Safe transfers for caregivers: getting out of bed, moving to a chair and protecting your back

Transfers such as getting out of bed, moving to a chair or sitting down on the toilet are the riskiest moments for both the person being cared for and the carer. Poor technique can lead to falls, shoulder and skin injuries and lasting back problems for carers. This guide sets out general principles; the safest way is to learn the method suited to the individual from a physiotherapist or occupational therapist.

Before a transfer: 5 questions

• How much can the person do themselves today? (Tiredness, pain and medicines can change through the day.)
• Are they wearing shoes or non-slip slippers, and is the floor dry and clear?
• Are the wheelchair brakes on and the footrests raised?
• Is the equipment you need (transfer belt, slide sheet, transfer board) within reach?
• Does this task need a second person or a hoist?

Basic posture principles

• Stand with your feet shoulder-width apart, one foot slightly forward.
• Lower yourself by bending your knees and hips, not your back.
• Stand as close to the person as you can; do not carry the load away from your body.
• Do not twist your back while moving them; if you need to turn, turn with your feet.
• Start the movement together: “On three, we stand up: one, two, three.”

What to avoid

• Lifting the person under the armpits: this can injure the shoulder.
• Pulling on the affected arm after a stroke.
• Dragging the person up the bed on the sheet: this can tear the skin and set the stage for pressure ulcers.
• Letting them hold on around your neck: if they lose their balance, you may both fall.
• Trying to lift a load you cannot manage alone “just this once”.

Getting out of bed, step by step

First roll the person onto their side, then help them into a sitting position by letting their legs come over the edge of the bed while they push up with the other arm and elbow. Let them sit for a few seconds and ask whether they feel dizzy. Their feet should be flat on the floor, with their hips at the edge of the bed. As they stand, they should push up with their hands from the bed or the armrests of the chair, while you keep them steady by holding the transfer belt.

Aids and equipment

A transfer belt, slide sheet, transfer board, stand aids and a patient hoist make care both safer and more dignified. Ask the healthcare team which equipment is suitable and always get training before using it.

When someone is falling, and after a fall

Do not try to catch someone who is falling and hold them up; stay close and try to lower them to the floor in a controlled way while protecting their head. Do not lift them straight away after a fall: first check for injuries, pain or a blow to the head. If they cannot get up, are in pain or have hit their head, call your local emergency number (112 in Türkiye and across the EU) and keep them covered and warm while you wait. If there is no injury and they can cooperate, guide them to get up by themselves with the help of a chair.

Protecting your own back

Back pain is one of the most common work-related problems among caregivers. Warm-up movements, regular exercise, a hospital bed at a suitable height and working with a second person when needed protect your health in the long term. Do not ignore pain; talk openly with the family about equipment and support needs.