By Joseph Destefano

Going for a doctor’s checkup, visiting family or friends, taking a trip to the store. While a ride in the car is a nice break in your loved one’s day-to-day routine, it can be a real challenge for YOU, as a caregiver, to help your loved one into and out of the car.

You can help make the experience safer and more efficient with the following guidelines:

For Loved Ones Who Can Walk (With or Without Your Help)

• Go Slow. Sometimes the simple act of leaving the house and going into the outdoors can be disorienting for your housebound loved one. Take your time getting from your home to the vehicle even if that means a rest stop or two along the way (weather permitting).
• Position Correctly. Regardless of whether your loved one is using a cane or walker, uses a wheelchair or scooter or walks without assistance, be sure that they are away from where the door swings. Wheelchairs and scooters should be at a 45-degree angle to the vehicle for the easiest transfer and for safety.
• Maneuver Creatively. If your loved one is standing, open the car door as wide as possible, and position your loved one with their back to the car.  Lower him or her slowly and protect his or her head from the door. Slowly ease your loved one onto the seat, with their legs facing you. Next, have your loved one swivel their legs into the car so that they are facing forward. This involves lifting the feet to clear the doorway.

For Loved Ones Who Cannot Walk (in a Wheelchair or Other Assistive Technology)

• Park the Car on a Level Surface. For safety reasons, do what you can to park your car on an even, level surface. If your car is on a hill or slants in one direction, it may be more difficult to get a wheelchair out of the car—and prevent it from moving! Help keep your loved one safe by parking somewhere level!
• Place the Wheelchair at a 45-Degree Angle. If for some reason the wheelchair begins to roll, it will stop after rolling a few inches back (against the car) or a few inches forward (against you). This positioning increases the distance you must travel by only one step and the extra safety value makes it worthwhile.
• Lock the Brake. Any significant movement of the chair could result in an awkward lift that could injure your back or cause a nasty spill for your loved one (or both of you).
• Lift Footplates to the Up Position. This will clear the footplates out of the way so that you can assist your loved one to a standing position.
• Secure Movable Arm and Leg Rests.  A sudden lurch in support can cause your loved one to shift their weight in such a manner as to cause a fall or wrench a muscle (your loved one’s or yours). 

If your loved one can bear weight, stand by for safety and to lend assistance as needed.

Helpful Tips

Usually there are handles on the car door and on the dashboard above the glove box. Encourage your loved one to use those handles while they are swiveling into and out of the forward facing position. If there are no handles on your car or if you prefer to use the back seat instead of the front seat, you can bring your car to the dealer for recommendations on places that will install handles for you. Certain dealerships may also make full car modifications so that your car can equip a wheelchair.

If your loved one is small and frail, they should always sit in the back seat for safety reasons.

Getting Your Loved One Out Of the Car Safely

• Ensure Proper Placement. If your loved one is in a wheelchair, place the wheelchair behind the arc of the opening door at a 45-degree angle to the front of the car. Be sure all brakes are set. Place leg rests in the up position. Secure movable arm/head/back rests.
  
  If your loved one needs a walker for assistance, place the walker at a 45-degree angle to the back of the car. Be sure side supports are snapped into position. If your loved one uses a cane remove it from the car before exiting to avoid entanglement (hook it over the outside of the door or the crook of your arm).
  
  If your loved one does not need a walker or other assistive tools (just you), position your loved one’s legs at a 45 degree angle, facing you, diagonally, from the seat of the car.
  
• Swivel. If your loved one is capable of moving his or her body into a 45 degree angle facing you, have them slowly do this (he or she may want to grab onto car handles if available). If not, then help your loved one turn to the side by lifting their feet and having him or her lean on your shoulder and side while you move their feet slowly to the side. If your loved one needs additional help; reach into the car, grasp the inside elbow with one hand, the inside knee with the other, and gently swivel to the outside. 
  
• Lift. Once your loved one is sitting at an angle, facing out of the car, and has his or her feet on the ground, you are ready to begin the lifting maneuver.
  
  Place your feet at a stance slightly wider than your shoulders. Your knees should be slightly bent. Place both hands under your loved one’s armpits. Do not use your back--use the muscles within your legs. Go slowly and remember as you lift up to move your loved one forward enough to avoid hitting his or her head on the roofline of the car.
  
  Take one or two steps backward. Hand your loved on his or her cane or help them to the walker or (bending from the knees), if he or she is in a wheelchair, lower them into their wheelchair.

NOTE: If your loved one is significantly taller and/or heavier than you are or if a damaged or painful limb or joint prohibits swivel and lifting techniques, you may have to consider a mechanical lifting device. Check with your car dealer to find out what may be available for your car.