How to safely get an elderly person out of bed?

According to the CDC, over 36 million falls are reported among older adults each year, making safe transfers critical for injury prevention. Learning how to safely get an elderly person out of bed is a fundamental skill that protects both the senior and the caregiver from unnecessary strain.

Quick Summary

Ensuring a safe transfer involves preparing the environment, assessing the senior’s mobility, using proper body mechanics by lifting with your legs, and employing appropriate assistive devices like gait belts or bed rails to facilitate movement and reduce the risk of falls.

Key Points

• Assess Mobility: Always check the senior's current strength, balance, and pain levels before attempting a transfer to determine the appropriate level of assistance.

• Use Proper Body Mechanics: Protect your back by bending your knees, keeping your back straight, and lifting with your powerful leg muscles, not your back.

• Prepare the Environment: Ensure the pathway is clear of obstacles, the bed and chair wheels are locked, and both you and the senior have non-slip footwear.

• Utilize Assistive Devices: Employ tools like a gait belt for extra support, a trapeze bar for senior-led lifts, or a patient lift for non-weight-bearing individuals.

• Communicate Clearly: Verbally guide the senior through each step of the transfer, counting aloud to coordinate movements and reduce anxiety.

• Ensure a Stable Base: Whether sitting or standing, make sure the senior's feet are flat on the floor and positioned to provide a solid foundation.

Preparing for a Safe Transfer

Proper preparation is the first and most critical step in ensuring a safe and dignified transfer. Rushing this process increases the risk of falls and injury for everyone involved.

Assess the Senior's Abilities

Before you begin, evaluate the senior's current condition. A sudden change in health or energy level can affect their ability to assist. Ask yourself:

• Can they bear weight on their legs?
• Do they have a stronger side? Always transfer toward the stronger side.
• Are they feeling dizzy, in pain, or weak today?
• Can they understand and follow simple instructions?

Ready the Environment

A clear path and secure surfaces are essential. Clutter is a major fall hazard.

• Clear the way: Remove any obstacles, throw rugs, or cords from the area between the bed and the destination chair.
• Secure the equipment: Lock the wheels on the bed and the wheelchair (if using one). Ensure the chair is stable and positioned at the correct angle.
• Wear proper footwear: Both you and the senior should wear non-slip, well-fitting shoes or socks with grips.
• Adjust bed height: If using an adjustable bed, raise it to a comfortable height for you and level with the surface you're transferring to.

Master Proper Body Mechanics

Protecting your own back is vital to long-term caregiving. Never lift with your back; always use your leg muscles.

• Maintain a wide base: Stand with your feet shoulder-width apart to provide a stable base of support.
• Bend at your knees and hips: Squat down rather than bending at the waist. Keep your back straight throughout the movement.
• Keep the senior close: The closer the senior is to your center of gravity, the less strain there is on your back. Avoid reaching or twisting.
• Use your legs to lift: Push up with your powerful leg muscles, keeping your core engaged. Pivot your feet to turn, rather than twisting your torso.
• Communicate clearly: Before each step, explain what you are about to do. Count to three to coordinate the movement. "On three, we'll stand up."

Step-by-Step Bed to Chair Transfer

For seniors with some weight-bearing ability, a pivot transfer is a common and safe technique.

1. Position the senior: Have the senior roll onto their side, facing the direction of the transfer. Bend their knees and swing their legs over the edge of the bed as you simultaneously support their upper body to help them sit up.
2. Sit for a moment: Allow them to sit on the edge of the bed for a moment to stabilize their balance and prevent lightheadedness.
3. Apply a gait belt: Fasten the gait belt snugly around the senior's waist. It provides a secure, easy-to-grip handle for you, but it is not for lifting.
4. Position yourself: Stand in front of the senior, with your feet bracing theirs. Bend your knees, keeping your back straight. Hold the gait belt with an underhand grip.
5. Lift and pivot: Count to three. As you both stand, use your legs to lift while the senior pushes off the bed with their hands. Pivot your feet together toward the chair.
6. Lower and seat: Once the senior's legs touch the chair, bend your knees to lower them gently. Ensure their hips are fully back in the seat before releasing the gait belt.

Assistive Devices for Bed Transfers

Different mobility challenges require different tools. Selecting the right device is key to ensuring safety.

Comparison of Common Devices

Device	Best For	How It Works	Caregiver Effort	Senior Involvement
Gait Belt	Seniors with some weight-bearing ability who need minor assistance	Provides a secure handle for the caregiver to steady and guide the senior	Low	Moderate
Trapeze Bar	Seniors with strong upper body strength	Allows the senior to pull themselves up into a sitting position	Very Low	High
Transfer Board	Seniors with limited or no leg strength	Acts as a bridge between the bed and chair, allowing a seated slide	Moderate	Low
Patient Lift (Hoyer)	Non-weight-bearing seniors	A mechanical lift with a sling that takes all the senior's weight	Low	Minimal

Other Helpful Aids

• Bed Rails: Offer a stable handhold for seniors to pull themselves up from a lying position.
• Leg Lifters: Assist seniors with limited leg strength to lift their legs into and out of bed.
• Adjustable Beds: Allow seniors to be raised into a sitting position with the push of a button, reducing the initial lifting challenge for the caregiver.

Final Considerations for Long-Term Care

Beyond the specific transfer, consider the ongoing safety of your loved one.

• Regular physical therapy: A physical therapist can provide tailored exercises to improve a senior's strength and balance, making transfers easier and safer over time.
• Ongoing assessment: Regularly check in with the senior about their physical capabilities and pain levels. Their needs may change.
• Know your limits: Do not attempt a transfer alone if you are unsure of your ability. Use a patient lift or ask for assistance. Injury to yourself could put both of you in a difficult situation.

Following these guidelines will not only help you safely get an elderly person out of bed but also promote their independence and preserve their dignity. Remember that communication, patience, and proper technique are your most valuable tools. For additional resources on fall prevention, you can refer to the CDC's STEADI initiative.

Conclusion

Safely assisting an elderly person out of bed is a critical aspect of caregiving that requires careful preparation, the use of proper body mechanics, and a calm, deliberate approach. By assessing the senior's abilities, readying the environment, and utilizing appropriate assistive devices, caregivers can significantly reduce the risk of injury for both themselves and their loved ones. Consistent communication and respect for the senior's needs are paramount throughout the process. Following these detailed steps ensures that transfers are performed with the utmost safety, confidence, and dignity, contributing to a better quality of life and reduced anxiety for everyone involved.

Frequently Asked Questions

What is a gait belt and how do I use it when getting an elderly person out of bed?

A gait belt is a safety device worn around the senior's waist that gives the caregiver a secure handle. To use it, fasten it snugly around their waist over their clothing before the transfer. Use it to steady and guide them, but do not use it to lift them entirely.

What if the elderly person becomes dizzy when sitting up?

If they feel dizzy, have them remain in a seated position on the side of the bed until the dizziness passes. Never proceed with the transfer if they are lightheaded. This is a common issue known as orthostatic hypotension.

When should I use a mechanical patient lift instead of manual transfer techniques?

Use a mechanical patient lift (such as a Hoyer lift) for seniors who are non-weight-bearing, have very limited mobility, or are significantly heavier than the caregiver. It prevents injury for both the senior and caregiver during transfers.

How can I get a heavy or 'dead weight' elderly person out of bed alone?

You should never attempt to lift a 'dead weight' person alone. This poses a significant risk of injury to both of you. In this situation, the use of a mechanical patient lift is required. If a lift is not available, call for professional medical assistance.

Can proper transfers help prevent falls?

Yes, using proper transfer techniques is a key component of fall prevention. A smooth, controlled transfer with the correct equipment minimizes instability and reduces the likelihood of a fall occurring during movement.

How do I move an elderly person closer to the edge of the bed?

To move them closer, have the senior bend their knees and push with their heels while you assist by placing a hand under their shoulder blade and another at their hip. A draw sheet can also be used under the senior to help slide them safely toward the edge.

What kind of exercises can help an elderly person improve their bed mobility?

Simple exercises like seated leg lifts, ankle pumps, and pulling up on a trapeze bar can strengthen the muscles needed for bed transfers. Consult a physical therapist for a personalized exercise plan.