A transfer is the move from bed to chair, chair to standing, or floor to anywhere. Families often treat transfers as something a veteran can still manage with a bit of help from whoever is nearby. When that help is always a family member lifting, the gap is real even if nobody has written it down.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

The signs that show up first

Look for the small changes before a fall. Dad grips the bed rail or furniture to stand and pauses before he moves. He waits for someone to come into the room before he gets up. He skips trips to the bathroom or the kitchen because the getting up feels like too much. A family member has sore hands or back after a day of helping him. A helper, if you have one, has been asked to lift him alone, or has said they will not do it alone.

Any one of these may have an ordinary explanation. Taken together, across a few weeks, they describe a daily need for a second person during transfers, and that is the need the VA's Aid and Attendance pension is built around.1

Keep a two-week transfer log

Write down each transfer for two weeks: the time, where he moved from and to, how many people helped, how long it took, and whether anyone had a near-fall or had to catch him. Keep the log on paper next to the bed or chair, so it gets filled in on the spot. At the end of the two weeks, you have a record a clinician can read in a few minutes, and a record that shows the family's need instead of a memory of a bad day.

Take the log to the right person

The log is an observation, not a diagnosis. Bring it to Dad's doctor or to a physical therapist and ask two specific things: whether the transfers as written are safe with one person or need two, and what method the clinician recommends. Do not settle the question by copying what you saw on a video or what a neighbor did. Ask the clinician, and keep their answer in writing.

Check the plan against the log

Once you have the log, compare it with the care plan. If a provider's hours cover bathing but not the getting-up that happens before and after it, the plan has a hole in the middle of the day. Ask the agency whether a second person can be scheduled for transfers, and what that adds to the hourly rate. Ask the same question of any family members who will be the second person, and decide in advance who covers when they cannot.

If you are not sure where to start in St. Louis, the Local Help: St. Louis Offices page lists the places to call. The reading order shows how this piece fits with the others.

1. VA, Aid and Attendance and Housebound benefits: https://www.va.gov/pension/aid-attendance-housebound/