How to get a heavy person out of bed? A guide to safe transfers

According to the CDC, over 1.6 million seniors are treated in emergency departments each year for fall-related injuries, many occurring during transfers. This guide details the proper techniques and equipment for how to get a heavy person out of bed safely, protecting both the caregiver and the individual from harm.

Quick Summary

Safely transferring a heavier person from bed requires proper technique, clear communication, and often, assistive devices to minimize strain. By using your legs, maintaining a straight back, and leveraging equipment like a gait belt or slide sheet, you can execute the move securely and comfortably for everyone involved.

Key Points

• Use Proper Body Mechanics: Always lift with your legs, not your back, and maintain a straight spine to prevent caregiver injury.

• Leverage Assistive Devices: Employ gait belts, slide sheets, or mechanical lifts, especially for individuals with limited mobility, to reduce physical strain.

• Prioritize Clear Communication: Verbally guide the person through every step of the transfer to ensure their cooperation and safety.

• Ensure a Safe Environment: Before starting, clear the area of obstacles, lock the bed and wheelchair wheels, and ensure the person has non-slip footwear.

• Know Your Limits: For very heavy or non-ambulatory individuals, recruit a second person or use a mechanical lift to prevent falls and injuries.

Prioritizing Safety: Protecting Yourself and the Patient

Getting a heavy person out of bed is one of the most physically demanding tasks for a caregiver, and it carries a significant risk of injury for all parties involved. Many back injuries sustained by caregivers could be avoided with proper training, technique, and equipment. The most crucial principle is to avoid lifting with your back and instead use the stronger muscles in your legs. By treating the transfer as a well-orchestrated process, you can minimize strain, ensure stability, and maintain the person's dignity throughout the move.

Assess the Situation Before the Transfer

Before attempting any transfer, a thorough assessment is vital. Consider the person's current condition and environment. Are they able to bear any weight on their legs? Can they follow simple instructions? Is the floor clear of any obstacles? Taking a moment to plan ahead can prevent accidents.

Essential Pre-Transfer Checklist

1. Communicate clearly: Tell the person exactly what you are doing and what they can do to help. Use short, clear commands.
2. Clear the space: Remove all clutter, rugs, and loose items from the area around the bed and the destination chair.
3. Position the destination: If using a wheelchair, position it on the side of the bed that aligns with the person's stronger side. Lock the wheels of both the bed and the wheelchair.
4. Check footwear: Ensure the person is wearing non-slip socks or sturdy shoes to prevent their feet from sliding.

The Step-by-Step Manual Transfer with a Gait Belt

A gait belt is a simple but effective tool for assisted transfers. It provides a secure handle for the caregiver, preventing the need to pull on the person's arms or clothing. This method is suitable for individuals who can bear some weight and follow instructions.

1. Prepare the person: Help the person to turn onto their side, facing the edge of the bed. Roll them towards you slowly and gently. Place a gait belt snugly around their waist, over their clothes, ensuring it's not too tight.
2. Move to a seated position: With the person on their side, place one hand under their shoulder blade and the other under their knees. As you count to three, swing their legs over the edge of the bed while simultaneously helping them push up with their arms to a seated position. This coordinated movement uses momentum and protects your back.
3. Reach the edge: Gently help the person scoot towards the edge of the bed so their feet are flat on the floor.
4. Stand up together: Stand in front of the person with your knees bent and back straight. Grasp the gait belt securely. Rock back and forth a few times to build momentum, and on the third count, lift by straightening your legs while the person pushes off the bed with their hands.
5. Pivot to the chair: Once standing, pivot your feet towards the chair. Do not twist your back. As the person feels the chair behind their legs, instruct them to reach for the armrests and sit down slowly. Guide them into a comfortable, secure position.

Understanding Assistive Devices

For individuals with limited mobility or a very heavy weight, assistive devices are essential for minimizing strain and ensuring safety.

Transfer boards

These rigid, smooth boards act as a bridge between the bed and a chair. The person must be able to sit up and assist with scooting across the board. A caregiver should use a gait belt to provide support.

Slide sheets

These slick fabric sheets are placed under the person to reduce friction, making it easier to reposition them in bed or perform small transfers without heavy lifting. They can be used by a single caregiver to pull a person up in bed, or by two caregivers for a sideways move.

Mechanical lifts (Hoyer Lifts)

For non-ambulatory individuals, mechanical lifts provide the safest and most efficient transfer method. A sling is placed under the person, and a hydraulic or electric lift raises and lowers them from one surface to another. This eliminates all heavy lifting by the caregiver.

Comparison of Transfer Methods

Method	Person's Mobility Level	Caregiver Effort	Equipment Needed
Assisted Pivot	Can bear some weight, follow instructions	Moderate	Gait belt, non-slip footwear
Slide Board Transfer	Can sit up, but needs help with lateral movement	Moderate-Low	Slide board, gait belt
Mechanical (Hoyer) Lift	Little to no mobility or weight-bearing ability	Low	Mechanical lift, sling

Training and Professional Guidance

Caregivers should seek professional training whenever possible to learn correct body mechanics and the proper use of assistive devices. Physical therapists or occupational therapists can provide invaluable instruction. For more information, you can find useful resources from health organizations and caregiving specialists like the one from Verywell Health on safe lifting techniques: Learning proper techniques from professionals.

Avoiding Common Lifting Mistakes

• Never lift with your back: Avoid bending at the waist. Keep your back straight and lift with your legs.
• Do not twist: Pivot your feet instead of twisting your trunk during the turn.
• Avoid pulling on arms or shoulders: This can cause dislocations or bruising. Always use a gait belt or a proper lifting technique.
• Don't rush: Sudden, jerky movements increase the risk of falls and injury. Move slowly and deliberately.

Conclusion: Prioritizing Safety and Dignity

Moving a heavy person from bed to a chair requires preparation, proper technique, and the right tools. By prioritizing safety for both the caregiver and the individual, and leveraging assistive devices when necessary, you can make the process manageable and injury-free. Clear communication and a focus on maintaining the person's dignity are key to a successful transfer. Always remember that asking for help from a second person or a professional is a sign of good judgment, not weakness, and it ensures the best possible outcome for everyone involved.

Frequently Asked Questions

What is the most important thing to remember when moving a heavy person out of bed?

The most important thing is to prioritize safety by using proper body mechanics, engaging your leg muscles, and utilizing assistive equipment to avoid injury to yourself and the person you are assisting.

What equipment is recommended for moving a heavy person?

Recommended equipment includes gait belts, slide sheets, and mechanical lifts (e.g., Hoyer lifts) for individuals who are not able to bear weight or assist with the transfer.

What is a gait belt and how is it used?

A gait belt is a safety device worn around a patient's waist that provides caregivers with a secure handle to grip during transfers, allowing for better control and stability. It is used in conjunction with proper leg-based lifting techniques.

Can one person get a heavy person out of bed alone?

It is strongly advised to have two or more people for the transfer of a heavy individual, especially if they have limited mobility, to ensure safety and prevent injury. If no assistance is available, a mechanical lift is the safest option.

What should I do if the person starts to fall during a transfer?

If a person begins to fall, do not try to stop the fall alone. Guide them safely to the floor by bending your knees, keeping your back straight, and protecting their head. You should never risk your own health to prevent a fall.

When should I consider using a mechanical lift?

A mechanical lift, like a Hoyer lift, should be considered when the person is unable to bear any weight, when the caregiver is unable to safely perform a manual transfer, or to prevent repetitive strain injuries from manual lifting.

What is the 'log roll' technique?

The log roll is a technique used to turn a person in bed in a single unit, keeping their head, neck, and spine aligned. It is often a first step before moving someone to a seated position, and is used to prevent injury to the spine.