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Moving up the bed
This technique is used to move the patient who has slipped down the bed. Depending on the level of help required, 1 or 2 persons may be required.

To move the person:

• Stand at the side of the bed
• Instruct the person to bend his knees or you may need to assist him to do this
• Place one arm under the person’s shoulder blade and the other under his thigh
  Note: Never pull on the person’s arms. This can damage the shoulder.
• Ask the person to kick and push himself up whilst the lift is performed, so that he can assist as much as possible
• Count to three, so that everyone is prepared to move at the same time

Moving from lying to sitting

• Ask the person to bend his knees, before you start
• Place one hand on the person’s knee and the other on the shoulder of the side furthest away from you. Roll the person towards you onto his side.
• Swing the person’s legs over the side of the bed
• Place one hand under the person’s shoulder, which is lying on the mattress and your other hand on his uppermost hip. Encourage the person to push up on the mattress with his free hand and lift him up into a sitting position

It is important to encourage the person to assist you as much as possible as you do not want him to be unnecessarily dependent. Do not fall into the trap of thinking that is will be easier and quicker to do it all yourself. You should also be conserving your energy for other tasks.

Moderate to Maximum Assistance

This transfer technique is used when moderate to maximum assistance is required to transfer a person. e.g. they may not have control of their sitting or standing balance.

• Make sure that you have plenty of room for the transfer.
• Place the wheelchair at a little less than 90° from the surface you are transferring from.
• Make sure the brakes are applied.
• Move the person’s bottom to the edge of the surface.
• Place your arms underneath the person’s armpits and around the upper part of his back.
• He may like to place his arms around your neck, so that he feels more secure.
  Note: For the person who has had a stroke, always transfer to the stronger unaffected side as this will be easier.
• If the person has one leg which is weaker, e.g. after a stroke, position your foot in front of the weaker foot to prevent it from sliding out. The person’s knees should be positioned at 90° and his feet squarely placed on the floor.
• Count to three aloud and then lift, so that you both move at the same time.
• Gradually lift in a smooth action, encouraging the person to assist as much as possible.

Minimal Assistance/ Supervision

The person may only need a little or standby assistance to transfer. In this case, encourage him to place his hand on the armrest of the wheelchair/chair furthest away from himself. If required, the carer can assist the transfer by supporting the person with one hand around the small of his back.

For transferring in and out of the car, the person should have reasonable control of his sitting balance.

• Place the front seat as far back as it can go, to give you enough space
• Position the wheelchair at 90° to the car seat
• Encourage the person to assist you as much as he is able
• Lift the person into the car using the arm lift
• You will need to ensure that his buttocks are as far back towards the driver’s side as they can be, before lifting his legs into the car.

An alternative method is to use a transfer board. Place the board in between the wheelchair and the front seat of the car. This will enable you to slide the person from one surface to the other.

To store the wheelchair in the back of the car, remove the footrests and armrests. Apply the brakes so that the wheels cannot move and fold the wheelchair. Hold on to the wheels to lift it into the back of the car.

If you need advice, please ask your occupational therapist or physiotherapist.

There are a number of common back problems. These include:

• Disc protrusion
• Back strain - sprain and tears of the muscles and ligaments
• Osteoarthritis
• Fractures

Causes of low back pain

• Poor sitting, standing, sleeping and working posture
• Incorrect lifting method
• Loss of strength and flexibility
• Trauma e.g. Injury

Tips to Remembering when Tranferring

When caring for someone at home, it is important to look after your back e.g. when transferring or assisting with activities of daily living. It is therefore important to note the following tips:

• A few tips for you to remember when lifting and transferring so as to avoid injuring your back.
• Maintain the correct posture: Keep your back straight and knees bent and let your thigh muscles do the actual lifting
• Hold the person close to you and not at arm’s length. Move with the person as one unit
• If the person is heavy or difficult to lift, get another person to assist you or use an assistive device such as a portable hoist or transfer board
• Avoid twisting when you transfer the person, as you can injure your back
• Make sure that the person is helping as much as he possibly can. This requires team
• work and clear communication
• Consult an occupational therapist or physiotherapist on the following:
  • safe and appropriate lifting or transferring procedures
  • suitable equipment to assist you
  • advice in modifying your home.

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