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(or Transferring Without Injury)
The ability to get around on our own isn't given much thought until we acquire conditions that affect our daily activities. Getting out of a chair, getting in and out of bed, or moving from one surface to another (i.e. moving from wheelchair to toilet) are tasks called "transfers". Some of us become aware of a problem when we experience arthritis aches and pains or have difficulty with transfers as a result of an injury or chronic condition. Others with more disabling conditions, such as stroke, multiple sclerosis or post-polio syndrome, may require physical assistance from another person or a mechanical aid to transfer.
"People who experience transfer difficulties and attempt transferring the same way they have always done it may not be aware that they are placing more stress on their joints and ligaments that can contribute to increased pain or injury," says Linda Fraas, an Occupational Therapist and Assistive Technology Practitioner at the Caring Services of Western New York, Inc. "There are specific techniques and many helpful products designed to help make transferring easier and safer while conserving energy and protecting the joints of the hands, hips, knees and lower back."
For example, Ms. Fraas suggests the following when getting up from a seated position:
Slide forward in the seat and place your feet a few inches apart and positioned behind your knees. Place your hands (palm side down) on the chair's armrests or on the seat next to your thighs. Push down with your hands and legs and bend your head and upper body forward over your knees. Straighten your knees and back until you are standing erect.
"It is always important to maintain good posture to avoid improper weight distribution and over-stretching ligaments which can lead to pain and fatigue," Ms. Fraas adds. "Wearing shoes with low heels is also recommended."
For those who are unsteady on their feet and need to hold onto something for balance and support as they transfer independently from the bed, toilet or chair to a wheelchair, the staff at Dynamic Living recommends the following products:
Grab Bars - are available in a large variety of lengths, colors and styles. When installing grab bars, be sure they have no more than 1.5" wall clearance, are the appropriate length and diameter for your needs and are placed where they will offer the most support. Remember to follow all precautions about appropriate wall preparation so the grab bar will be able provide the support you need.
The SuperPole - is a tension pole that is secured between the floor and the ceiling and provides a full range of heights to hold onto while sitting or standing up. Unlike a grab bar, the SuperPole can be installed anywhere there is a floor and ceiling, to provide support exactly where it is needed. There is an optional horizontal bar that pivots to move with you in safe small steps. When ceilings are too high or cantilevered, there is also a floor-mounted pole that adjusts up to 32" in height and is secured to the floor for stability.
"It is easier to transfer from a wheelchair to another surface if they are about the same height," Ms. Fraas advises. "Whenever possible, the wheelchair should be placed at a 60 degree angle to the surface area for easier transfer. Always lock the wheelchair brakes before standing or transferring."
When you are caring for someone who uses a wheelchair or who has difficulties moving from one place to another, it is very helpful to be aware of the proper techniques and aids used for helping them transfer without causing injury to themselves or to you.
Ms. Fraas suggests the following guidelines:
Maintain a broad base of support by standing with your feet apart about shoulder width, knees bent slightly, and one foot slightly forward for support. Your head and trunk should be in an upright position. Lift, carry or support the person as close to the body as possible to maintain your center of gravity. Always lift with your legs, not with your back. Move your feet to turn, do not rotate your spine.
For turning, the Pivot Disk is a durable, turntable-style transfer disk that helps people who can stand, but have decreased trunk and hip mobility. The person stands on the disk while the caregiver gently nudges their body to the correct position.
"Above all, know your limitations," Ms. Fraas emphasizes. "When in doubt, do not lift alone. Wear shoes with low, non-slip soles."
Some individuals cannot bear weight on their legs or are too unstable to complete a standing transfer. These individuals are best suited for seated-sliding transfers.
The Beasy Board System - includes two pieces: a long plastic board and a round disc that slides the length of the board, secured within the board's track. The disc moves in a frictionless manner and rotates 360 degrees making it easy to sit, turn and slide across the board. "If a caregiver is sliding the person across the board, it is important to remember to go slow," Ms. Fraas recommends. "Some people may complain of dizziness if movement occurs too fast."
It is important to remember that a transfer belt should be used for all transfers if the person requires caregiver assistance to complete the task. The caregiver needs control of the person's body movement during the transfer to control the speed at which the person sits as well as to avoid pulling on arms, hands or shoulders. "If you must hold on to the person requiring assistance, support them with an open hand around the back," suggests Ms. Fraas. "The caregiver should be sure the person they are transferring knows the transfer procedure. That will eliminate any confusion about how the transfer will take place and help to avoid injuries."
The use of assistive products and appropriate transferring techniques can help you master the skills you need to get around while keeping the wear and tear on your joints, ligaments and muscles to a minimum. If you seek more information on transferring or need assistance, contact an Occupational Therapist or Physical Therapist in your community.
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© Copyright 2002
Dynamic Living, Inc.
Dynamic Living Newsletter may only be redistributed in its unedited form. Written permission from the editor must be obtained to reprint or cite the information contained within this newsletter.
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