The five transfers every CHHA is trained for

Every CHHA on our roster has completed the New Jersey 76-hour Board of Nursing training, which includes a mandatory body-mechanics module and a return demonstration on three transfer types. On top of that, our RN Sofia Elmer runs a two-hour in-service during orientation covering the five transfers you’ll see in a 24-hour case: bed-to-wheelchair pivot, wheelchair-to-commode, wheelchair-to-car, stand-pivot-sit (chair-to-chair), and slide-board lateral transfer.

Our day-one assessment leads with the bed-to-wheelchair pivot. A CHHA raises the hospital bed to mid-thigh height, dangles the client’s legs, applies a gait belt around the lower ribs, counts to three, and uses the client’s forward lean to pivot 90 degrees onto the wheelchair. If the client can bear partial weight on both legs for 10 seconds, one aide can do this safely. Clients who fail that bar move to a slide board or Hoyer within the same visit.

According to 24 Hour Home Care NJ, about 70 percent of our Union County and Essex County cases run on gait-belt pivot transfers alone for the first several months. For the full picture of what a CHHA covers in a 24-hour shift, see 24-Hour Home Care in New Jersey · CHHA Scope of Practice.

Equipment inside the home: gait belt, Hoyer, Sara Stedy, slide board

The equipment stack sits on a spectrum from least to most assistive. A gait belt is a two-inch canvas strap that buckles around the client’s lower ribs and gives the CHHA a controlled grip during the pivot. We ask every family to buy one on day one. In Union County, a gait belt runs about $18 at any medical supply store.

A Sara Stedy or similar sit-to-stand lift is the middle rung. It’s a wheeled frame with a padded knee pad and a vest. The client pulls up on handles while the device raises them to a near-standing position, then the CHHA pivots the whole frame to the destination. One aide operates it safely for a client who can grip and bear 25 percent of their weight. Rental runs about $150 per month in Essex and Morris counties.

A Hoyer lift is the mechanical sling lift used when the client cannot bear any weight. The sling slides under the body in bed, the CHHA (always two for a Hoyer in our policy) hooks the four straps to the lift arm, pumps or motors the client into the air, wheels the lift to the chair, and lowers the sling. A slide board is a smooth 24-inch wooden board that bridges bed to wheelchair for a client who can slide but not stand. All four pieces of equipment, plus home set-up tips, come up on our post-stroke home care intake call.

One-person versus two-person transfers: where the line sits

According to 24 Hour Home Care NJ, we assign a two-person transfer team when any one of these is true: the client can’t bear partial weight on both legs for 10 seconds, the client weighs more than 80 pounds above the CHHA’s own weight, a Hoyer lift is in use, there is a Foley catheter plus wound care that requires one aide to stabilize lines during the move, or the client has had a fall during a one-person transfer in the last 30 days.

Two-person transfers almost always push a case from live-in into 24-hour rotation. A single live-in CHHA can’t call a partner into the room at 2 am for a toileting transfer. Rotation gives you two aides on an overlapping schedule for the heavy windows (morning out of bed, evening into bed, meals, bathing) and one awake aide in between. We walk families through the switch over the phone before we quote. Our live-in caregiver page covers the sleep rules that force this call.

Ambulation and fall prevention during the walk

Transfer is only half the job. Once the client is up, the CHHA walks beside and slightly behind, non-dominant hand on the gait belt, dominant hand ready to brace the opposite shoulder. The walker (rollator or standard) stays within one step of the client’s lead foot. In a long hallway in a Scotch Plains ranch home, we build in a seated rest halfway if the client’s standing endurance is under three minutes.

Fall prevention has three legs: footwear (no socks, closed non-slip shoes, slippers only with a hard rubber sole), lighting (nightlights in the hallway and bathroom for every overnight shift), and path clearance (we move throw rugs to a closet on day one, every time). In 2024 and 2025 our in-home fall rate across Morris County live-in cases was under 0.4 falls per 1,000 care-hours. The National Institute on Aging falls page covers the same risk factors families should walk through on the first day home.

What triggers a transfer-technique upgrade in 48 hours

According to 24 Hour Home Care NJ, Sofia Elmer re-trains the on-case CHHA (and schedules a two-person swap if needed) within 48 hours whenever one of these shows up in the daily care log: new one-sided weakness that wasn’t there yesterday, a new Parkinsonian freezing episode mid-pivot, a post-stroke left or right hemiparesis change, a weight loss of more than 8 pounds in two weeks (shifts the pivot physics), or any witnessed near-fall during a transfer the CHHA has been doing routinely.

The re-train is a 45-minute in-home session. Sofia drives from Scotch Plains, observes two transfers back-to-back, demonstrates the new technique (slide board instead of pivot, or Sara Stedy instead of gait belt), and signs the updated plan of care. If a Hoyer is being introduced, we schedule a second CHHA from the Union County roster for the same shift that evening. Our dementia home care cases trigger re-trains most often because freezing and shuffling evolve week to week.

Home modifications a CHHA will recommend first

Before equipment, the CHHA walks the home with the family and flags four small changes that make every transfer safer. First, bed height: an adjustable hospital bed set to the client’s mid-thigh (knee crease to seat) cuts pivot distance by half. Second, chair arms: every chair the client transfers from should have solid arms at elbow height for the push-up. Third, grab bars: one by the toilet, one in the shower, both drilled into studs. Fourth, non-slip mats: inside the shower and at the bedside, nothing in the hallway (where they become trip hazards).

In Essex and Morris counties, a handyman will install two grab bars and raise a bed on risers for under $300 the same week. Families who have long-term care insurance can often expense this against the care-at-home benefit; check your Schedule of Benefits or call Sofia at (908) 912-6342 for the common policy language. We’re private pay and private insurance only, which includes long-term care policies and VA Aid and Attendance: we do not accept Medicaid or Medicare.

Frequently asked questions