Guide to Making Safe Wheelchair Transfers

Master your wheelchair not your life. Wheelchair transfers are a skill that can increase independence and safety for wheelchair users. Whether you’re a new wheelchair user, a carer or just want to improve your transfer techniques this guide will walk you through everything you need to know about safe and effective wheelchair transfers.

Transfers aren’t always easy and there’s no one size fits all. Each wheelchair user is different, with different abilities, strengths and needs. The good news is with proper technique and practice most transfers get easier over time.

What are Wheelchair Transfers?

Wheelchair transfers refer to the process of moving from a wheelchair to another surface (bed, toilet, car seat, shower chair) and back again. These are fundamental daily activities for wheelchair users and require strength and coordination.

Key Requirements for Transfers

Two essential components make wheelchair transfers possible:

1. Strength - particularly in the upper body and core

2. Coordination - the ability to time and sequence movements

Depending on your abilities you may be able to do transfers independently or may need assistance from a carer or family member.

The Basics: Steps for Safe Transfers

Whether transferring to or from a bed, toilet, shower chair or vehicle the principles are the same. To transfer safely, follow these important steps:

1. Move your wheelchair as close as you can to where you're transferring to

2. Make sure the wheelchair brakes are securely locked

3. Move footplates out of the way (flip up or to the side)

4. Consider using a gait belt for extra support if assistance is needed

5. Keep a natural curve in your back to reduce injury risk

6. Keep 90 degrees at both hips and knees if possible

Solo Transfers

If you have enough upper body strength and mobility you can do solo transfers with practice. Here’s a step-by-step guide to using it:

Using a Transfer Board

One trusted way to make transfers easier is with a transfer board. This tool—often called a sliding board—creates a supportive link between your chair and where you're going, so you can slide instead of lift.

1. Start by positioning your wheelchair at a slight angle, as close as you can to where you're moving to

2. Lock the brakes to keep the chair steady

3. Gently slide one end of the transfer board under your thigh and place the other end securely on the surface you’re moving to

4. Use your arms to push yourself up slightly and slide across the board to your destination

5. Remove the board once in position

Transfer boards are great for those with limited strength or transferring to surfaces that aren’t at the same height as the wheelchair.

Direct Transfers Without a Board

With time and good upper body strength, you might find you don’t need a transfer board at all:

1. Move your wheelchair close to the surface, leaving as little gap as possible

2. Lock the brakes to keep things steady

3. If you’re able, place your feet flat on the ground—not on the footrests

4. Push up from the wheelchair seat using your arms (like a pressure relief push-up)

5. Pivot your body towards the surface

6. Lower yourself down safely onto the new surface

This requires good upper body strength and balance. With regular practice the muscles used for this movement will strengthen over time.

Assisted Wheelchair Transfers

When assistance is needed clear communication is key. Before you start explain to your helper exactly how you plan to move and what help you need from them.

Common Assisted Transfer Methods

From Behind:

1. The assistant stands behind the electric wheelchair

2. They reach over the backrest and provide lift support under your seat

3. They may hold onto a gait belt, belt loops or waistband to help with turning

From the Front:

1. The assistant stands in front of the wheelchair facing you

2. You lean forward slightly into them during the transfer

3. They provide lift support by holding a gait belt, belt loops or under your hips

For more complex transfers two assistants may be needed—one handling the upper body and one supporting the legs.

Specialised Transfer Scenarios

Floor-to-Chair Transfers

Finding yourself on the floor is a common occurrence for many wheelchair users. Getting back into your chair requires specific techniques:

1. Move your wheelchair close and lock the brakes

2. Remove any cushions that might make the seat unstable

3. Position yourself facing the chair

4. Use your arms to lift your buttocks onto the wheelchair seat (there are several ways depending on your strength and flexibility)

This is a tricky transfer to practice with a therapist before trying alone. The technique will depend on your individual abilities and strengths.

Car Transfers

Getting in and out of a car can be especially challenging because of the height difference and the tight space to manoeuvre. The basics are:

1. Position the wheelchair at an angle to the car seat

2. Lock the brakes

3. Remove or swing away any parts of the wheelchair that might get in the way

4. Transfer into the car seat using either a board or direct transfer method

5. Once seated bring your legs into the carMany wheelchair users find it helpful to have someone assist with car transfers when first learning. With practice many people can transfer independently.

Tips for Easier and Safer Transfers

• Build strength through regular exercise targeting core and upper body muscles

• Practice regularly to improve technique and build muscle memory

• Use the right equipment like transfer boards or gait belts when needed

• Wear the right clothes that won’t catch or bunch during transfers

• Make sure surfaces are stable before you transfer

• Consider the height difference between surfaces and adjust when you can

• Take your time don’t rush transfers

• Learn from the experts like occupational therapists who can teach you the proper technique

When to Get Help

See an occupational therapist or physiotherapist if:

• You’re new to using a wheelchair

• You’ve had a change in physical ability

• You’re struggling with certain types of transfers

• You need to learn new transfer techniques

• You or your carers need guidance on assisted transfers

They can give you personalised advice based on your individual needs and abilities.

Resources

There are many great videos out there that demonstrate different wheelchair transfer techniques. Watching these can be a great visual aid to go along with written instructions. Look up videos that match your specific type of transfer—whether it’s from bed, into a car, or something else.