What Do We Mean by Transfer Safety?
Transfers, from an allied health perspective, relate to moving or repositioning the body from one surface to another. For example, moving from sitting to standing from a lounge or dining chair, getting up to standing from lying in bed, moving from standing to sitting in a car seat, getting on and off a toilet.
Improving safety during the various transfers a person performs around the home, can significantly reduce risk of falls and injury for both the person and any person assisting.
For a person with reduced mobility, this is particularly important as they may not be able to take weight through their legs effectively, they may have leg and back weakness, and may be experiencing some balance issues. Such a person may already be relying on adjacent furniture, structures or a carer for physical support the during the transfer.
It is equally pertinent for someone with cognitive issues such as confusion, memory loss, or task planning or perception issues. The person may not be fully risk aware or they may have difficulty sequencing the steps to transfer.
Things That Can Influence Transfer Safety Include:
Related to the person:
Mobility
Pain experience
Muscle strength
Fatigue (energy levels may be better or worse at particular times of the day)
Foot placement (if the person is weight-bearing during transfers)
Cognitive function
Concentration/Alertness
Effect of medication (on alertness and balance)
Related to the environment:
Floor surface (is it slippery? is it easy to distinguish from surroundings?)
Lighting (brightness of the area, any shadows cast that impede clear vision?)
Trip hazards (rugs, furniture, electrical cords, pets)
Suitability of any assistive equipment in place (is it stable, the correct height, in the right position?)
Noise (may impact concentration)
Research suggests that most falls during sit-to-stand transfers occur in the rising phase (on the way to standing) more than in the stabilisation (standing) phase of the transfer. Falls during rising tend to be backward or straight down. Falls during stabilisation are more likely to be sideways and to involve injury. During balance loss, most people tend to reach to grasp weight-bearing objects. Hence it is important to have good load bearing supports nearby during transfers if the person is at risk.
What Can You Do to Improve Transfer Safety?
Consider what kind of supports or equipment the person is currently using and are they effective? If they are not, seek input from an Occupational Therapist (OT) or Physiotherapist.
Remove loose floor mats or clutter to reduce risk of tripping or slipping.
Ensure there is good lighting in the area.
Reduce unnecessary distractions to improve concentration e.g., turn down the TV/radio.
Use simple cues and prompts to encourage the person in setting up a good position for the transfer. These may be a combination of verbal and visual cues.
How Allied Health Professionals Can Help:
An OT can advise on appropriate assistive equipment, strategies, and home modifications to help reduce falls risk for the person and reduce the risk of back and shoulder injury to carers.
A Physiotherapist or Exercise Physiologist can develop a suitable exercise program to assist the person in increasing their muscular strength and coordination and thereby improving transfer ability.
A Dietician can advise about appropriate calorie intake, nutritional needs and hydration levels which can positively impact a person’s energy and concentration.
Some solutions that our OTs have facilitated for clients have included:
Threshold ramps or platform steps to reduce step height.
Installation of load bearing grab rails at access points.
Provision of assistive equipment to improve ease and safety during transfers, such as slide boards, toilet surrounds, shower chairs, transfer benches, bed rails and transfer hoists.
Facilitation of bathroom modifications.
Education in good transfer technique and strategies relating to altering the environment or communication to improve safety.
If you think that the person and/or carer are not safe during transfers, please feel free to contact our friendly Allied Health Team to discuss the issue and for help in determining what assistance may be appropriate.
To find out more details please call 1300 657 473, or visit At - Home | Community Gateway
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