Transfer Techniques: Moving Safely At Home

The independence you gain from being safely mobile, with or without a walking aid, brings a significant level of freedom; the freedom to choose where you want to meet friends, how far you want to travel or when to pop to the shops. It can frequently also be a deciding factor in whether you need the help of a carer at home.

Mobility as a Secondary Aspect of Independence

But did you know that mobility is actually a secondary aspect of independence? As infants we learn to roll, sit up and crawl before we walk. These foundational skills strengthen our cores and help us develop coordination and balance. But as we develop, the environments we’re in become just as important, either hindering or facilitating transfers.

If unstable, poor transfers can lead to falls and accidents in the same way poor mobility can.

We’ve all felt it!

Whether or not you have a disability, an injury or class yourself as fully able, you will likely still have noticed how different it feels getting off of the low-level camp bed in the caravan to your own divan with firm mattress, or rising from your friend’s futon against the ease of standing from the 3 piece suite! This is because transfer heights and surfaces dramatically affect the effort and skills needed to move.

The Challenge of Transfers

The techniques needed to transfer will depend significantly on your starting position and your destination as well as your functional abilities, but as a general rule, the lower and softer the surface, the more challenging a transfer will be.

Using your upper body to help any standing, whether from a chair, toilet or even transferring down a step, can significantly ease the strength needed from your legs. Using a dining chair with arms or an armchair instead of a sofa could be the subtle change you need to stay independently transferring from seated, but if you still struggle, a well-placed grab rail could help give you the lift and stability you need. Whether a permanent rail like the traditional chrome grab bar or a temporary suction style rail, the ease they can bring to otherwise painful or unstable transfers can be pretty liberating!

Transfers Without Standing

However, transfers do not always have to involve standing. If you have had surgery and are advised to be non-weight bearing on a leg, are a lower limb amputee, have back and spinal problems, or even neurological problems, you may find the ability to stand at all is too difficult. In these situations, you may be strong enough to use your upper limbs to take your weight, allowing you to lift your sacrum and ‘bounce’ yourself from, say, a wheelchair to a bed or chair.

But if you have additional injuries or conditions that affect your arms and shoulders, this may be impractical and could exacerbate your health issues further. In this case, a simple but extremely effective transfer board such as the Moov board could be all you need.

Can't Stand? Try a Slide Transfer

The principle of these boards involves a gliding technique to perform a lateral transfer, meaning minimal weight is passing through your arms and legs. As long as you have good sitting balance and trunk control, this simple device could keep you independent getting into a wheelchair, bed, or even onto a toilet. However, ensuring you start and final destination surfaces are at equal heights is quite integral to the success and effort of the transfer, so it’s worth taking a quick measure of your furniture before deciding if this is for you.

Do also consider your room layout, as you’ll need to be able to place your furniture items closely beside each other to use a transfer board safely. Depending on your abilities, it may be really useful to consult a Physiotherapist or an Occupational Therapist to advise on the techniques that would optimize your use of a transfer board, as positional changes and the use of additional small aids can make significant improvements to your overall independence.

Want to Stay on Your Feet?

In some situations, you may find you can stand but not for long, or in the case of some people with neurological conditions, including Parkinson’s, you may be able to stand but then unable to step around to your destination.

Whenever you can stand, it’s generally a good idea to do so as it helps reduce pressure risks and encourages maintenance of core strength, but if you need help to move, the safety of your carers is just as important as yours. It’s for this reason I love standing turner transfer aids.

The Orbi turn is one such example. These turners not only give you the freedom to ‘swivel’ around to your destination but protect the person helping you as they do not have to take your weight. With back problems highly prevalent in many carers, a standing turner can be a win-win for both you and your helpers. They are equally helpful if you struggle to stand, as unlike walking frames, you can safely pull up on these turners, using your upper body strength to help you rise up. Just make sure you only ever do this when a second person is standing on the brake!

And please do not be tempted to use this as a mobility aid – the wheels are simply there to roll the equipment into storage or closer to you before use and should never be used to transport you. Instead, grab a wheelchair, a tandem frame, or even a shower chair for a quick and safe move between rooms indoors.

Keeping Safe Indoors

When it comes to the smaller rooms in the house, transfer risks can be increased, particularly in bathrooms which are full of slip hazards. Baths are a challenge to transfer in and out of! Requiring good flexibility and balance to step in, and much strength to rise out, it’s commonplace to have rails dotted around the walls for reassurance, but what happens when your arthritis won't let you lift your leg over the bath edge anymore or worse still you’re getting stuck in it?

Equipment can still help! From seated transfer boards, such as the Ariel Adjustable Bath Board, to sliding and swivel boards, there are still ways to safely transfer into the bath. Primarily, these items allow you to sit and swing your legs over, removing any fear of the wobbles as you balance on one leg to step in. Then scooting yourself to the center of the board, you have the choice to stand and remove the board, giving space to sit down and immerse yourself in the water, or simply stay seated and use long-handled sponges and brushes to complete your routine.

However, if your seated balance is poor or you simply feel nervous of the sliding motion of a swivel seat design, the sliding chair may be more beneficial due to its full-body support. The inclusion of a caddy is an excellent idea, keeping all your washing items within arm's reach while on the chair, meaning you avoid any unnecessary hazardous twisting or bending.

If you still feel unable to get down to the base of the bath, a bath lift may offer the independence you need with bath transfers. With the Heben Bathlift having a similar slide assist function to the Bathmate bath board, its ease of use means it often gets my recommendation.

Don’t Let Your Struggles Make You Unsafe

Falls can be devastating and can often be the result of a struggle standing from seated or rising from a bed. If equipment can increase the safety or confidence of your transfers, or reduce your dependency on others, it’s certainly worth considering further. Staying in one position for more than a few hours can be seriously detrimental to your physical health, so being able to change your position or stand even just for a few seconds can still be a great proactive and preventative measure.

Whether you stand, pivot, slide, or even get lifted in a hoist, with the right equipment, the ease and safety of your transfers could be greatly improved, keeping you more independent for longer. But such a wealth of choice can lead to confusion, so please do always consult any instructions or guidance that comes with the transfer aid. Better still, consult an equipment specialist or health professional before making a purchase, or visit a store and try everything for yourself first. You’ll be surprised at the independence the right item can give you!