Helping someone move safely around the house

Call 911 if a fall causes a head injury, a suspected broken bone, loss of consciousness, or the person cannot be safely moved off the floor. Do not drag or lift someone who may be seriously injured.

Call your care team the same day if the person falls during a transfer, even if they seem unhurt. MedlinePlus advises contacting a health care provider if the person falls. Call the same day too if new dizziness, sudden weakness in a leg, or a change in balance is making transfers unsafe, so the cause can be looked at before the next fall.

Caregivers hurt themselves helping people move more often than they expect, and it is almost never because they were not strong enough. It is because the movement was improvised.

MedlinePlus sets out a sequence for moving someone from a bed to a wheelchair. The same principles carry over to most transfers around the house.

Before anything moves, MedlinePlus advises explaining the steps to the person, so you are both doing the same manoeuvre at the same time, and clearing anything that could be tripped over.

If a wheelchair is involved, position it next to the bed either parallel or at a slight angle, put the brakes on, and move the footrests out of the way. Footrests left in place are one of the commonest causes of a transfer going wrong.

The person needs to be sitting up before any transfer. MedlinePlus describes rolling them toward the side where the chair is, then swinging their feet off the edge of the bed and using that momentum to bring them into a seated position.

Then pause. MedlinePlus advises allowing the person to sit for a short while to prevent dizziness. Standing straight up from lying down is how people faint.

Lower the bed so their feet reach the floor. A bed at the wrong height turns a controlled stand into a drop or a haul.

Here is where your own body matters. MedlinePlus's instructions for the caregiver:

• Stand close to the person, and place their outside leg between your knees for support.
• Bend your knees and keep your back straight.
• Use your leg muscles to lift rather than your back.
• Shift your weight from your front leg to your back leg as the person comes up.
• If a gait belt is available, put it on the person so you have something to grip.

Count to three out loud so you move together, and stand slowly while the person pushes off the bed with their hands. Then pivot toward the chair, keeping your back in line with your hips rather than twisting.

As they sit, MedlinePlus suggests asking them to reach for the wheelchair armrest while you lower them by bending your knees and shifting your weight forward.

Never let the person wrap their arms around your head or neck. MedlinePlus says this directly, and it is the rule caregivers break most often.

MedlinePlus gives one instruction for a transfer that is failing: lower the person to the nearest flat surface — bed, chair or floor.

That is counterintuitive under pressure. The instinct is to hold on and pull them back upright, which is how two people end up injured instead of one person ending up on the carpet. A controlled descent to the floor is a good outcome, not a disaster.

Written steps are a starting point. If moving someone is going to be a regular part of your day, ask the care team whether a physical or occupational therapist can watch you do it once and correct you. A ten-minute demonstration prevents months of doing it slightly wrong.

Ask too about equipment. MedlinePlus is direct about the limit here: if the person cannot use at least one leg, you will need a lift to transfer them. Ask the care team what equipment suits this person and how to get hold of it.

MedlinePlus says to think through the steps before you act and to get help if you need it — specifically, if the person cannot stand, take small steps, or support their own body weight. If transfers have become the part of the day you dread, asking for a second pair of hands is the instruction, not a weakness to hide.