Safely lifting an elderly person from bed requires careful planning and proper technique to prevent injury to both the individual and the caregiver. Incorrect transfers increase the risk of falls for the elderly and back strain for the assistant. Understanding how to manage the transfer process minimizes physical strain, builds confidence, and creates a safer care environment. Focusing on preparation and appropriate lifting mechanics is necessary for a successful transfer.
Preparation and Safety Assessment
Before attempting any physical transfer, a thorough safety assessment of the environment and the individual is necessary. Clear the immediate area of any clutter, cords, or obstacles that could impede movement or cause a trip, and ensure the destination surface, such as a wheelchair, is locked and positioned correctly. Effective communication with the elderly person is equally important; clearly explain each step before you begin, and encourage them to assist as much as they are able.
Caregiver body mechanics are fundamental to preventing injury, since over half of caregivers report injuries from lifting or transferring. Always maintain a wide base of support by standing with your feet shoulder-width apart and one foot slightly in front of the other. Bend at your knees and hips, keeping your back straight and neutral, ensuring your leg muscles—not your back—are doing the work. For nearly all assisted standing transfers, a gait belt must be secured snugly around the person’s waist to provide a secure grip and point of control.
Technique 1: The Assisted Sit-to-Stand Transfer
The sit-to-stand transfer is used when the elderly person can bear some weight on their legs and is able to follow instructions to assist in the movement. Begin by moving the person from a lying position to sitting on the edge of the bed, a position known as ‘dangling,’ with their feet flat on the floor. This step allows the individual’s blood pressure to stabilize, reducing the risk of dizziness or a fall upon standing.
Once the person is safely sitting, position yourself directly in front of them, placing your feet around their feet and knees, which helps to block their legs to prevent them from slipping or buckling during the lift. The elderly person should be coached to lean their head and shoulders forward, bringing their nose over their toes. This shifts their weight forward and makes the standing motion a forward and upward movement rather than a vertical lift. This forward momentum is necessary for generating the force needed to stand.
Grip the gait belt securely at the person’s back. On a verbal cue, such as “one, two, three, stand,” use your leg muscles to straighten up, transferring your weight backward. The goal is to move the person into a standing position, not lift them vertically with your arms. Once standing, complete the transfer using a pivot motion, turning your feet instead of twisting your back toward the destination chair. Back the person up until the backs of their legs touch the new surface, and control the descent by bending your knees slowly.
Technique 2: Transfers for Non-Weight Bearing Individuals
When an elderly person cannot bear weight, is mostly or completely immobile, or is significantly heavier than the caregiver, manual lifting is unsafe and should be avoided to prevent serious injury to both parties. Non-manual lifting methods and specialized equipment become necessary for safe movement.
For repositioning an immobile person higher in the bed, a transfer aid like a draw sheet is used, which is a reinforced fabric placed under the person’s torso and upper thighs. This tool reduces friction, allowing two caregivers to grip the handles and use their body weight to slide the person with minimal physical strain. This method is suitable only for horizontal repositioning and is not designed for bed-to-chair transfers.
For transferring a non-weight-bearing individual from the bed to a wheelchair, a mechanical lift, such as a Hoyer lift or a sling lift, is the safest and most recommended device. These lifts use a sling placed under the person while they are lying down, and a hydraulic or electric mechanism performs the heavy lifting and movement, eliminating the caregiver’s risk of strain. A two-person lift should only be considered when mechanical aids are unavailable, and it is limited to short-distance or non-standing transfers. Coordination is paramount in a two-person lift, with the taller person stabilizing the torso at the head, and the movement must be initiated simultaneously on a clear count.