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Transportation Solutions for Caregivers: A Starting Point

Providing Physical Assistance

| Introduction | Communication | Sensitivity | Preventing Agitation | Dealing with Agitation | Transportation Review | Providing Physical Assistance | Resources for Caregivers

Whether helping your loved one into the car, transferring from a wheelchair to the car, or handling a wheelchair (or other device such as a walker), it is important to use proper body mechanics. Most muscle strain injuries to both the caregiver and care receiver are preventable.

Body Mechanics

• Plan the lift -- check the area for slippery spots or possible tripping hazards. Wearing appropriate footwear, non-skid heels and soles will be safer for both you and for the person whom you are assisting.
• Use proper stance -- spread your feet to a width that feels comfortable to you, usually shoulder’s width apart.
• Keep your head and upper body as upright as possible.
• Lower your hips to the height of the object you intend to lift by bending your knees and hips rather than your back.
• Carry weight as close to your center of gravity as possible.
• Get close to the object you plan to lift. Bear weight  on your forearms rather than your hands.
• Lift with your legs.
• Do not attempt to lift with your back alone.
• When lifting, do not rotate your spine; shift the position of your feet to turn (pivot).
• Know your limits.
• Push or pull an object instead of lifting whenever you can.

Wheelchair Transfers

When transferring and positioning from a wheelchair to a car:

• Have the person you are helping wear a gait belt, if one is available.
• Open the car door.
• Stand with your back to the inside of the car door and pull the wheelchair toward you -- between the car door and seat.
• Talk your loved one through the transfer process step by step so that he can assist if possible.
• Hold on to the gait belt and help him to a standing position -- using your legs to pull up for strength.
• Have your loved one lean weight forward toward you and put his arms around your shoulders (not your neck), if possible.
• Carefully pivot yourself and your loved one so that his backside is toward the inside of the car.
• Help him sit on the seat with his legs still out of the car -- be careful that his head clears the door frame while he is sitting down.
• Once sitting and given a moment to gain balance, help move his legs into the car (a swivel cushion is helpful for this).
• Assist with the seat belt and close the door before going to the drivers seat.

Positioning

Make certain that your loved one’s seat belt is securely fastened while in transit and that he does not unfasten it until the vehicle has come to a complete stop. Provide assistance when he enters or exits the vehicle, but do not make him feel rushed. Give your loved one extra time to do what is needed.

If your family member has had a stroke and has right-sided or left-sided hemiplegia, weakness or neglect, seat his affected side nearest the door (i.e., if left-sided weakness, seat on driver-side of back seat). This can aid with balance and allows you to position the weak side into the car and also encourages your loved one to assist. The seat belt with shoulder strap can be of great help with balance in the back seat. It may also be beneficial to keep a pillow in the car for positioning.

It can be difficult to assist someone who has had a stroke or has limited movement or understanding to get positioned comfortably in the car, especially if he cannot assist. A few helpful ideas:

• Have your loved one wear a gait belt for a secure place for you to hold while assisting.
• Use a swivel cushion to make it easier to swing his legs in while in a sitting position on the car seat.
• Place a towel on a plastic bag on your cloth seat or directly on your leather seat. Then, help your loved one sit on the towel covered seat. Next, go to the other side of the car and pull the towel toward you to slide him further into the car. Finally, pivot his legs into the footwell of the car.

The National Center on Senior Transportation is funded through a cooperative agreement with the U.S. Department of Transportation, Federal Transit Administration and with guidance from the U.S. Administration on Aging. NCST is administered by Easter Seals Inc. in partnership with the National Association of Area Agencies on Aging (n4a).