Transferring to and from a wheelchair is one of the essential skills a wheelchair user will learn. Whether they transfer themselves or transfer with the help of a caregiver, it’s vital to understand the safest techniques and the equipment available to make the process safer and easier. Transferring between a wheelchair and a bed is risky if done incorrectly, and is a common cause of falls and injury.
In this article, we’re going to look at some of the equipment that is available to wheelchair users and caregivers, before outlining how to prepare for a transfer and four of the most popular transfer techniques.
Equipment That Helps Wheelchair Users Move to and From Their Bed
Whether a wheelchair user needs any equipment at all depends on their strength, their mobility, and whether they can support their weight without assistance. Transfer equipment reduces the risk of a fall and makes it easier for wheelchair users and caregivers to quickly and safely complete a transfer.
- Gait belt. If a wheelchair user requires assistance when transferring, a gait belt is essential. Gait belts are fabric belts or harnesses worn by the wheelchair user. They give caregivers something to hold while steadying the patient as they move to or from the bed. It should be noted that gait belts are used to support patients, not to lift them.
- Transfer board. A transfer board is a stiff, flat board used to bridge the gap between the wheelchair and the bed. Wheelchair users use the transfer board to provide support as they slide themselves from the bed to the wheelchair.
- A height-adjustable home hospital bed. Ideally, the surface the user is being transferred to is slightly lower or the same height as the surface they are transferring from. This is easily achievable with a home hospital bed with a Hi-Lo adjustment.
- Mattress with border-edge protection. Consumer mattresses tend to have soft edges, which can make it difficult for wheelchair users to transfer to and from their bed. Transfer Master home hospital bed mattresses are equipped with stiffened edges which provide better support during a transfer.
- Guard Rails. Sturdy guard rails on your home hospital bed can provide a solid anchor point when sitting up, changing positions, or getting in and out of bed.
Other equipment may be useful for particular transfer techniques, and we’ll introduce it when we discuss those techniques.
Preparing to Transfer a Wheelchair User
Before attempting a transfer to or from a wheelchair, it’s essential to be prepared. Poor preparation increases the risk that something will go wrong during a transfer, resulting in a slip, fall, or injury to the caregiver.
If you are helping to transfer someone from a hospital bed to a wheelchair, begin with an assessment of their strength and mobility. Identify which is the dominant or strongest side of their body. Ideally, the transfer should be attempted with the chair on the wheelchair users’ dominant side. They will be able to give you more assistance as you help them to move.
Ensure that nothing is obstructing the floor between the bed and the wheelchair. Trip hazards should be moved to one side or picked up. Even something as seemingly innocuous as a slipper or paper towel can present a substantial risk.
Next, ensure that the wheelchair is locked in place using its brakes. The wheelchair should be a stable platform and should not be able to move during the transfer. Also, the wheelchair’s footrests should be in the upright position so that the user’s feet can get as close as possible to the seat without becoming tangled.
Finally, if you’re helping someone move, explain to them what’s going to happen and the technique that you will use to transfer them. They should understand the process so they can help you with the transfer as much as possible.
Four Wheelchair to Bed Transfer Techniques
We will discuss four transfer techniques, beginning with self-transfer techniques and then techniques caregivers can use to help wheelchair users transfer safely.
Self-Transfer With Gravity Assist
This technique is best for wheelchair users with substantial upper body strength or some ability to support themselves on their legs. We will discuss moving from the bed to the wheelchair, but the reverse process is similar.
- Position the wheelchair next to the bed and carry out the preparations we outlined above. You may find it easier to transfer if the wheelchair is placed at a 30-degree angle to the bed.
- Use the Hi-Low adjustment of the home hospital bed to put the top of the bed at the same level as the wheelchair or just above.
- Sit on the edge of the bed with feet on the floor. Make sure the wheelchair is in reach.
- Use one hand—the trailing hand—on the stiff edge of the mattress and the other hand—the leading hand— on the seat of the wheelchair for support. Lean into the direction of movement as you lift yourself and pivot into the wheelchair.
- Reposition yourself so you are securely in place on the wheelchair.
Self-Transfer With Transfer Board
A transfer board helps wheelchair users slide from the bed to the seat of their wheelchair. With a transfer board, there is no point during the transfer when the body is unsupported. This technique is better for wheelchair users who do not have sufficient upper body strength to lift and move without support.
- Sit on the edge of your bed with your feet flat on the floor.
- Place the wheelchair at a 30-degree angle to the bed.
- Adjust the height of the bed to match the height of the wheelchair.
- Slide one end of the transfer board under your thigh and place the other end on the wheelchair seat. Ensure that the board is fully on the seat so that it does not move or pivot the wheelchair when weight is applied.
- Use your arms to lift your body slightly and to slide along the board. It may take several movements to get from the board to the wheelchair.
- Once you’re on the chair, remove the transfer board and adjust your position for comfort and safety.
Assisted Transfers (Stand and Pivot)
Assisted transfers, also known as stand and pivot or a pivot transfer, take advantage of the strength and stability of a caregiver to aide the wheelchair user as they transfer. Assisted transfers are useful when the wheelchair users can move partially with support from a caregiver.
- Position the wheelchair at a 30-degree angle to the bed.
- Place a gait belt or transfer harness securely on the wheelchair user’s waist. The belt should be snug but not too tight.
- The upper surface of the mattress should be level with the seat of the wheelchair.
- Help the wheelchair user into a sitting position with their feet flat on the floor.
- Position yourself in front of the wheelchair user with a firm grip on the gait belt. Ask the wheelchair user to put their arms around your waist, not your neck.
- As the wheelchair user lifts and pivots themselves, support their efforts with the gait belt. Be careful not to haul them up—a gait belt is not a lifting device.
- Ensure the wheelchair user is appropriately positioned in the wheelchair before letting go of the gait belt.
For patients with minimal mobility, a patient lift—also known as a patient hoist, Hoyer lift, or a hydraulic lift—may be necessary. Patient lifts feature a sling attached to a gantry. The sling with the patient in it is lifted with hydraulics or electric motors, allowing caregivers to transfer the wheelchair user from the bed to the wheelchair without manual lifting.
The use of patient lifts is more complicated than the other transfers we’ve discussed and they require professional training, so we won’t give a full outline here.
As you can see from the techniques we’ve discussed, a home hospital bed plays a vital role in safely moving from bed to wheelchair and back again. Height-adjustable home hospital beds significantly reduce the risk of a transfer. Hospital bed mattresses with border-edge protection make it safer and easier to transfer yourself or a patient.
When we founded Transfer Master almost 30 years ago, we named the company because of how a well-designed home hospital bed can assist with patient and self-transfers. We believe everyone should have a safe and dignified process for getting in and out of bed every day, which is why our entire home hospital bed lineup has been engineered with transfers in mind.
To learn more about home hospital beds and mattresses, contact our hospital bed experts today.