For most of us, getting in and out of a chair is a task that we do often without a second thought. For an older adult or an individual with mobility issues, physical impairments, or joint difficulties, this simple task can be difficult, take a lot of energy, and sometimes even be painful.
Repetitive use of awkward postures during transfers may lead to increased risk of obtaining a musculoskeletal injury such as a back injury.
The lower the seat height of the chair we are transferring into and out of, the more effort that is required. This can be impacted further by physical impairments.
When an individual has difficulties with chair transfers, they sometimes rock to get momentum or require increased effort to get themselves out of the chair and to a standing position. When transferring back into the chair, they may not have the energy or strength to lower themselves carefully and may just drop their body weight into the chair.
For many, using these methods for chair transfers can increase the amount of energy required which decreases their endurance for other activities. They may also be at increased risk of falling, obtaining an injury during their transfers, or they may not get up as often due to the difficulty of the transfer.
Chair transfers for caregivers
It’s easy for caregivers to get into an awkward position when assisting with chair transfers due to the size or height of the furniture and the space in the area where the transfer is occurring. Repetitive use of awkward postures during transfers may lead to increased risk of obtaining a musculoskeletal injury such as a back injury.
Strategies for Increasing Safety and Independence with Chair Transfers
There are different strategies to increase the ease of chair transfers. For example, sitting in a firm, high chair with arms, using furniture risers for chairs, or adding a firm cushion that can help increase the seat to floor height of the chair. However, these may not be safe options for adapting every chair.
There are lift seats that can be placed on top of a chair. However, compatibility with the chair being used needs to be determined.
Working with a Physiotherapist to determine appropriate exercises for improving mobility and strength can also increase the ease of completing transfers. Consult with a health care professional to determine if this would be an appropriate option.
In collaboration with the involved health care professionals and caregiver(s), an individual may decide to obtain a lift chair. A lift chair has a lifting system in its base to help the individual rise from a sitting position to a standing position and back again.
Most styles of lift chairs for the home look like a regular recliner however, the chair raises while the base and the frame remain stable. Once the individual is in the chair the angle can be changed.
It is important for the caregiver and the individual who will be using the lift chair to understand their functional abilities, how they transfer, and what their needs are for the lift chair.
Consultation with a health care professional such as an Occupational Therapist or a Physiotherapist can help you and the person in your care to understand the functional mobility needs.
Sometimes lift chairs are purchased that are not the correct size for the person using the chair. It is important to have the correct lift chair size or else when the chair raises, the individual will not be in the correct position to stand or they could experience poor posture when sitting in the chair.
Some areas to consider prior to purchasing a lift chair:
How will the chair be used?
- The length of time spent in the chair
- The activities completed in the chair
- How often the individual transfers
- How often will the lift chair be used
Some individuals choose to sleep in their lift chairs. However, an individual with limited mobility or impaired skin should consult with their health care professional(s) before sleeping in their lift chair for long periods of time.
Sleeping in a lift chair may place some people at increased risk of pressure and/or shear at their coccyx. This increases the risk of pressure injuries or skin breakdown depending on the positioning and the type of lift chair used.
Lift chair positions
Lift chairs can be purchased with up to four different position options depending on the manufacturer.
Two position lift chair: The footrest moves with the backrest as it reclines to 45 degrees. This is a good chair for sitting in.
Three position lift chair: This chair reclines almost to a horizontal position (but not flat) and can adjust to any angle in between. The footrest also moves with the backrest.
Infinite position lift chair: This chair is capable of lying flat and reclining not only to a horizontal position but also to virtually any angle. The footrest moves separately from the backrest so it can be adjusted regardless of the position of the back.
Zero gravity lift chair: The backrest and footrest move independently from one another. The zero gravity lift chair will also adjust so the feet are above the level of the heart and helps to reduce lower back pressure. These chairs are not as frequently manufactured as the other lift assist chair options.
Most lift chairs come with a choice of colours and fabrics. The fabric should be chosen to meet the needs of the person in your care. For example, having a chair that fits in with the decor of the home or the individual’s preference can make it feel less like a medical device.
A chair made with washable material should be considered if the individual plans on eating or drinking in the chair or experiences incontinence.
Lift chair dimensions - size to fit the person
It is important to have a lift chair that is a proper fit for the individual using it because if it’s not, then the chair will not be functional for use and will affect transfers, positioning, and tolerance of sitting in the chair.
Depending on the manufacturer of the lift chair, most chairs are available in petite, small, medium, or large sizes.
When ordering a lift chair, you’ll want to consider the following measurements to ensure the correct chair size is selected.
Person: Measure from the user’s tailbone to the back of the knee.
Chair: Measure from the front of the seat to the back of the seat near the backrest.
Person: Measure from side to side.
Chair: Measure from one armrest to the other armrest.
Person: Measure from the tailbone to the top of the head.
Chair: Measure from the top of the seat back to the seat of the chair.
Seat to floor height:
Person: Measure from the bottom of the foot to the back of the knee.
Chair: Measure from the floor to the top of the chair seat.
When the footrest of the lift chair is extended, the individual’s heels will hang over the edge of the footrest. If the heels rest on the footrest of the lift chair, there is increased pressure on the heels and legs. When the heels are resting over the footrests, then the weight is on the calves and is distributed over a larger portion of the legs rather than just the heels.
Chair size to fit the living space
It is important to consider the space where the chair will be located and the overall width of the lift chair.
- Where will the chair be placed?
- How far will the chair be from the wall?
- What is the distance required to recline the chair?
Some manufacturers make what they call a “wall hugger” lift chair. This type of chair is made so that it does not take up as much space when reclined.
Lift chairs come with a hand control or remote with buttons to control the direction of movement plus any extra features of the chair. Most lift chairs come with the hand control located on the right side.
If the person is left handed or has a weakness in their right side that affects use of their right hand, check to see if the hand control can be switched to the left side or detached so that it can be controlled by the left hand.
Each lift chair will have a maximum weight capacity so it is important to confirm that it is compatible with the user’s weight. If the weight capacity for the chair is exceeded, damage could occur to the chair making it unsafe to use. If there is anticipation of frequent changes in weight, then this should be taken into consideration as well.
Record the height of the individual using the lift chair. There is a height rating for each lift chair with a minimum and maximize height. The height rating determines how far the chair rises. If the height of the chair is not considered, you may end up with a chair that is too short or too tall for the individual.
Some lift chairs come with extra features such as removable armrests, heat and massage, arm covers, etc. Review any extra features available and whether or not they are required for the individual using the lift chair.
Using assistive devices such as a lift chair can increase the ease of chair transfers for both the user and the caregiver(s).
Depending on the functional needs of the individual, lift assist chairs can help restore independence for the individual and decrease the energy required for chair transfers. They may also reduce the amount of assistance required by the caregiver.
If the decision to use a lift chair is made then it is important to obtain a lift chair that is the correct size for the person in your care and accurately meets their functional needs in order for the lift chair to be of benefit.
At Elizz, we provide caregiver support for you and home care services for those who depend on you. Elizz is a Canadian company powered by Saint Elizabeth, a national not-for-profit health care organization that has been caring for Canadians since 1908.