Loss of muscle strength, range of motion or flexibility, coordination or cognition may result in difficulty independently moving and transferring oneself. We often take for granted the number of times we change position throughout the day. Rolling over in bed, getting in and out of the car or bath, on and off the toilet or different seated surface can pose a significant challenge for anyone with a mobility impairment.
Injuries can easily occur during these transitions both to the person trying to transfer and to those trying to assist. Poor body mechanics and insufficient tools can cause back or other injuries when attempting to help someone reposition and falls can happen if someone doesn’t have the support they need. Falls are a serious cause of injury and death, especially among the elderly. In the U.S. in 2018, one in four adults reported falling resulting in 88 deaths per day amongst older adults . In fact the CDC predicts the number of yearly falls will increase from 36 million to 52 million by 2030. The medical costs for falls alone reached over $50 billion dollars and there is a high risk for increased morbidity after each fall (Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2020).
Luckily, an entire industry of adaptive equipment has been created to assist you in maximizing both success and safety during transfers. Check out some of the helpful devices and examples below and know that this is by no means an exhaustive list, but a place to get started.
**IMPORTANT DISCLAIMER: this information is meant to alert you to the equipment that exists to help you but is not intended as a training module to use it safely. Please contact the manufacturer of each device or a qualified therapist to help you select devices most appropriate to you and to teach you how to use it safely.
**This post may contain affiliate links from Amazon Associates or other affiliate programs through which I may earn a portion of qualifying purchases
If you’ve ever spent any time in the hospital you have likely seen the yellow bands adorning the wrists of many patients. “Fall Risk!”, they shout at any staff or passersby. Somewhere along the lines some crafty individual figured out that if we could just hold onto these folks we could hopefully avoid any untimely collisions with the floor and thus the gait (transfer) belt was born.
These belts secure around a person’s waist, or in certain circumstances when that area is unavailable, around the upper chest and provides a place for a caregiver or attendant to grasp the person and both steady them and provide a point of leverage to help with transfers. The Cloth Gait Belt secures around the torso and is secured with a buckle mechanism that consists of teeth to hold the belt securely in place. These can be easy to locate but not necessarily easy to clean.
Another option is the wipeable gait belt made of vinyl material that can be easily sanitized. This is an obvious benefit and may be best in some occasions. You can purchase one with a plastic clasp or metal teeth. I tend to prefer the metal teeth over the plastic clasp as I find it can be difficult to pull the belt tight enough and secure it using the plastic clasp.
Finally, we have looped transfer belt which is constructed with a serious of loops attached along the length of the belt to allow a caregiver or family member to provide assistance with scooting, standing or transferring from, for example, a wheelchair.
A simple yet genius piece of equipment. The transfer, or slide board as it is sometimes called, is typically a rectangular or oblong piece of wood or other plastic that helps to cover the gap that exists between two transfer surfaces. The space between the seat of a wheelchair and the seat of a toilet has never looked so vast until you are attempting to scoot over there and your legs aren’t helping much.
Transfer boards come in various sizes and shapes but the basic concept remains the same. The board is somewhat slick to allow a person to slide more easily across its surface. It prevents the need to fully stand up and allows even persons with no functional use of their lower extremities to move between surfaces. One end of the board sits on the surface you are moving to and the opposite end get’s tucked under your bottom. If you have one of those fancy gait belts on someone can even help you to scoot across it.
One piece of advice, (don’t ask me how I learned this the hard way) as tempting as it may be, do not loop your fingers through the handy dandy hand hold opening on the end of the board that you are sliding toward. Though it seems like a great way to get a firm grip, undoubtedly as your weight shifts onto that side of the board you will only succeed in smashing your fingers beneath the weight of your body. Just. Don’t. Do it.
Much like the transfer board, the transfer sheet is a slippery piece of material whose primary goal is to move a person from here to there. These devices are primarily used to help reposition a person in bed without having to lift them.
In one version of the transfer sheet there are actually Two sheets stacked on top of one another which are placed beneath the person by rolling them onto their side and tucking it underneath. By grasping the top sheet one can reposition the person on the bed as the top sheet slides easily across the bottom sheet thus reducing friction.
The second option is a Single transfer sheet with handles. This typically consists of a single sheet but is also placed beneath the person and used to more easily slide them laterally or up and down on the bed.
Depending on the person and the device you may find it easiest to have a second person available to help.
A transfer disc or pivot disc allows a caregiver to transfer a patient between surfaces without them needing to take a step. Picture a lazy susan that you would put on the dining room table and spins 360 degrees to give everyone access to the goodies. Instead of on the kitchen table, however, this device sits on the floor in front of the person transferring and their feet are placed on the disc. As the person stands (partially or fully) the caregiver can direct the person’s hips toward the adjoining surface and their feet will simply come along for the ride as the disc turns. As one can imagine this device may pose a risk for falls if one does not control the transfer well so this is a good one to practice with the help of a trained professional first!
Mechanical lifts come in many forms and brands. These are large in-home devices that typically consist of some sort of sling that is placed under the person being transferred which is then attached to a lift device overhead. The mechanical lift then raises the person up into the air and the device can be turned or moved throughout the house to reposition the person elsewhere such as in a chair or bed. As you can imagine these devices are costly, take up quite a bit of space and require appropriate training to use safely but some insurance plans may pick up all or part of the cost of the device and can make the difference between someone living comfortably with their loved ones in their home or in a skilled nursing facility. For insurance authorization a physician’s prescription is most likely always necessary. Make sure to do your research or talk with a DME company to determine which device is appropriate for you.
These devices are appropriate for individuals that require more than 75% assistance for transfers or who aren’t able to safely or effectively bear weight through their legs. Here are several examples of mechanical lift devices and you can click on them to see these devices and similar ones in detail.
Stand Assist Devices
The final device we are going to talk about today is a category of equipment called a stand assist device. These can be electric or manual and provide assistance to pull a person up into standing. The manual devices such as the Lumex Stand Assist Patient Transport Unit roll in close to the person and provide a set of handles from which they can pull themselves into standing and block the lower legs to keep the knees from buckling. Typically, some type of seat is available to flip behind them and then they can rest into the seat. These devices are on wheels so once the person is secured in the device it can be moved throughout the home as necessary. The electric devices look similar in design except a sling is placed behind the individual and the electronics of the device lift the person into standing for those that do not have the strength to pull themselves up. These devices may also be covered by insurance and would need a prescription from a physician. For an example, check out the Graham-Field Lumex Sit-to-Stand Battery-Powered Patient Lift
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. “STEADI—Older Adult Fall Prevention.” Centers for Disease Control and Prevention, 2020, https://www.cdc.gov/steadi/. Accessed 16 10 2020.