How to Lift and Transfer a Parent Safely (Without Injuring Your Back)

The golden rules

1. Never lift a person's full weight by yourself. If the person cannot bear weight or help at all, use equipment and a trained second person, or do not move them without professional advice. 2. Encourage the person to do as much as they safely can. Independence keeps muscles working. Use the fewest helping hands needed. 3. Never pull on arms, shoulders or clothing, or lift under the armpits. This can injure shoulders and skin, especially after stroke or in fragile skin. 4. Prepare before you move. Most injuries come from rushing. 5. Explain each step and agree on a signal, such as "ready, steady, stand". 6. Stop if something hurts, if the person feels faint, or if you feel strain. Lower them safely to a seat or bed, and reassess. 7. Never leave a person who might fall unattended in a standing position. 8. If someone has fallen, do not try to lift them yourself; see what to do after a fall and how to get up after a fall.

Step one: assess before every move

Ask yourself quickly:

• The person: Are they alert and able to understand and cooperate? Can they bear weight on both legs? Any pain, dizziness, breathlessness, new weakness or confusion today? Any recent surgery, fracture or stroke with movement restrictions? Is the skin fragile? Are there tubes, drains or a catheter? Is blood pressure likely to drop on standing?
• Yourself: Are you well, rested and free of back, shoulder or knee pain? Are you wearing sensible footwear and clothing that lets you move?
• The task: How far is the move, and what is the surface? Is the bed too low or high? Is the chair stable and has arms? Are wheelchair brakes working?
• The space: Is the floor dry? Are rugs, cables and clutter removed? Is there enough room to turn?
• Help and equipment: Do you have a second person? Are aids ready?

If the answers raise doubts, stop and get advice. A person who suddenly cannot bear weight, is newly confused, has chest pain or feels faint needs medical attention rather than a transfer. Call 112 for emergencies such as collapse, chest pain, signs of stroke or a suspected fracture after a fall.

Step two: prepare the space

• Clear the area of rugs, footstools, cables and furniture.
• Position the chair or wheelchair at a slight angle to the bed (about 30 to 45 degrees), on the person's stronger side where there is one.
• Lock the brakes on wheelchairs and commode chairs, and fold or swing away footrests; check that the chair will not slide.
• Adjust the bed height so that the person's feet are flat on the floor and their knees are at about a right angle; a bed that is too low makes standing very hard; see hospital bed at home guide and bed rails guide.
• Check the floor is dry and non-slip; avoid socks on tiles; see choosing shoes for older feet.
• Make sure lighting is good, particularly at night.
• Use firm, stable furniture, not wobbly stools or soft sofas.

Step three: protect your own body

You cannot help anyone if you are injured.

• Stand close, feet shoulder-width apart, one foot slightly ahead, knees soft. A wide base keeps you stable.
• Keep your back straight. Bend your knees and hips rather than your spine; hold the person or the aid close to your body.
• Avoid twisting. Turn your whole body by moving your feet.
• Use your legs, not your arms and back, to provide force; rock gently on count of three to build momentum.
• Breathe out as you move, rather than holding your breath.
• Do not lift above shoulder height or stretch awkwardly.
• Work at a good height. Raise the bed to waist level for care tasks such as washing and dressing, then lower it before the person gets up.
• Pace yourself. Alternate heavy tasks with lighter ones; take breaks.
• Know your limit. If you feel strain, stop.

Simple transfers, in principle

These are outlines, not a substitute for being shown. Ask a professional to observe and correct you.

### Sitting to standing, from a chair or bed edge

1. Position the person at the front of the seat, feet flat and slightly back, shoulder-width apart. 2. Ask them to lean forward, nose over toes, and place their hands on the chair arms or on their thighs (not around your neck). 3. Stand in front, slightly to the weaker side, with your knees blocking theirs if they need support and your hands in the way you have been shown, for example on a transfer belt at their waist or hips. 4. On "ready, steady, stand", they push up with their legs while you guide them forward and up. 5. Let them stand for a moment to check for dizziness before they walk or turn.

### Standing to sitting

1. Back the person up until they feel the chair against the back of their legs. 2. Ask them to reach back for the arms of the chair. 3. They bend knees and hips and lower slowly while you guide them. Avoid a sudden drop.

### Bed to chair or wheelchair (a pivot transfer)

1. Sit the person on the edge of the bed with feet flat on the floor and the chair close, angled and braked. 2. Stand them as above, then turn their feet, pivoting on the stronger leg, until the back of the legs touches the chair. 3. Lower them slowly and check their position, hips well back, feet on footplates or floor.

### Moving up the bed or turning in bed

This calls for a draw sheet or slide sheet and often two people, not pulling the person by the arms; see turning a bedridden patient and positioning a bedridden parent.

### Toilet, commode and bathroom

Bathrooms are wet and tight. Use grab bars, a raised seat, a commode, a bath transfer bench or a shower chair; see bath transfer bench guide, bathing safely with a shower chair and commode chair cleaning and hygiene. Never let a person hold a towel rail or sink for support, since these can come away from the wall.

### Car transfers

Park on level ground; recline the seat; have the person sit first, then swing legs in together; protect the head. Ask the physiotherapist to demonstrate.

Aids that help

• Transfer belt (gait belt): a belt with a firm grip, fitted around the person's waist over clothing, gives you a safe handle to guide movement. It should not be used on someone with certain abdominal or chest conditions without advice, and should be fitted snugly as shown. See how to use a transfer belt.
• Slide sheets: reduce friction when moving in bed.
• Transfer or slide boards: bridge a gap between bed and chair for some people.
• Bed rails and handrails: give the person something to hold; make sure they are fitted correctly and used on advice, since gaps can trap limbs; see bed rails guide.
• Raised seats and chair risers: make standing easier.
• Wheelchair and commode: safe, braked and correctly sized; see wheelchair buying guide.
• Hoists or lifts (mechanical): for people who cannot bear weight, with training; ask the physiotherapist and the supplier.
• Non-slip footwear and mats.

See bed transfer techniques.

Special situations

• After a stroke: the weaker side needs protection; never pull on the weak arm; move toward the stronger side where advised; see caring for a parent after a stroke.
• Parkinson's disease: freezing and slowness need patience and cues; see parkinsons freezing and falls.
• Dementia: explain simply, keep calm, avoid sudden moves; see dementia communication tips.
• After hip surgery or fracture: follow the surgeon's movement restrictions exactly; see hip fracture recovery at home.
• Very heavy or very frail person, or one who resists or is in pain: seek professional help and equipment rather than a heroic effort.
• Skin and bones: older skin tears and bones fracture easily, so handle firmly but gently.

When the person starts to fall

Do not try to catch them. A person who is going down is too heavy to stop. Guide them gently to the floor, protecting their head, or ease them onto the nearest seat or bed. Protect yourself. Then follow the fall steps and call for help.

When to ask a professional

A physiotherapist or occupational therapist can assess your parent and teach safe, hands-on techniques at your home. A trained nurse can show care tasks such as turning and bed transfers. A doctor should review new weakness, pain or dizziness. A supplier can explain aids, but ask a professional which suit your parent. In an emergency, call 112.