up from chair by Bryan Williams

up from chair

Bryan Williams

Nov 2, 2025 3:52 AM

Summary

Introduction to the Problem (00:05): Many caregivers struggle to help care recipients transition from sitting to standing due to physical, emotional, and mechanical challenges arising from either the caregiver or the care recipient.
Physical Challenges (01:16): Key issues include the chair height being too low, incorrect positioning, and misuse of mobility aids like walkers, which may cause caregivers and care recipients to employ ineffective methods for standing up.
Mechanical Issues (03:56): Factors include incorrect body positioning (e.g., shoulders not over knees) and the tendency for care recipients to pull backward instead of pushing forward, complicating the standing process.
Emotional Factors (10:20): Care recipients may fear falling, feel passive or weak, or experience frustration that inhibits their willingness to attempt standing. Caregivers too may feel anxious about hurting the care recipient, fearing they lack the strength to assist adequately.
Facilitating the Transition (16:39): Among the principles for assisting in standing, it’s vital for care recipients to do most of the work while caregivers facilitate movement rather than lift, focusing on proper leverage and pre-positioning.
Proper Technique for Standing (19:16): The care recipient should sit at the front of the chair, with proper alignment (ankles behind knees, shoulders over knees) and engage their muscles correctly while rocking forward before standing up.
Caregiver's Role in Safety (22:30): Caregivers should guide care recipients verbally throughout the process to ensure they utilize effective techniques and only provide physical assistance when necessary to help with balance or direction.

Transcript

How to get somebody out of a chair? https://google.com So we need to state the problem. Many caregivers, family caregivers and professional caregivers, generally have difficulty helping their care recipient move around. One of the problems that they have is how to get their care recipient out of a chair or out of a sitting position easily. There are several reasons why caregivers have trouble doing this.

Some of the reasons are physical. Some of the reasons are emotional. Some of the problems are the fault of the care recipient. Some of the problems actually lie at the feet of the caregiver. We're going to look at some of these common reasons why people can't get out of a chair, and then we're going to talk about what we can do to help them do that better. Now, as I was saying before, some of the common reasons,

some of the main challenges that people have getting in and out of a chair or in and out of a sitting position have to do with mechanical or physical limitations or physical barriers or physical impediments. On the caregiver's or on the care recipient's side, some of these physical challenges could be a number of things. One of the things that the care recipient has is that they're sitting too low. In other words, if the chair is too low

or if the hips basically are lower than the knees, it's going to be very difficult for that person to get out of a chair, especially if they're infirm, if they have pain, if they may be a little cognitively impaired, or they may just be weak. They're going to have trouble getting up out of a chair if their hips are lower than their knees. So that's one of the things that a caregiver can actually look at and see what is the level of the seat height that the patient is sitting in

or that the care recipient is sitting in. If possible, elevate the seat. Not so much put a pillow in the chair, but elevate the seat itself, whether on a platform or something like that. One thing that caregivers may realize is that their care recipient has an easier time getting out of a wheelchair than they do out of a comfortable chair or an easy chair, simply because wheelchairs are generally the seat is higher in a wheelchair,

and it's easier for the care recipient to get out of that. Another physical challenge is that the care recipient is simply out of position. Likewise, with the seat being too low, the care recipient may be sitting further back in the chair, and they just may be out of position. It may be easier for them to get out of the chair if they're sitting toward the front of the chair versus toward the rear of the chair.

Another thing that caregivers do not realize is that mechanically, if a person is in the wrong position, then they can't really get out of the chair. If they're sitting further back in the chair, if their shoulders are not over their knees, if their ankles are not behind the perpendicular line of their knees, it's going to be very difficult for that person to get out of a chair. It's going to be very difficult for that person to stand up.

But yet caregivers may not understand that their recipient is in the wrong position to even try to attempt to stand up. Another mechanical impediment may be that the care recipient is pulling to get up. Sometimes people will have a walker in front of them, and they will try to get leveraged using the walker to stand up, and they end up pulling themselves up by the walker, and the walker generally will tip over.

The walker is not necessarily built to help a person get out of a chair. That's not what it's designed to do. That's why it's called a walker. A walker is meant for walking and not for standing up from a chair. If the person isn't using a walker and the caregiver is trying to pull them out of the chair, again, mechanically and from a physical standpoint, when the care recipient is pulling on something to stand up,

it's generally going to be very difficult for them to stand up because physiologically speaking or mechanically speaking, if you're pulling on something, then you're generally falling backwards. You're not coming forwards, and you need to come forwards when you're getting out of the chair. Another mechanical problem is that the care recipient is pushing in the wrong direction. Many caregivers know all too well

that when they try to assist the care recipient out of a chair, the care recipient tends to pull the caregiver back into the chair. That is not an indication that the care recipient is weak or too heavy or anything like that. It's an indication that the care recipient is actually pushing backwards into the chair when they try to stand up. Instead of pushing forwards out of the chair, if the caregiver or if the care recipient was pushing in the proper direction,

then they wouldn't end up going back into the chair and they wouldn't end up pulling the caregiver into the chair with them. So those are four areas, mechanical areas, physiological areas, that may cause problems when a caregiver is trying to get their recipient out of a chair. Now, from the caregiver standpoint, there are a couple of other physiological issues or mechanical issues that also prevent the caregiver or the care recipient from easily getting out of the chair.

Number one, the caregiver may simply be assisting from the wrong position. A lot of times caregivers will stand right in front of the patient and they will try and pull the patient up. It would be better if the caregiver is standing up. Well, I can't say. In many cases, it's better if the caregiver is standing up to the side and assisting the patient from the side or the care recipient from the side, allowing them a smooth and easy and open area

where they can transfer to a standing position versus right in front of them. In some respects, or in some instances, the caregiver may be quote-unquote crowding the care recipient. In other words, rather than standing too far away, the caregiver is standing too close and they're not allowing the care recipient to have a forward motion, and so it is difficult for the care recipient to go forward out of the chair

because the caregiver is standing too close to them or hugging them and trying to pull them out of the chair. Another mechanical issue on the caregiver part is lifting the recipient. Many times a caregiver will try to lift a patient off of the seat as if they're picking up a box or if they're picking up a bag of groceries or something, and this motion in itself does not allow the caregiver or the care recipient

to achieve the proper positioning in order for them to stand up. And so because of this, the caregiver feels the weight of the patient and has a difficult time getting them to standing because they're simply trying to lift the patient or the care recipient rather than trying to help them stand. Following this line of thought, another problem that the care recipient or the caregiver has is that they feel as though they need to do all the work

that the care recipient cannot help them stand up. This is a mistake because in many cases the care recipient has been standing up all of their life. They've been going from sitting to standing, and it's something that they know how to do. It's just something that is difficult for them to do for a number of reasons mechanically and emotionally. Since we've looked at some of the physical limitations or the physical impediments of standing up and the mechanical impediments,

let's take a look at some of the emotional factors that may be playing into a person's inability or difficulty standing up from a chair. So on the part of the care recipient, the elderly person or the infirm person, there could be a number of emotional factors, either individually or that combine together, that makes it difficult for them to stand up. Number one is the fear of falling. A lot of older people fear, or a lot of humans,

we fear a loss of control. And many older people just don't feel as sharp as they used to, and they have a fear of falling and getting hurt. And so that fear prevents them from going into the proper position to stand up. Another emotional component might be the fact that they have a very passive attitude. Maybe family caregivers or professional caregivers have been caring for this person for such a long time,

or maybe the care recipient themselves have simply more or less given up, and they want other people to do things for them, and so emotionally they don't help getting up out of a chair. They rely on other people to do it, or mechanical machines to do it, such as Hoyer lifts or something like that. And so they may have a more passive attitude. In addition to that, they may think that they're too weak. Many people who are infirm or who have been hospitalized

or who are up in age and, quite frankly, have not been that active, have been more sedentary over the last little bit, may feel that they're too weak to attempt to stand up. And this may be because they burn up a lot of energy doing a lot of things wrong that we've mentioned in the previous section as far as pushing in the wrong direction or trying to pull up. They're not using the right mechanics, the right tools,

in order to achieve standing up out of a chair. A lot of people will think that they're too heavy. They try and try and try to get up out of the chair, and emotionally they feel that they're too fat, and they give up trying to get out of the chair, and they feel as though they need help because they're not strong enough to overcome their weight. Another emotional factor that may play into difficulty getting up from a chair or in and out of a chair

is simply frustration with the situation that they're in. They may feel frustrated that they can't do a lot of things that they used to do, or they may feel frustrated or depressed about their health care situation or their status in life. And that level of frustration may play a part in preventing them from being able to get up from a chair. Now, there are emotional components on the caregiver side also.

The caregiver, while they may not have the same concerns, they have similar concerns that the care recipient has. One of the things a caregiver may find themselves thinking is that they don't want to hurt the care recipient. If they really try to get them out of a chair, they don't want to struggle with them. They don't want to, quote-unquote, drop them. They don't want to hurt the care recipient in any way.

And so emotionally they don't look for ways to really try and solve this problem. They're more fearful of doing damage than assisting. Caregivers may also feel, especially if it's an older spouse, they may also feel that they're not strong enough to help a care recipient out of a chair. They may feel too weak. They may feel this way because instead of really trying to get out of a chair, they end up wrestling with the care recipient

because the care recipient is either pushing in the wrong direction or they're in the wrong position, and it becomes very difficult for the caregiver to assist. And they may feel that they're too weak to help this person up from a chair. As I said before, one of the major emotional factors from the caregiver's perspective is that they don't want to, quote-unquote, drop the patient. In other words, they're still thinking

that they're lifting the patient off of the chair. They're lifting the patient like a box or a bag of groceries. And they don't want to drop them, rather than feeling as though they're actually just helping them stand. In the caregiver's mind, they're actually lifting them, and they have a fear of letting them go and that they won't be able to hold them. Another emotional factor that plays into the part of the caregiver

is that they think the patient is too heavy to lift. Again, it goes back to the idea that they have to do all the work and that they have to lift the patient or the care recipient off of the chair or out of the bed or off of the toilet, rather than trying to facilitate motion or movement off of the chair. They're trying to lift, and so they feel, emotionally they feel that this person may be too heavy for them to lift,

which plays into they are not strong enough to lift them up. So what can we do to help address some of these mechanical and some of these emotional barriers that we have, or that caregivers may have and care recipients may have, to help people get out of chairs easy, or get up and moving around easier? A better understanding of the mechanics of rising from a chair will go a long way to eliminate most, if not all,

of these mechanical or emotional impediments that people have. Once everyone involved has a better understanding of the mechanics, of human mechanics of rising from a chair, combined with a relative change in the way that the problem is viewed by both the recipient and the caregiver, it will get rid of most of these emotional and physical impediments. Before we go any further, let's look at several principles

that I would encourage you, the caregiver and the care recipient, to understand and to consider as you are helping your person mobilize or helping with the duties of caregiving. There are four principles. The first principle is this, that the care recipient, what the objective is, is to get the care recipient to do as much of the work of getting out of the chair as safely possible. That's principle number one.

Number two, the caregiver doesn't do the work, but facilitates the movement. The caregiver doesn't do the work, but helps the care recipient perform the movement. Number three, the caregiver and the care recipient need to understand that they are using leverage, but not strength. It's not a matter of lifting, it's a matter of moving. And the last principle is the principle that I call pre-positioning. And this is where, prior to even attempting to get out of the chair,

the caregiver or the care recipient will pre-position themselves in order to make the movement easier. So let's start at what is the proper position that someone needs to be in to get out of a chair. Many people don't realize it, but human beings have to move in certain ways. It's mechanical. It's a mechanical imperative. It's a mechanical law. We all have to move the same way. We all have to walk the same way.

We all have to run the same way. Providing that we have two legs and two arms, we all have to move in the same general way. We cannot do otherwise. So in order for a human being to get up from a chair, certain things have to happen in order for them to get up from a chair easily. And that's what we're going to look at as far as what position the care recipient should be in prior to attempting to stand. Now, number one, the care recipient needs to be sitting

close to the front of the chair rather than down in the pocket or back into the chair. The care recipient needs to move their rear end out toward the front of the chair. Now, looking at the client from the side or the care recipient from the side, the ankles need to be beyond or be behind the perpendicular line of the knee. No one can stand up. It doesn't matter whether you're a bodybuilder or an Olympic athlete.

No one can stand up with the ankles in front of the knees. It's impossible. Secondly, you have to understand that shoulders have to be over your knees in order to stand up. That puts the body in the correct position to get the best leverage to stand up. You will hear a lot of physical therapists say nose over toes, but that's actually not too accurate. What you really want is you want your shoulders over your knees

in order to stand up. Moving on from that position, your hand placement should be either on the arm of the chairs or the seat of the chairs rather than on the walker or holding onto something in front of the patient. The patient, we tend to forget this, but the patient has been pushing from a wheelchair or pushing from a chair to get up or pushing from the ground to get up for all of their life. They never pull from something to get up.

That's why the arms of the chairs are made the way that they are. Now, while the arms are on the chair and while the shoulders are over the knees, this is when the care recipient will engage the muscles and get up out of the chair. But instead of pushing straight up like a rocket, what humans have to do is push forward and rock forward over their feet, rock forward over their toes. So with the shoulders over the knees,

push the shoulders a little bit past the knees while at the same time lifting your rear end from the chair. As you lift your rear end from the chair, as your shoulders go past your knees, the last step in the process is to rock your body weight over your flat feet, off from your heels and over your flat feet, and stay in a crouched position until you are balanced on your feet. Once you're balanced on your feet,

that's when you stand direct and look forward. When a person is getting up out of a chair, their eyes should not be forward. Their eyes should be down toward the ground. Only when the care recipient is balanced on both feet should the care recipient try to stand up and bring the eyes forward. The caregiver actually should facilitate or talk the care recipient through this process versus trying to lift the care recipient out of the chair.

The caregiver will facilitate the process and only provide assistance when the care recipient is going in the wrong direction or when they need just a little bit extra oomph to get up out of the chair.

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