these challenges to provide effective and safe assistance. Proper technique is not only safer for the senior but also protects the caregiver from back strain and other injuries.

The Importance of Communication and Preparation

Before any transfer, clear communication is essential to build trust and ensure the process goes smoothly.

Verbal cues

• Tell the person exactly what you are going to do before you do it.
• Explain each step simply and calmly.
• Use a consistent verbal cue like “ready, steady, stand” to signal the start of the movement.

Environment setup

• Clear the area around the chair of any clutter, rugs, or obstacles.
• Ensure the path to the next destination (e.g., walker, bathroom) is also clear.
• Check that the chair is stable and has firm footing. Avoid soft, deep chairs or those with wheels that aren't locked.

Step-by-Step Guide: The Basic Transfer Technique

This method is suitable for a senior who can bear some weight but needs guidance and support.

1. Position the senior: Help them slide forward in the chair so they are sitting on the edge with their feet flat on the floor, about shoulder-width apart.
2. Position yourself: Stand directly in front of the senior. Place your feet in a wide stance for a stable base.
3. Engage the core: Instruct the senior to lean forward, bringing their nose over their toes. This shifts their center of gravity forward, making it easier to stand.
4. Verbal cue: Say your cue ("ready, steady, stand") and, on the last word, provide a gentle lift.
5. Lift with your legs: As they push up with their arms, you should bend your knees and use the strength of your legs to help lift, keeping your back straight.
6. Support and stabilize: Once they are standing, let them balance for a moment before moving.

Advanced Techniques and Assistive Devices

For those needing more support, various tools and methods can help.

Using a gait belt

A gait belt is a safety device worn around the senior's waist. It provides a secure place for the caregiver to hold on, preventing a pull on the person's arms or shoulders.

1. Application: Fasten the gait belt snugly around the person's waist, over their clothes, ensuring it is secure but not too tight.
2. Technique: Follow the basic transfer steps, but instead of holding their torso, grip the belt firmly on either side of their back.

Lift chairs

• These are recliners with a built-in lifting mechanism that gently tilts the chair forward to help the person stand.
• They are ideal for reducing the physical strain on both the senior and the caregiver.

Couch stand assist aids

• These are sturdy frames with handles that slide under the legs of a couch or chair.
• They provide stable armrests for the senior to push off from, offering more security than the chair's own armrests.

Comparison of Assisting Methods

Feature	Basic Transfer Technique	With a Gait Belt	Using a Lift Chair
Level of assistance	Low to moderate	Moderate	Minimal to none
Equipment required	None	Gait belt	Lift chair
Caregiver exertion	Requires moderate physical strength	Reduces strain; easier to control	Minimal caregiver effort
Senior independence	Encourages participation	Provides secure support	Maximizes independence
Best for	Individuals with some strength	Individuals at risk of falling	Those with significant weakness

When to Consider Professional Help

If the senior becomes heavier or weaker, or if you begin to feel physical strain, it may be time to seek professional help. Home healthcare services can provide trained professionals who are experts in patient transfer techniques and can recommend the right equipment. Always prioritize safety over personal pride. For further reading on caregiver best practices, consult the National Institute on Aging here.

Preventing Future Difficulties

To proactively address mobility issues, consider the following:

• Physical therapy: A physical therapist can create a tailored exercise plan to build strength and improve balance.
• Regular movement: Encourage gentle, daily exercises, even if it's just walking a few steps.
• Home modifications: Make simple changes like adding grab bars in key areas and using non-slip mats.

Conclusion

Assisting an elderly loved one out of a chair requires patience, communication, and the right technique. By understanding the biomechanics and utilizing proper methods, caregivers can perform transfers safely, reduce the risk of falls, and maintain the dignity of the person they are helping. Whether using the basic method, a gait belt, or assistive technology, the key is to be prepared and prioritize safety above all else.

Frequently Asked Questions

What is the safest way for a caregiver to assist an elderly person from a chair?

The safest method involves proper caregiver body mechanics (lifting with legs, not back) and good communication. The elderly person should be positioned at the edge of a stable chair with their feet flat on the floor, and the caregiver should use a gait belt for a secure grip during the transfer.

What kind of chair is best for elderly people with mobility issues?

A chair that is firm and has sturdy armrests is best. Avoid low, soft couches or chairs that are difficult to get out of. A lift chair, which has a motorized mechanism to assist with standing, is an excellent option for those with significant weakness.

When should I consider using a gait belt?

A gait belt is recommended whenever a caregiver needs to provide moderate to high levels of assistance. It offers a firm, secure hold around the person's waist, reducing the risk of falls and preventing you from pulling on their arms, which can cause injury.

How can I prevent falls when helping an elderly person stand up?

To prevent falls, ensure the environment is clear of obstacles, the person is wearing non-slip shoes, and you communicate each step clearly. Encourage them to lean forward to shift their weight, and allow them time to find their balance once they are standing.

What if the elderly person cannot bear weight on their legs?

If the elderly person cannot bear weight, attempting a manual lift can be dangerous. It is essential to use mechanical lift equipment, such as a patient lift, or to consult a professional for safe transfer techniques. Never attempt to lift a person beyond your physical capacity.

What is the 'nose over toes' technique?

The 'nose over toes' technique is a verbal cue that helps a person shift their center of gravity forward. By leaning their head and upper body forward, their weight is correctly positioned over their feet, making it much easier to stand up from a sitting position.

Are there exercises to help an elderly person get out of a chair on their own?

Yes, seated exercises that build leg and core strength can be very effective. A physical therapist can recommend exercises like seated leg lifts, ankle rotations, and practicing the sit-to-stand motion with minimal assistance. This can gradually improve their independence.