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Caring Tips >Correct Postures and Transfer Methods

Correct Postures

Purpose: Prevent joint stiffness and pressure injury, and reduce oedema and other symptoms to improve the patient’s mobility and quality of life .

Lying position

General principles
  • Use a bed with a firm base and a thin mattress (about 5cm thick)
  • Support the body properly with pillows
  • Adjust the position of the patient to a comfortable one so as to enhance sleep especially at night time
  1. Support the limbs with pillows and keep them slightly apart (Use extra pillows to elevate the limbs for patients with more obvious symptoms of oedema)
  2. Use extra pillows to support the upper body when the patient has shortness of breath
Lateral position
  1. Support affected upper limb with elbow and wrist extended
  2. Put pillow in-between knees

Sitting posture

General principles

  • Use chairs with a back support and armrests
  • Keep the back straight and close to the back of the chair; stay symmetrical
  • Use chairs with a suitable height so that your feet can be placed flat on the floor. (If the chair is too high and the ankles are off the floor, consider using a footrest. However, beware of the safety precautions: when you leave the chair or stand up, you need to remove the footrest first)
  • Some patients may have oedema when they sit with their feet down for a long time. Try to place your legs at a more elevated position to reduce swelling
  • Support the upper limbs with armrests or pillows, so that the upper limbs, head and shoulder muscles can relax. (If the patient has weak head and neck muscles, use a headrest for extra support.)
  • Put your hands on your thighs (be careful not to get stuck between the axles of the wheels)
  • Put your feet firmly on the footrests

Seating assessment

Based on individual needs, occupational therapists can conduct seating assessment to review the postures and recommend suitable cushions and pressure relieving devices to help patients to improve their seating postures and reduce the risk of pressure injury. For more details about pressure injury, browse Caring tips > Pressure injury.

Transfer Methods

Getting on and off the bed

  • Bend both your knees
  • Turn your upper body and knees to the edge of the bed
  • Support with your upper limbs when getting up and gently slide your legs down from the bed
  • Active participation of patient is highly encouraged, especially for those with strong upper limbs, in the presence of carers

Supine<->lying on right side


  • Kneel on the bed with one knee
  • Keep your back straight, bend the patient’s knees and bring the patient’s left arm to the front of his/her body and avoid lying on the left arm when the patient turns
  • Put your hands on patient’s shoulder and pelvis to assist turning

Supine<->sit up

  • The carer should first turn the patient to the side, then move his/her feet off the bed
  • Use your forearm to support the shoulder and place another hand on the pelvis; the patient can press against the bed for support


For patients weak on one side
  • Place the chair/wheelchair on the stronger side of the patient and at right angles to the bed. The carer should stand on the weak side of the patient and support him/her at his/her shoulder and buttocks
  • The patient reaches out to press against the armrest of the chair with his stronger hand, leans forward and pushes with his legs to lift up his/her buttock then stands up, turns around and sits on the chair
For patients weak on both sides
  • Two carers should do a half squat to lower the centre of gravity; keep the waist straight and support the patient at his/her armpit and buttocks
  • Patient places both feet on the floor. Carer counts one, two, three and all work together to bring the patient to lean forward to transfer the patient to the bed/chair
  • Do not drag the patient’s hands and feet to avoid hurting the weak limbs or causing pain
  • Patients should change their position every two to three hours during the day to avoid pressure injury
  • In case of pain, consider using appropriate painkillers to reduce the pain during movements
  • The carer should keep the back straight, use the lower limbs to exert force and shift the centre of gravity, and coordinate with the patient and another carer
  • Seek advice from a physiotherapist if you need to use any tools or the two-person support method

For the transfer method of wheelchair or walking aid users, browse Caring Tips > Use of wheelchair and walking aids.

Consult your medical team in case of any questions.