How to transfer from wheelchair to toilet

Setup

As with any transfer, the environment must to be set up appropriately beforehand for successful completion. Transfers between level surfaces tend to be easier to perform. To perform a true pivot transfer, the two surfaces should be adjacent to each other so that no steps need to be taken. The floor should be dry and clear of obstacles to prevent slips and trips.

• Position the wheelchair directly next to the surface (bed, toilet, tub bench, car, sofa, etc.). A slight angle of 30-45 degrees is helpful but not absolutely necessary. 
• Lock the wheelchair brakes and move the footrests out of the way of the feet. The armrest on the side you will be transferring to can also be moved out of the way if desired.
• Always talk to the person being transferred so that assistance is being given at the appropriate time, allowing for coordination of efforts.
• Gait/transfer belt should be placed securely.
• Move person's bottom to the front of the surface they are sitting on so that the feet are in firm contact with the floor.
• If needed, assistance can be given to block the person's knees to provide additional support for weight bearing.
• To complete the transfer, the person should lean forward over their feet, use their hands to push from the surface they are sitting on, swing their bottom around to the adjacent surface and slowly sit back down.

Next Section: Pivot Transfer: Wheelchair to Bathtub

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• Once in the standing position, slowly pivot and shuffle the individual in a clockwork motion towards their stronger side, and towards the toilet.

• When the individual is directly in front of the toilet seat, slowly guide them backward until contact is made with the toilet and the back of their legs.

• While you support them, the individual removes undergarments to prepare for sitting on the toilet. For individuals unable to assist in removing their own clothing, you will want to remove the clothing prior to performing the transfer. If clothing removal is an issue, you may want to look into obtaining a commode wheelchair or bedside commode.

Prevent injury while helping someone use the toilet

Most family caregivers aren’t trained on how to safely help older adults with limited mobility move from one place to another.

One common task is to help someone in a wheelchair move to the toilet. If you don’t use safe lifting and transfer techniques, it’s easy to hurt yourself or your older adult.

To help protect your body, we found a helpful 7 minute video from mmLearn.org with a step-by-step demonstration of the proper technique to safely transfer from wheelchair to toilet.

We share an overview of the video and emphasize the essential safety tips.

Get a real-life demonstration of a safe transfer from wheelchair to toilet

In this 7 minute video, a woman uses safe lifting and transfer techniques to help a taller man move from his wheelchair to the toilet.

This demonstration shows what to do in bathrooms where the wheelchair can be placed near the toilet. It also shows what to do when the bathroom isn’t large enough to fit the wheelchair inside

The video also shows what not to do and which movements are likely to cause injury.

Get ready

• Remove bath mats or rugs
• Keep good body mechanics in mind
• Have gait belt handy (optional)
• Move the wheelchair into the proper position and lock the brakes
• Move the wheelchair “feet” out of the way
• If needed, unfasten the person’s belt and/or unbutton their pants

Get up from the wheelchair

• Ask them to scoot to the edge of the wheelchair seat and lean forward
• Ask them to place their hands on the arms of the wheelchair and push up or to hold your forearms
• Stand closely in front of them and hold the gait belt (if using) or their waist and stand up together in a controlled motion – use your knees to raise and lower your own body, don’t bend over and potentially injure your back
• If their legs are not strong, place your knees in front of theirs (called blocking) while they stand – shown at 2:45 minutes in video
• If they have a weaker side, stand on their weaker side to provide support

Sit on the toilet

• Use small steps to guide them to pivot and turn 90 degrees and back up until the toilet seat is at the back of their knees
• Keep one hand on the gait belt and help them pull down their pants and underwear
• Ask them to bend their knees and slowly lower themselves down to the seat – use your knees to raise and lower your own body, don’t bend over and potentially injure your back
• If there’s a toilet frame or raised seat with arms, ask them to reach back and use those arms to help lower themselves onto the seat

Return to the wheelchair

• Ask them to scoot forward on the toilet seat and lean forward
• Ask them to place their hands on the arms of the toilet frame and push up or to hold your forearms
• Stand closely in front of them and hold the gait belt (if using) or their waist and stand up together in a controlled motion – use your knees to raise and lower your own body, don’t bend over and potentially injure your back
• Use small steps to guide them to pivot and turn 90 degrees and back up to the wheelchair (be sure the brakes are still locked)
• When they feel the wheelchair seat at the back of their knees, ask them to slowly sit
• Stand closely in front of them and hold the gait belt (if using) or their waist and lower together in a controlled motion – use your knees to raise and lower your own body, don’t bend over and potentially injure your back

Remember these essential safety tips

DON’T

• Bend from your waist
• Try to pull your older adult up
• Ask them to hold onto your shoulders or neck
• Let them use toilet paper holders, towel bars, or other non-sturdy items to help them sit or stand

Reduce accidents by visiting the bathroom regularly

As the video shows, it takes some time to help an older adult get from their wheelchair to the toilet.

That’s why it’s a good practice to make regular trips to the bathroom. 

This reduces urgency, decreases the chances of having a bathroom accident, and reduces the risk of injury due to rushing.

Help your older adult use the toilet after meals and every couple of hours. Don’t wait until they say they need to go – by then the need might be urgent.

Next Step  See how to safely help someone transfer from wheelchair to toilet (7 min)

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By DailyCaring Editorial Team

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