One of the biggest challenges as a therapist or caregiver is helping patients get out of bed. I’ve seen CNAs, therapists, and nurses injure themselves after doing something as simple as scooting a patient up in bed, assisting them out of bed, or helping them roll in bed.
For caregivers and healthcare professionals, the bed is where most injuries occur. It happens from bending, lifting, twisting, and straining our necks, arms, and back.
In this article, I’ll discuss some simple ways a patient can get out of bed and transfer to a wheelchair or toilet when they can’t walk.
#1 Sit to Stand Lift (Recommended)
If you’ve never heard of a Sit-to-stand, it’s probably one of the greatest inventions for patients who are unable to walk. It’s also one of the most underrated lift devices for therapists, CNAs, and caregivers, and it’s my number one recommended device for safe transfers.
A sit to stand lift, also known as a sit to stand aide, transport lift or stedy, is a device that helps patients pull to stand with a seat, so the patient is able to rest while being wheeled to the wheelchair or toilet.
Unlike a walker, the sit-to-stand has a grab bar, so the patient can pull themselves to stand. This makes standing so much easier, because the patient is able to pull to stand, rather than push off from the bed or walker to stand.
And it puts less stress on the caregivers back when lifting.
It’s also better than a wheelchair, because it’s easier to move around.
The sit-to-stand is also a great device, because it’s small and can fit into tight areas. It can be used to transfer on and off a toilet, bedside commode, and can be used for in the shower.
A sit-to-stand is also one of the safest ways to transfer a patient, because their knees are blocked when standing. If they do lose their balance, they will usually return to their previous sitting position in bed.
It’s the best option for any patient who needs just a little extra lift. Here’s a video to help you understand how to use a sit-to-stand manual lift.
Who should use a sit-to-stand lift?
A sit to stand lift is for patients who are able to bear weight in their lower extremities, but it can be used for patients who are only able to bear weight in one lower extremity.
It’s also for patients who need 25-75% assistance to be able to stand. This may include patients who have experienced the following injuries.
- Stroke
- Hip replacement
- Knee replacement
- Fractures of the lower extremity
Patients who would not benefit from a sit-to-stand manual lift include
- Patients unable to maintain balance to sit upright
- Require 2 person (Total) assist for sit to stand
- Unable to use bilateral lower extremities
- Non-weight bearing in bilateral lower extremities
- Unable to sit and shake hands crossing midline
- Unable to use bilateral upper extremities
- Patient with significant kyphosis
What’s the best sit to stand lift?
I prefer the Sara Stedy lift, because it can be used for small and large patients. I also like how the seat opens for larger patients or patients who have difficulty standing. I don’t like how the seat can get in the way of bed rails or bedside commode armrests, but this can be an easy fix if you have a drop arm commode.
My second option would be Lumex assist patient transport unit. The device works just like the Sara Stedy, but it’s smaller and fits in smaller bathrooms. The seat works great if your assisting a smaller patient. It’s also much more affordable.
# 2 Squat Pivot Transfer
If the patient is unable to stand or walk, they may be able to do a squat pivot transfer onto the wheelchair or commode. A squat pivot transfer requires that the patient is able to partially stand with assistance.
The caregiver or therapist can then guide them to the chair as they pivot their feet. With practice, they may be able to do this on their own. The key is being close enough to the bed, with their nose in front of their toes, so they can pivot to the chair.
A squat pivot transfer won’t work for everyone. If they aren’t able to do a squat pivot transfer, they may need a slide board.
#3 Use a slide board
If you’re unable to stand and pivot to a bedside commode or wheelchair, a slide board can help. It’s best to have help the first few times by a trained therapist.
First, make sure the wheelchair arms or bedside commode rail is down. When you start the transfer, the patient should lean to one side and place the board under their buttocks.
The other end of the board should be facing where you want the patient to be. Encourage the patient to use both hands to slide on the board. Guard the patient’s knees for support. When the patient transfers to the chair, have them lean to one side to remove the board.
Here’s a video that might help.
Conclusion
According to OSHA.gov, the most injured workers in the U.S are nursing staff. Nurses make up the majority of the population that are helping the aging population with bed mobility, and the majority of these patients are obese.
These three ways to help patients transfer can be helpful, but if you still find that you’re lifting in excess, it’s best to use a mechanical lift.
I hope this was helpful, subscribe below, and check out the posts below to learn other techniques to help patients with toileting.
How to use the toilet after a hip replacement to avoid pain and dislocation
How to use the toilet after a hand injury or surgery
David is the lead editor of OT Focus. He has been practicing as an Occupational Therapist since 2013. He specializes in acute care, hand therapy, and ergonomics.
