Moving From Bed to Chair: Transfer Techniques for Families

First: decide how much the person can do

Transfers depend on how much weight the person can bear and how much they can follow instructions. A physiotherapist or occupational therapist can assess this, but you can start with a simple view:

• Independent with supervision. Can stand and pivot with no or little help, but needs someone close for safety.
• Needs some help. Can bear weight on at least one leg, can follow instructions, but needs steadying, a belt or a cue.
• Needs a lot of help. Can bear little weight; needs one or two trained people or equipment such as a sliding board or hoist.
• Cannot bear weight. Needs a hoist or a full-lift technique by trained staff.

Weakness can vary through the day, and from week to week, with pain, medicines, fatigue and illness. Check each time: can they stand today?

Set up before every transfer

1. Explain what you are going to do, and agree the signal, for example "ready, steady, stand". 2. Choose the destination and place the chair, wheelchair or commode close to the bed, at about 45 degrees to it, on the person's stronger side, with the seat facing the direction of travel. See wheelchair buying guide and commode chair guide. 3. Lock the brakes on the wheelchair and the bed. Fold or swing away the footrests of the wheelchair. Remove armrests if they swing away. 4. Set the heights. The bed should be about level with the chair seat, or slightly higher, so the person moves downhill. A height-adjustable bed makes this easy; see bed height and getting out of bed. 5. Clear the floor. Remove rugs, slippers, cables and clutter. Make sure the floor is dry and not slippery. 6. Position the person on the edge of the bed, with feet flat on the floor, slightly apart, and knees bent. Ask them to sit for a minute to avoid dizziness; see dizziness and low blood pressure when standing. 7. Footwear. Put on non-slip shoes or slippers with a back, or grip socks. Bare or sock-covered feet on polished floors are slippery. 8. Check equipment such as the transfer belt, sliding board and walking aid; see how to use a transfer belt. 9. Check yourself. Wear sensible shoes, tie back long hair, remove dangling items and take off a watch. 10. Have a plan if the person starts to fall: do not try to hold them up; lower them to the floor; see what to do after a fall.

Technique 1: stand and pivot (for those who can bear weight)

This is the most common transfer, suited to people who can stand briefly on one or both legs.

1. The person sits on the edge of the bed, feet flat, slightly back so the heels are under the knees, and the stronger leg slightly behind the weaker. 2. The carer stands in front and slightly to the weaker side, feet apart, knees bent. If a transfer belt is used, it is fastened snugly around the person's waist over clothing, and the carer holds it firmly with an underhand grip. 3. The person leans forward, "nose over toes", with hands on the bed or the carer's forearms, not around the carer's neck. 4. On a count of three, the person pushes up with their legs and arms while the carer guides and supports, not lifts. 5. Once standing, the person pauses to steady themselves. 6. The person takes small steps to turn, or pivots on the stronger leg, until the back of their legs touches the chair. 7. They reach back for the chair arms and lower slowly, while the carer controls the descent, bending their own knees. 8. Adjust the position, hips well back in the chair, feet on the footplates or floor.

For a person with one weak side, such as after stroke, the transfer is usually made towards the stronger side; see bathroom safety after stroke and stroke recovery at home guide. Do not pull on the weak arm.

Technique 2: belt-assisted transfer

A transfer belt (also called a gait belt) is a strong belt with a buckle, worn around the waist. It gives the carer a safe hold, instead of grabbing under the arms or on clothing. See how to use a transfer belt.

• Fit it snugly over clothing, at the waist, with room for two fingers under it. Not over the ribs or stomach, and not over a stoma or wound.
• Hold with an underhand grip on each side or at the back.
• Use it to steady and guide, not to lift the person's whole body weight.
• Do not use a belt on someone with certain abdominal, heart, lung or back conditions without advice.

Technique 3: sliding board (for those who cannot stand but can sit)

A sliding board is a smooth, sturdy plank that bridges the gap between bed and chair. The person sits on the board and slides across by shuffling or being guided, without standing.

1. Position the chair next to the bed, with brakes on and the near armrest and leg rest removed or swung away. 2. Help the person lean away from the chair, and slide the end of the board under their buttock, with the other end on the chair seat. 3. The person leans forward and moves in small steps across the board, while the carer guides at the hips or belt. 4. Once seated in the chair, lean the person away the other side, remove the board and adjust position.

Sliding boards need adequate sitting balance and some arm strength. They are not for people who cannot sit unsupported. A therapist should teach the technique.

Technique 4: sit-to-sit transfers with slide sheets

Slide sheets are low-friction sheets that reduce drag when moving a person up the bed or across a surface. They help with repositioning and, with training, short transfers. See turning a bedridden patient.

Technique 5: hoist transfer (for those who cannot bear weight)

A hoist is a lifting device with a sling that lifts a person from bed to chair. It protects the person and the carer. Hoists can be mobile (floor) hoists, or ceiling track hoists. They need space, training and the right sling. A hoist is advisable when the person cannot bear weight, is heavy, or when carers are at risk of injury. Ask an occupational therapist or nurse to assess and train you, and see hospital room at home complete setup for equipment planning. Never improvise a hoist or use one without training.

Special situations

• Parkinson's disease. Freezing and slow starts make standing hard; cues like counting help; see bathroom safety for Parkinson's disease and Parkinson's freezing and falls.
• Hip or knee replacement. Follow the surgeon's movement rules, which may include avoiding deep sitting or twisting; see bathroom setup after hip replacement.
• Dementia. Explain simply, use gentle cues and consistent words, allow time; see dementia communication tips.
• Painful joints. Pre-medicate if the doctor advises, and allow slow movement.
• Heavy person. Use equipment and more than one trained person.
• Catheters and tubes. Move bags first and keep them below the bladder.
• Pressure-relieving mattress. Edges may be soft; the person may sink; ask a nurse how to transfer from an air mattress.
• Bedside commode. Place it at the right side, with brakes on; see night toileting from the bed.
• Car transfers. See getting an elderly person in and out of a car.

Common mistakes

• Pulling the person up by the arms or under the armpits, which can injure shoulders.
• Letting the person put their arms around your neck.
• Lifting with a rounded back.
• Not locking the brakes.
• Placing the chair too far, forcing a long pivot.
• Standing in front without a plan if the person falls.
• Doing the transfer in a hurry.
• Transferring from a bed that is too low, or a chair that is too soft.
• Ignoring dizziness.
• Carers working alone with a person who cannot bear weight.

Protect yourself

• Keep a wide stance, knees bent, back straight.
• Keep the person close to your body.
• Avoid twisting; move your feet.
• Use equipment.
• Ask for help.
• Rest between tasks.
• If you have pain, stop, and see a doctor.

See how to lift and transfer safely, caregiver burnout signs and prevention and sharing care among siblings.

When to ask a professional

A physiotherapist or occupational therapist can assess how much weight your parent can bear, show you the best technique, advise on belts, boards and hoists and teach you to protect your back. A nurse can show transfers with tubes, catheters or pressure care. Ask a doctor about sudden loss of ability, falls, pain or dizziness. Contact emergency services after a fall with injury or head strike.