Repositioning in bed and lateral transfers without lifting

In one line: nobody should be lifted or dragged up a bed. Repositioning and bed-to-bed transfers are done with low-friction equipment, profiling functions and the person’s own participation — and the number of carers is decided by the task, not by habit.

Start with the bed

Most repositioning problems are bed problems. An electric profiling bed with a height range lets the carer work at the right level, uses the knee-break to stop the person sliding down, and lets a person who can push through their feet do much of the work themselves. If the bed cannot do these things, the first recommendation is usually a different bed.

Slide sheets: the method, not the object

Low-friction slide sheets convert a lift into a glide, but the technique has rules: the right size for the person and the bed; inserted and removed without rolling the person unnecessarily; the movement led by the carers’ weight transfer, not their arms; and the person told, and ideally cued, so they contribute. Where a person cannot help at all and the task is repeated many times a day, an overhead hoist with a repositioning sheet may reduce both the effort and the number of carers while protecting the skin.

Lateral transfers

Bed to trolley or bed to bed is a controlled slide across a bridge — a transfer board — with the surfaces at the same height and the brakes on. The number of handlers depends on the person’s size, ability and attachments. Air-assisted transfer systems reduce the force dramatically for larger or fully dependent people. What is never appropriate is pulling a person across the gap by the sheet they are lying on.

Skin is part of the risk assessment

Shear and friction damage happen during handling, not at rest. A person with fragile skin, moisture or existing pressure damage needs a method that removes drag entirely, and the plan should say which. If the person has a pressure-redistributing mattress, the plan should say whether it can be set firm for the task.

How many carers?

The honest answer is: it depends on the task. A person may need two for a turn and one for everything else. Our assessments list each bed task separately, with the method and minimum staffing for each, so that a package is not set at two carers because a single task once needed two.

Positioning limbs

A heavy, oedematous or painful leg is a handling task in itself. Supporting a limb for dressing or personal care may need a limb lifter, a sling or a second pair of hands. The plan should name it.