Have you ever seen a caregiver effortlessly transfer someone to or from a wheelchair? While it may seem like they just have the magic touch or some sort of superpower, it's more likely that they've simply learned the techniques that make safe wheelchair transfer a routine task.
Anyone can learn these techniques. Just read below and watch the accompanying videos for basic information and pro-tips on how to safely transfer someone to and from a wheelchair.
Basic Rules for a Wheelchair Transfer
Moving in and out of a wheelchair takes both strength and coordination. While some people who use wheelchairs are able to manage this daily task on their own, others require assistance. Assisting them effectively requires knowing how to properly prepare the person being transferred, as well as properly positioning yourself.
To make a safe wheelchair transfer, whether to or from a car, toilet, or shower seat, it's important to:
- Move the wheelchair as close as possible to where you are moving the person.
- Transfer on the stronger side of the person's body.
- Lock the wheelchair, and keep it locked while the person is moving into or out of it.
- Have the foot pedals and / or leg rests moved out of the way.
- Use a gait belt to prevent injury to the person.
- Protect your back: bend your knees during the transfer and maintain a natural curve in your back.
- Once the person is in the wheelchair, if you're moving upward—for example, up a curb or stairs—pull the wheelchair backwards.
- Have the person seated with their legs at a right angle (90 degrees) at both the knees and hips.
- Have the person seated with their feet flat on the floor, unless they have been directed otherwise.
- If they start to fall, don't try to stop the fall, but rather, bend your knees and slowly lower them to the chair, bed, floor, or other safe surface. Call for help, if necessary.
And remember: communication is important throughout this process. Before beginning the transfer, explain your approach. This ensures that you can work together as well as possible and that the person being transferred can help you to the best of their abilities.
Making Different Types of Wheelchair Transfers
Each person's abilities vary, and so do their transfer needs. The amount of help you provide will depend on the specifics of the situation, including whether the person is moving in or out of a car, toilet seat, or shower chair. The tips and techniques can help makes transfers easier and safer for both people.
Transferring Between Wheelchair and Car
Being a caregiver, whether you're a professional or a family member, often requires helping a person with transportation to and from doctor visits, physical therapy appointments, and other commitments. If the right techniques aren't used, making a transfer from a wheelchair to a car and back can be difficult and even cause injury to you as a caregiver, especially if you're new to the task, have physical limitations of your own, or are tired or physically stressed. But you can make a safe transfer between a wheelchair and a vehicle if you take the proper steps.
Here are the steps for making a safe wheelchair transfer to and from a car. Please also watch the video below for a demonstration:
- Be prepared by gathering any items you need before you start. Have your keys, gait belt (if using one) and any other items gathered before you go outside.
- Move the car to a location that will allow easy access for the wheelchair.
- Move the car seat back as far as possible.
- Familiarize yourself with the wheelchair's features: Does it have footrests that flip up? Leg rests that can swing out of the way?
- Move the wheelchair, with the person in it, as close to the car as possible, at an angle with the car.
- Lock the brakes for safety.
- If the wheelchair has footrests or leg rests, swing or flip them out of the way.
- Have the person lean forward slightly, and apply a gait belt or other belt around their waist. Place it below the ribcage and above the hips. This provides increased safety by allowing you to hold onto the belt, rather than the person's arm, which may cause injury to the person.
- Help the person move to the edge of the chair and lean forward; this shifts their weight over their feet and will make it easier for them to stand and transfer.
- Avoid having the person hold on to you; instead, have them place their hands on the armrests of the wheelchair and push up.
- Stand in front of the person and bend your knees. To protect your back, keep your knees bent and maintain a natural curve in your back during the transfer.
- Get a good grip on the gait belt and help them stand. If the person's legs are not strong, you can block their knees with your knees while they stand up.
- Guide the person to pivot and turn with small steps and back up to the car seat.
- Have the person bend their knees and slowly sit in the car seat — remind them to bend their head forward to avoid hitting their head.
- Help the person turn and assist in lifting their legs into the car.
- Apply the seat belt and close the door.
To transfer a person out of the car and into the wheelchair, reverse the above process by taking these steps:
- Position and angle the wheelchair as close to the car as possible.
- Lock the brakes.
- Move the leg or footrests out of the way.
- Unbuckle the seat belt.
- Have them lean forward and position the gait belt on them.
- Help the person turn their body.
- Lift the person's legs out of the car and help them scoot to the edge of the seat.
- Stand in front of the person and bend your knees. To protect your back, keep your knees bent and maintain a natural curve in your back during the transfer.
- Get a good grip on the gait belt and help them stand. If the person's legs are not strong, you can block their knees with your knees while they stand up.
- Guide the person to pivot and turn with small steps.
- Have them reach back for the armrest and sit in the chair when they feel the back of the chair.
- When they're comfortably seated, place the leg or footrests back in the original position.
- Unlock the brakes.
In this video, a caregiver shows how to make a safe wheelchair transfer to and from a car, explaining how to start the transfer, the importance of body posture and safety, and how to position the wheelchair and the car:
To get instructions and a demonstration of safe wheelchair transfer in Spanish, watch the video below:
Transferring Between Wheelchair and Toilet Seat
It's common for caregivers to have questions about how to transfer someone from a wheelchair to and from a toilet, and it can be challenging to do this safely, efficiently, and with dignity. Here are the steps for making a safe wheelchair transfer to and from a toilet.
- Be prepared by gathering your gait belt and any other items you or the person will need.
- Familiarize yourself with the wheelchair's features: Does it have footrests that flip up? Leg rests that can swing out of the way?
- Remove any rugs from the bathroom.
- Put the toilet lid up, and put the toilet seat down.
- Have the person lean forward slightly, and apply a gait belt or other belt around their waist. Place it below the ribcage and above the hips. This provides increased safety by allowing you to hold onto the belt, rather than the person's arm, which may cause injury to the person.
- If the wheelchair has footrests or leg rests, swing or flip them out of the way.
- Wheel the person in the wheelchair to the bathroom doorway.
- If the bathroom doorway is wide enough for the wheelchair to pass through, wheel the person into the bathroom and follow these steps:
- Place the wheelchair at a right angle to the toilet with just enough room for person to stand, pivot, and sit as described below. If they have one side that's weaker, position that side toward you rather than the toilet so that you can support them.
- Lock the wheelchair.
- If the person is wearing a belt, have them unfasten it or do that for them.
- Help the person move to the edge of the chair and lean forward; this shifts their weight over their feet and will make it easier for them to stand and transfer.
- Stand in front of the person and bend your knees. To protect your back, keep your knees bent and maintain a natural curve in your back during the transfer.
- Get a good grip on the gait belt and help them to stand. If the person's legs are not strong, you can block their knees with your knees while they stand up.
- Avoid having the person hold on to you. Instead, have them push up on the wheelchair armrests.
- Guide the person to pivot 90 degrees with small steps and back up to the toilet seat. Turn with them so you are still facing them.
- Use one hand to firmly grip the gait belt, while using the other to help them lower their pants and undergarments.
- Grasp the gait belt again firmly with both hands.
- Have the person bend their legs and slowly lower themselves to the toilet seat. (Bend your knees rather than leaning forward!)
- Rather than holding onto you, have the person use a handrail installed on the wall or, if using an elevated toilet seat, the handrails attached to the seat.
- If the bathroom doorway is not wide enough for the wheelchair to pass through, follow these steps:
- Lock the wheelchair.
- If the person is wearing a belt, have them unfasten it or do that for them.
- Help the person move to the edge of the chair and lean forward; this shifts their weight over their feet and will make it easier for them to stand and transfer.
- Stand in front of the person and bend your knees. To protect your back, keep your knees bent and maintain a natural curve in your back during the transfer.
- Get a good grip on the gait belt and help them to stand. If the person's legs are not strong, you can block their knees with your knees while they stand up.
- Avoid having the person hold on to you. Instead, have them push up on the wheelchair armrests
- Move to their side; if they have one side that's weaker, stand on that side.
- Take several slow, small steps with the person to the toilet.
- Taking small steps, guide the person to pivot 180 degrees and back up to the toilet seat. Step around to face them.
- Use one hand to firmly grip the gait belt, while using the other to help them lower their pants and undergarments.
- Grasp the gait belt again firmly with both hands.
- Have the person bend their legs and slowly lower themselves to the toilet seat. (Bend your knees rather than leaning forward!)
- Rather than holding onto to you, have the person use a handrail installed on the wall or, if using an elevated toilet seat, the handrails attached to the seat.
To transfer a person off of the toilet and into the wheelchair, reverse the above process.
Transfer Aids
In some cases, extra help will be required to move the person in and out of the wheelchair, and to make the process safer for both them and you, especially if your senior is interested in aging in place. Common transfer aids include gait belts, mechanical lifts, and sliding boards. Before using these devices, inspect all straps, materials, stitching, hooks and chains to ensure that they are in good condition. If they look frayed or broken, refrain from using them.
When to Call for Help With Wheelchair Transfers
The appearance of new sores or skin problems, differences in the condition of the person's shoulders, arms, or other body parts, and complaints of new pain following a transfer are signs that you should call the doctor.
If you are uncertain about the transfer process or have any questions, a trained healthcare professional, such as a physical therapist or nurse, can be a valuable resource.
If you're looking for a comprehensive resource for family caregivers, check out our online Family Caregiver Guide.
