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How To Keep The Elderly From Falling Out Of A Wheelchair

If the senior in your life has become wheelchair-bound, they rely on this chair to get around in their day-to-day life. Sometimes, you may worry that your senior will slip right from their chair and take a tumble. This could lead to significant, even life-ending injuries, which is obviously something you absolutely want to avoid.

Here is how to keep the elderly from falling out of a wheelchair:

  • Check that the chair fits the person
  • Ensure the senior can physically stay upright in the chair
  • If the senior has dementia or another cognitive disorder, eliminate confusion about things that may cause falls
  • Try products designed to prevent wheelchair falls

Understanding what causes wheelchair falls in the elderly is a great first step in preventing the person from hurting themselves. The information in this article will also be of assistance, as you’ll learn proper, safe wheelchair usage for seniors, as well as recommendations for products that help keep the elderly in their wheelchairs.

How Do You Use A Wheelchair Safely?

In addition to the tips we suggested in the intro, you should also teach your senior loved one the correct way to use a wheelchair. Improper usage could cause them to slip or fall to the floor.

In this section, we’ll cover:

  • how to open a wheelchair
  • how to sit in a wheelchair
  • getting up from the wheelchair
  • and how to close a wheelchair in order to get it out of the way or to put it into a vehicle, etc.

Make sure that you educate both yourself and the senior on the following wheelchair usage rules:

How To Open A Wheelchair

If your senior’s wheelchair is one that folds open and closed, then it will likely begin in a compressed state.

To open the wheelchair:

  • Position yourself in front of it.
  • Then, put your hands on the arms of the chair or along the inside of the arm’s frame.
  • Press outward on the arms (or frame) with a firm grip on the sides of the chair, making sure the seat comes down fully.
  • The positioning of your fingers is important here, so make sure the senior knows their fingers should be inward during this step. Otherwise, their fingers could get stuck, which would be painful.

When the seat is opened all the way, you must next set up the cushion:

  • Find this cushion (often attached somewhere on or near the wheelchair) and put it at the back of the seat.
  • Many cushions are labeled “front” and “back,” so make sure the back faces the right direction.

How To Sit In A Wheelchair

Next, it’s time for the elderly person to sit in the wheelchair.

  • Before they ever get near the chair, you want to ensure that you have put the brakes on. This will keep the wheelchair from slipping as the senior sits, which prevents an unnecessary fall.
  • Next, adjust the footplates – folding them if you can – and setting them to the sides of the chair so they’re not in the way.
  • Tell the senior to position themselves in front of the chair with their back to the seat.
  • Next, they should put their arms behind them on both armrests, and grip them tightly.
  • Then, they should gradually sit down on the chair.
  • After they are seated, you or they can push the footplates back down so they have a place to rest their feet.

Getting Up From The Wheelchair

When the time has come for the senior to get up:

  • First, check that the brakes of the wheelchair are set.
  • You’ll need to fold up the footplates and move them away to either side of the chair.
  • Get the senior’s walking aid ready or be there so they can grab onto you as they stand.
  • The senior should grip the wheelchair’s armrests – with a hand on each one – when they attempt to stand.
  • They will then scoot their body towards the edge of the wheelchair, with their feet on the ground.
  • Then they can rise from the chair.

How To Close A Wheelchair

  • With the senior standing up and the chair empty, remove the cushion.
  • Push the footplates up so they’re out of the way.
  • Take the cushion and put it back where it belongs.
  • Now, putting yourself at the wheelchair’s side, firmly grab the canvas or material at the back and front of the wheelchair. Give it a tug upwards and the entire thing should collapse inward, into a folded position.

Products And Wheelchair Cushions To Prevent Falls

I wish I had known about some of these products when my mom was in a wheelchair during the last few months of her life. She had a glioblastoma (brain tumor) that took away her ability to move her legs, so she couldn’t keep herself in the wheelchair if she started to slide.

That meant that, more than once, Mom slipped out of the chair and landed on the floor. Poor Dad wasn’t strong enough at age 94 to keep her from sliding and he couldn’t pick her up once she had fallen out.

This resulted in several 911 calls so that first responders could get her off the floor and back into the chair – something that embarrassed Mom to no end. Had I known these products existed, I would have gotten something to help her, but at that point, we were sort of just “putting out fires” and reacting as situations came up, instead of being proactive.

If your elderly parent or loved one could use a little more help staying in their wheelchair, you may want to try any of the following products. They’re designed specifically for avoiding falls, making their inclusion a smart and safe choice.

What Is A Pommel Cushion Used For?

The first product you might use for a senior is known as a pommel cushion. This has a front protuberance that goes between your senior’s legs (similar to a pommel on a saddle) so they can’t slip out of the wheelchair as easily.

Pommel cushions are useful for other applications as well. For instance, by creating a natural knee separation, the hips don’t move as much, which could cause less pain for seniors. Also, there is less body weight on the coccyx, which again reduces pain.

What Is A Lap Buddy?

Another option you have is the Lap Buddy. Instead of going between the legs like the pommel cushion does, the Lap Buddy sits in the lap of the person in the wheelchair, acting almost as a lap bar.

It’s made of soft, inflatable material with no seams or poky edges. The Lap Buddy also provides a place for the person to rest their forearms and hands.

With the Lap Buddy in place, the senior can’t get up easily.

Besides keeping the elderly in their wheelchairs, the Lap Buddy can also support the person’s extremities, possibly reducing back pain.

Chair Wedge Anti-Slides: How Do They Work?

If you’re still looking for a product to help keep your senior in their wheelchair, you may consider a wedge cushion. This type of cushion goes on the seat of the wheelchair, with the low end towards the back of the seat. The thickest part of the wedge goes under their knees.

It’s a good idea to get one that has a removable, washable cover and that has ties on either side for attaching it securely to the wheelchair.

The angle of a wedge cushion is such that it becomes more difficult for a senior to fall out of their chair with the wedge in place.

TIP: The cushion shouldn’t be too high. The senior’s feet should still be able to touch the wheelchair’s footplates or the floor with the wedge cushion in place.

Non Slip Pads For Chairs: Are They A Good Option?

In the same vein as the wedge cushions, there are non slip wheelchair pads. These are anti-restraint and there are a variety of options out there on the market.

They should be made of a material that doesn’t slide easily, thus keeping the person in their seat. Another thing you may want to look for is one that is leak proof if your loved one has a tendency towards being incontinent.

Lap Belt Restraints For Elderly – Are They Safe?

While we don’t recommend them, some adult children and caretakers of the elderly will consider using lap belt restraints for seniors in wheelchairs. These restraints work like a sort of foam or fabric seat belt that Velcros, buckles, or otherwise attaches across the person’s waist.

There is certainly no risk of the senior falling out of their wheelchair with a lap belt restraint, but these belts may not be as smart as they seem. There is a possibility that lap belts can contribute to the injury and / or death of a restrained person.

According to an article on SeniorsMatter.com, at one time, it’s believed that upwards of half of United States elderly patients had wheelchairs with lap belt restraints. That number has since dropped to 10 percent as their dangers have become known.

…when used improperly or in ways other than intended, injury or even death can result. Although widely prescribed, little evidence is available to direct professionals on the appropriate use of these restraints and lap belts and for whom these restraints are indicated. – Chavez, et al. Review of the use of physical restraints and lap belts with wheelchair users

In fact, in the Chavez, et al review of studies (quoted above), the authors found that, “Nine studies reported the frequency of asphyxial deaths caused by physical restraints, nine studies reported the long-term complication and indirect adverse effects of physical restraints and lap-belt use, and seven studies reported the benefits of physical restraints and lap belts with individuals using wheelchairs.”

Although senior deaths have been reported due to lap belt restraints, it should be noted that those were mostly in nursing homes. So, for example, a nursing home assistant could put the belt on a resident, get busy somewhere else, and then forget about the senior for hours. You can see how easy it could be for injury or even death to result.

Since lap belts are actually a form of medical treatment, their use should really only be administered by a doctor or other medical professional. This professional can ensure the belt is on correctly and isn’t too tight.

Although they have fallen out of favor, you can still buy lap belt restraints online and in medical supply stores. If you must use a belt of this kind for your senior, then do it for as little time as possible.

Is A Wheelchair Seatbelt Considered A Restraint?

Okay, so what if instead of a lap belt restraint, you outfit your senior’s wheelchair with something a little more humane, like a seat belt. People wear these in cars every single day, so they’re a much better option, right?

Not exactly. If wheelchair seat belts were safe, every chair would have them. While they do work to keep a senior in their chair, should the senior need to get up of their own volition, they might not be able to. That makes a wheelchair seat belt a restraint.

Conclusion

If your senior loved one uses a wheelchair regularly, then it’s probably one of your worst nightmares that they may someday fall out.

It’s best if the person is in good physical and mental condition when using a wheelchair, as that may reduce falls. So, too, will teaching them the proper way to open and close a wheelchair – as well as how to get into and out of the chair.

Products like the Lap Buddy, wedge cushions, anti-slide pads, and pommel cushions are items meant to keep seniors in their wheelchair.

Do reconsider using wheelchair seat belts and/or lap belt restraints, as these could cause injury and, in some cases, even death.

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