Transfers / Proper Body Mechanics 

Maintaining proper body mechanics is imperative for caregivers to prevent fatigue or injury when lifting, assisting with transfers from the bed to the wheelchair and back to bed again, or even for helping to re-position your client.

There are some general rules of proper body mechanics that will lend to preventing injuries and fatigue of the back and neck when caregivers help patients to transfer or re-position in bed. One general rule of thumb to follow as a caregiver is to consistently encourage your client to do as much as he/she can on their own.

Good Body Mechanics:  “BACK”

Balance- Feet, shoulders and hips wide apart.

Align- your back…shoulders over hips.

Contract- your abdominal muscles.

Knees- bend your knees.

Golden Rules for Transfers:

  1. Ask the person for his or her help, using simple step-by-step instructions, even if you think the person will not understand you. Allow plenty of time to respond. You should only be assisting, not doing for the individual. Sometimes, all a client actually needs is a hand on the lower back and one on the shoulder to gently guide them forward.
  2. Use transfer devices whenever possible to slide, push, and pull instead of physically lifting. You’ll have better success at not injuring yourself.
  3. Get equipment ready. Have the walker nearby or position the wheelchair close to the bed or chair and lock the wheels. If possible, remove the armrest and swing away or remove the leg rests in preparation for the transfer. Check the area for clutter on which you or the client might trip on.
  4. Use your body properly. Take in account your body type as well as the body type of your clients. Where you place your hands and your approach will differ depending on your body type and your clients. But the golden rule is – get yourself in a position that allows you to maintain a “neutral” spine. Anytime that you lose the natural lumbar curve, you’re putting your back at risk for injury. It’s the small micro traumas that develop into an injury versus just one single isolated event.
  5. Position the clients body properly. For example: For standing transfers, make sure the person’s feet are positioned slightly under his or her knees.
  6. For seated transfers, make sure your clients head/shoulders are bending away from the surface he or she is transferring.
  7. Know your clients assets and deficits. You want to maximize the person’s assets so the person is doing the most he/she can do – and you as the caregiver do the least. Keep in mind that it’s therapeutic for your client to help as much as possible because it helps the person maintain muscle strength and mobility.   For example:  If your client has a stronger left or right side, make sure to lead with that side.
  8. If your client tends to push or grab, lead with the person’s non-pushing /grabbing side or control the “pushing/grabbing arm(s)” by how you position your hands.
  9. Communicate, giving simple step-by-step instructions, especially when you’re ready to transfer. That’s why counting to three is helpful – you and your client then move at the same time.
  10. Use momentum, like rocking and counting to three, to transfer.
  11. Give the person a moment to adjust to each new position. Elderly clients react slower then we do, and rushing a person can be disastrous.

Transfer Devices:

  1. Transfer/Gait belt: Safety device used to transfer clients who are weak, unsteady or uncoordinated. The belt fits around the outside of the clothes and around the clients waist. The transfer belt gives you something firm to hold onto when assisting with transfers.
  2. Slide or Transfer Board: Can be used with clients who are unable to bear weight on their legs.  Slide boards can be used with almost any transfer that involves moving from one sitting position to another.  Make sure clients don’t use this with bare skin and that their hands and fingers aren’t under the board when transferring.
  3. Mechanical or Hydraulic Lift: Is used when a client is unable to bear weight or is overweight and is unable to be transferred using a belt or board. It allows clients to be moved with minimal physical effort. Lifts help to prevent injury to your client.