Reducing the Physical Toll on Carers

Caring for someone at home is physically demanding. Across Australia, 3 million people take on unpaid caring roles, representing 12% of the population. Data from the Australian Institute of Health and Welfare shows a clear impact on wellbeing, with only 17% of unpaid carers describing their health as good or excellent, compared with 46% of other Australians.

Paid carers face significant physical strain in their day-to-day work. Data from ABS Safe Work Australia shows that lifting, pushing, pulling and bending are the leading cause of work-related injury, contributing to 24% of all injuries in 2021–22. Within residential aged care, Jobsafe SA reports that manual handling accounts for around 58% of all staff injuries.

Over time, the physical and emotional demands of caring push many workers out of the sector. Reporting from Australian Ageing Agenda shows that more than 3,000 nurses left aged-care workplaces between July and September 2023, and the Herald Sun estimates that over 75,000 nurses have left the profession in recent years, with physical strain, burnout and workload pressure playing a major role.

Reducing the physical toll is essential for sustaining safe care – at home and in the workforce.

Understanding the Risk: Hazardous Manual Tasks

Safe Work Australia defines hazardous manual tasks as any task that requires a person to lift, lower, push, pull, carry or otherwise move, hold or restrain a person, animal or object in a way that involves repetition, high or sudden force, or awkward or sustained postures.

For both informal and paid carers, these risks show up in similar ways:

• Back, neck and shoulder injuries
• Muscle and ligament strains
• Chronic pain and fatigue
• Reduced ability to keep working or providing care

The goal is not to eliminate all movement, but to redesign tasks and use equipment so that the physical load is as low-risk as reasonably possible.

High-Risk Tasks for Carers

Everyday Transfers

Both unpaid and paid carers are at highest risk during transfers such as:

• Getting someone in and out of bed
• Moving between bed, chair, toilet and shower
• Standing, pivoting or short assisted walks

These tasks often involve supporting part or all of a person’s body weight, sometimes in cramped spaces or on wet floors. Without equipment, carers tend to bend, twist or “catch” weight suddenly – all key risk factors for musculoskeletal injury.

Repetitive Low-Level Strain

Risk is not just about “big lifts”. Repetition adds up:

• Frequent repositioning in bed or chairs
• Adjusting cushions and supports
• Pushing wheelchairs or mobile equipment over long distances

These micro-strains contribute to long-term back and shoulder problems, especially when carers are fatigued or working short-staffed.

Safe Staffing and the “Two-Person Transfer” Question

Many carers are told that transfers “should always be done with two people”. The picture is more nuanced:

• WorkSafe Victoria–linked guidance for transfer equipment notes that “WorkSafe Victoria recommends two handlers when using an electric sling hoist”, and that some organisations insist on 2-person hoisting as policy.
• Guidance also recognises that in home-based care, only one carer may be available. In these situations, the focus is on selecting equipment and techniques that allow one-person operation as safely as possible, based on a professional risk assessment.

So while there is no blanket national law that every transfer must always involve two people, best practice is:

• Use two trained workers for higher-risk transfers where reasonably practicable (particularly in facilities).
• In home and community settings – where one person is often alone – use mechanical aids and safer task design to keep risk as low as possible.

Practical Ways to Reduce Physical Load

1. Get a Professional Assessment

Whether you are a family carer or part of a home-care or aged-care team, an occupational therapist (OT) or physiotherapist should be your starting point. They can:

• Assess mobility, balance and strength
• Observe real tasks like bed–chair, shower and toileting transfers
• Identify awkward postures, cramped spaces or unsafe techniques
• Recommend specific equipment and home modifications

For unpaid carers, referrals can come through a GP, My Aged Care or NDIS plan. Paid workers should flag issues through their organisation’s WHS processes.

2. Minimise Manual Lifting

Safe Work Australia’s guidance is clear: you must eliminate or minimise hazardous manual tasks so far as reasonably practicable, which means changing the task, environment or equipment – not just relying on “good lifting technique”.

Wherever possible:

• Use slide sheets, transfer boards, standing aids, hoists and height-adjustable beds
• Avoid “boosting” or dragging people up the bed without a slide sheet
• Break tasks into smaller, controlled steps instead of one big movement
• Ask for an extra person for higher-risk transfers when available

3. Use Equipment Correctly and Consistently

Equipment only reduces risk if it is:

• Correctly set up and adjusted for the person and carer
• Used every time it is needed, not just when staff are available or time allows
• Supported by training and clear procedures

For paid carers, employers must provide training and safe systems of work. For unpaid carers, ask suppliers and therapists to demonstrate equipment and provide written instructions or checklists.

4. Protect Your Own Body

For both informal and paid carers, some core principles apply:

• Keep the person’s weight close to your body
• Bend at the hips and knees, not through the waist
• Avoid twisting while supporting weight – step your feet to turn
• Use your legs to drive movement, not your lower back
• Plan rest breaks between heavier tasks where possible
• Seek early help for pain, pins and needles, weakness or loss of function

Ignoring symptoms is one of the main ways minor strain becomes a long-term injury.

5. Design the Environment to Work With You

Environmental changes can dramatically reduce the physical toll:

• Clear clutter so there is space around beds, chairs and in bathrooms
• Install grab rails, non-slip surfaces and appropriate lighting where recommended
• Use adjustable-height beds and shower chairs
• Position commonly used items between knee and shoulder height

Many modifications and items may be funded through My Aged Care, NDIS or workers’ compensation schemes, depending on the situation.

When the Current Setup Is No Longer Safe

Warning signs that the physical demands are becoming unsafe include:

• Frequent “near misses” or actual falls during transfers
• Needing to physically “hold up” most of the person’s weight
• Carers (paid or unpaid) reporting persistent pain or fatigue
• Regularly needing two or more people but only one being available
• Staff turnover or family carers considering stopping because their body “can’t keep doing this”

At this point, doing “more of the same” is not safe. It’s time for a comprehensive review of equipment, staffing, environment and care setting.

When to Consider Advanced Integrated Solutions Like Behn

For some people with higher support needs, basic aids still leave carers doing multiple heavy transfers each day. In those situations, integrated systems such as Behn can reduce the physical toll by simplifying movements.

Behn is designed to:

• Combine an adjustable homecare bed, powered transfer system, shower chair and day chair in one integrated unit
• Support single-carer operation with predictable, powered movements rather than manual lifting
• Reduce the number of separate transfers between bed, chair, commode and shower
• Minimise clutter and equipment changes that increase risk and fatigue

By cutting down the number of manual handling moments and replacing them with controlled, mechanised movements, solutions like Behn can support both:

• Unpaid carers, who often work alone in the home and want to keep loved ones at home safely
• Paid carers, who need safer systems that reduce injury risk and support sustainable careers in aged care, disability and home-care services

If you are noticing the physical toll of caring increasing – whether you are a family member, support worker or nurse – talk with your OT, care coordinator or planner about whether an integrated system such as Behn could be an appropriate part of a safer, long-term care plan.

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Take care of yourself ❤️ Discover practical ways to stay well while providing care in our guide: How to Prevent Burnout: The Essential Guide to Caring for the Carer →