II. Transfer: From wheelchair to dental chair two-person method

1. Approach

The two-person method is designed for heavier patients and allows
less experienced caregivers to safely perform a transfer“Hello, Mr./Ms. △△. I am a clinical intern and my name is 〇〇. ”“I would like move you to the dental chair. May I do that now?”

1. Approach
2. Wheelchair positioning and braking
3. Caregiver position and posture
4. Transfer process

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2. Wheelchair positioning and braking(1) Position wheelchair close to thedental chair.
(20-30 degrees or parallel)
The angle between the wheelchair anddental chair should be parallel, or up to20 to 30 degrees. Reduction of travel
distance is the key factor.

What are the positions of the wheelchairand dental chair?

20-30°
Dentalchair• The position between the wheelchair and the dental chair isgenerally considered to be adequate at 20-30 degrees, thoughparallel is also mentioned. We found no literature supporting
either.

Wheelchair

20-30°• This text is based on the principle of shortening the distanceto be traveled, and specified as 20 to 30 degrees or parallel.

Dentalchair(2) Lock the wheels.

Wheelchair

Parallelmeans brake34

3. Caregiver position and posture(3) Position the dental chair to be at the same height as the wheelchair(1) Caregiver stands behind the wheelchair.
(2) Asks/helps the patient to cross their arms across their chest.
(3) Caregiver places both arms under the patient’s upper arms andgrasps their wrists.

Adjust the dental chair seat to the same height as the wheelchairseat.
Reduce the horizontal movement
distance as much as possible.

If the armrest can be removed, makesure the wheelchair seat and the dental
chair seat are at the same height.
Holding the wrist on the ipsilateral side may
cause the arm to open, leading to an accident.

56(5) When the caregiver is on the lower body side, both legsshould be opened and the patient's knees held(4) When the caregiver is on the upper body side, both legsshould be opened for stability
Widen the angle of the feet
Lower the center of gravity
Keep close to the patient's body
Bend the back as little as possible.
Step with both legs open

Widen the angle of the feetLower the center of gravity
Keep close to the patient's body
Bend the back as little as possible
Step with both legs open

Sometimes a caregiver will grasp the patient's arms after opening bothlegs.
It is important that the caregiver has both legs open before the transfer.

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The caregiver grasps the patient's rightwrist with the left hand and the left wristwith the right hand.

84. Transferring patient to dental chair(2) The caregiver supports the patient until stabilized with theirback against the backboard of the dental chair(1) Caregiver on the upper body side initiates and leads the lift witha prearranged count (ex. “1-2-3-lift”).

The caregivers lower their center of gravity.
Use muscles in the lower extremities
The caregiver should bend their back as little as possible
Perform transfer by caregivers shifting their weight9

The caregiver should remain on the upper body side and support
the patient's body until the end of the examination.

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III. From dental chair to wheelchair
1. Talk to the patient and explain
2. Wheelchair positioning and braking
3. Caregiver position and posture
4. Transferring

1. Talk to the patient and explain
Inform the patient that they will be transferred to a wheelchair.
“We are now going to move you to a wheelchair.”

2. Wheelchair positioning and braking(1) Position the wheelchair close to thedental chair.
(20-30 degrees or parallel)
The angle between the wheelchair andthe dental chair should parallel if
possible, or 20 to 30 degrees to reduce
the travel distance.
(2) Lock the wheels.

20-30°Wheelchair(3) Position the dental chair to be at the sameheight as the wheelchair.

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Dentalchair

Dentalchair

Wheelchair3. Caregiver position and posture(parallel or 20-30 degrees =)The angle between the wheelchair and thedental chair should be parallel or up to 20
to 30 degrees to reduce travel distance.

13(1) The caregiver stands behind the wheelchair(2) The caregiver places their arms under the patient’s upper arms
and grasps their wrists.
(3) Stay close to the patient and make their body as round as possible.

14(4) When the caregiver is on the lower body side, open
both legs and hold the patient's knees.

4. Transferring(1) Transfer on cue.

Widen the width of the feet
Lower the caregiver’s center of gravity
Bend the caregiver’s back as little as possible
Transfer the patient by shifting weight

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Transfer slowly on the cue of the upper body side caregiver.
Horizontal shift
Reduce travel distance16

(2) Fit the patient's body to the wheelchaire. Place patient’s feet on the footrests.

Seat the patient deeply in the wheelchair.
Ensure that the patient's body is not leaning.
Place the patient’s feet on the footrests.
a. The caregiver holds the patient’swrists.
b. The caregiver should bend theirback as little as possible.
c. Extend one leg backward (increasethe width of the feet).
d. The caregiver pulls and moves thepatient’s body (no lifting).

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In clinical practice, only a two-person method will be used.

References
Toru Naito, Jun Akitake, Michiko Makino, Shinsuke Mizutani: Dentistry for the
Elderly: First Steps, Basic Skills for Care and Assistance, 1st Edition, Tokyo: Ishiyaku
Publishers, p70-71, 2017.
Toshiyuki Ito and Noriko Kamakura: ADL and its surroundings - Practice ofevaluation, guidance and care, 1st Edition, Tokyo: Igaku-shoin, p80-81, 1994.
Keiko Aoyagi: One-point nursing care techniques (Vol. 85): Be aware of bodymechanics and assist with transfers, Fureai care, 24:38-39, 2018.

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