Getting In and Out of a Car Safely: A Senior Guide

Why the car door is a fall spot

One in four adults 65 and older falls each year, and falls are the leading cause of injury and injury-related death in that age group.³ The car door asks for three of the hardest movements in one place: lowering yourself onto a seat that is often knee-height or lower, twisting at the hips to face forward, and lifting both legs over a sill. Getting out adds a fourth, standing up from a low seat with nothing solid to push against, usually on a sloped driveway or wet pavement.

The fix is partly technique and partly a few dollars of equipment. The technique is the same one hospital occupational therapists teach patients going home after hip surgery, and it works for anyone with stiff knees, a sore back, or a wobbly first step.¹

The sit-first, swing-second technique

Northwestern Memorial Hospital’s occupational therapy department publishes the version below for hip patients. We have kept the order and softened the surgical parts for everyday use.¹

Set up the seat. Slide the front passenger seat all the way back and recline it slightly. Clear off purses, phones, and sunglasses so nothing is under you.¹

Back up to it. Open the door fully. Walk to the car with your cane or walker, then turn around until your backside is lined up with the seat and you feel the edge against the backs of your legs.¹ Hand the walking aid to a helper or set it against the car within reach.

Hold the frame, not the door. Put one hand on the dashboard or door frame and the other on top of the seat back. Do not hold the car door, because it can move.¹ This is the single most common mistake we see, and it is how a steady person ends up on the ground.

Sit, then scoot. Lower yourself onto the seat. Once you are safely seated, scoot back toward the driver’s seat as far as you can.¹

Lean back and bring your legs in. Recline, lean back, and swing both legs in together without twisting your body.¹ Then raise the seat to a comfortable angle and buckle up.

Reverse it to get out. Legs out first, scoot to the edge, hands on the frame and seat back, push up. Wait until you feel stable before you take your cane or walker.¹ Have your helper hold it ready rather than leaning it against the car.

After a hip or knee replacement

The same sequence applies, with precautions layered on top. After a hip replacement, surgeons typically ask you not to bend the hip past 90 degrees, not to cross your legs, and not to turn your toes inward, with most restrictions easing after about 6 to 8 weeks depending on the surgical approach.²

In the car, that means a firm pillow on the seat so your hips stay above your knees, the seat all the way back and reclined, the operated leg kept out in front of you as you sit, and leaning back as you bring your legs in so the thigh-to-torso angle never closes past 90 degrees.¹ Keep your legs apart and your knees below your hips while riding.¹

Two more points people get wrong:

• Use the front passenger seat, not the back. It slides and reclines; back seats mostly do not, and it is easy to get stuck.
• Driving comes later. The American Academy of Orthopaedic Surgeons says it is generally safe to drive again once you are no longer taking opioid pain medication, and your surgeon makes the final call.²

Our guide to preparing your home for joint replacement recovery covers the rest of the first six weeks.

Three cheap aids that help most

You do not need a vehicle conversion. For most people, one or two of these solves the problem.

A door-latch handle (the “car cane”)

A car assist handle is a 9-inch steel bar with a rubber grip. The metal tip slips into the U-shaped door latch striker on the door frame, and you grip the bar to lower yourself down or push yourself up.⁵ The best-known model, the Stander HandyBar, is rated to 350 pounds and lists at $34.99.⁵

• Good: a solid handhold exactly at hip height, portable between cars, no installation.
• Watch for: it needs a U-shaped striker held on by two screws or bolts. If your door latches onto a single round striker bolt, it will not work.⁵ Look at the latch on the door frame before you order. And take it out before you shut the door.
• Best for: anyone whose trouble is the push-up from the seat, and anyone who has been grabbing the door.

A window-frame strap

A car assist strap buckles around the top of the window frame and hangs a padded handle at about eye level, so you can pull yourself up while sitting on the edge of the seat.⁶ The Stander CarCaddie adjusts from 7 to 16 inches, is rated to 250 pounds, and lists at $16.99.⁶

• Good: fits any car with a window frame, can stay on while the window rolls up, and gives a pulling handle where the latch bar gives a pushing one.⁶
• Watch for: it needs a window frame, so frameless doors on some coupes and convertibles are out. It will not hold you up by itself; it is a steadying aid, not a lift.
• Best for: someone who pulls rather than pushes to stand, often because of weak legs or a sore shoulder on one side.

A swivel seat cushion

The twist is the hard part for stiff hips and bad backs. A swivel cushion is a padded disc with a base that turns, so you sit facing out the door and rotate into position without twisting at the waist.⁷ The Drive Medical padded swivel cushion is about 15.6 inches across, 2 inches thick, turns a full 360 degrees, and is rated to 300 pounds.⁷

• Good: removes the twisting motion entirely, works on any seat, and doubles for a dining chair.
• Watch for: the 2 inches of height raises your knees relative to your hips, which is fine for most people but works against the under-90-degree rule after hip surgery; use a firmer, flatter pillow in those weeks instead. Use it on the passenger side and take it out before anyone drives on that seat, since a seat that turns under the driver is not what it was made for.
• Best for: arthritis, back pain, Parkinson’s, and anyone who says “it’s the turning that gets me.”

Does the car itself matter?

Yes, more than any gadget. A low sedan means a long way down and a long way up. A tall pickup or full-size SUV means a step up and a running board that is often wet. The easiest vehicles sit with the seat cushion at roughly hip height for the passenger, which for most adults is a mid-height crossover or minivan. If a new car is on the horizon, bring the person who will use it and practice getting in and out in the lot. Five minutes there is worth more than any review.

If a new car is not on the horizon, a free CarFit check is the next best thing. CarFit is an educational program developed with AARP and the American Occupational Therapy Association (AOTA) that checks how well your vehicle fits you, including seat position and the distance between you and the steering wheel, which should be at least 10 inches.⁸ Events are listed at car-fit.org, and there is an online version if none is nearby.⁸

If you are the one helping

Helping someone into a car is where caregivers hurt their own backs. The Family Caregiver Alliance’s rules for any transfer apply here.⁴

• Bend at the knees, not the waist. Your knees support you and save your back.⁴
• Keep them close to your body, and do not let them put their arms around your neck.⁴
• Say what you are going to do and count to three so you move together.⁴
• Use a gait belt around their waist so you have a safe place to hold instead of their arms or clothing.⁴
• If you feel a strain, get help. Do not do it alone.⁴

The best single move: ask their doctor for a physical therapy referral so a therapist can teach you a safe car transfer in one visit.⁴ If getting in and out has become a two-person job or a daily struggle, that is also a sign to read our guide on when it is time for more help at home.

When to call a specialist

If technique and cheap aids are not enough, there are two professional routes.

A driver rehabilitation specialist. Certified Driver Rehabilitation Specialists (CDRS) are usually occupational or physical therapists who evaluate how a person gets into, sits in, and operates a vehicle, and who prescribe adaptive equipment such as transfer seats that swing out of the door.⁹ ADED, the professional association, keeps a searchable list by state.⁹

The VA, if you served. Veterans with certain service-connected conditions, including loss of use of a foot or hand and ankylosis of a knee or hip, can apply for a VA adaptive equipment grant that covers changes such as power seats and lift equipment to get in and out of a vehicle. You must get VA approval before you buy anything.¹⁰

What it costs, and who pays

The three aids together run about $50, the handle at $34.99 and the strap at $16.99 from the maker, with swivel cushions in a similar range at pharmacies and medical supply stores.⁵⁶

Where this fits

The car is one more sit-to-stand in a day full of them. If standing up from the passenger seat is hard, standing up from the sofa probably is too, and a lift chair or the right cane, walker, or rollator solves the same weakness at home. If the person uses a wheelchair, our guide to choosing a wheelchair covers transport chairs that fold into a trunk. And if a fall does happen in the driveway, how to get up after a fall is worth reading before you need it. For the front door itself, see accessible home entrances.

Key takeaways

• Sit first, swing second. Hands on the dashboard and seat back, never the door. Reverse it to get out, and wait until you are steady before taking your cane.
• Three aids under $50: a door-latch handle (check for a U-shaped striker), a window-frame strap, and a swivel cushion to kill the twist.
• After hip surgery, pillow on the seat, seat back and reclined, hip under 90 degrees, no crossing, no pigeon toes, for as long as your surgeon says.
• Helpers steady, they don’t lift. Knees bent, gait belt, count of three, and ask for a PT visit to learn it properly.

What’s next

• Recovering from surgery? Read preparing your home for joint replacement recovery.
• Pick the right walking aid for the trip from the car to the door: cane, walker, or rollator.
• Make the same move easier indoors with a lift chair.
• Know what to do if a fall happens: how to get up after a fall.

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Reviewed by John Smith, CAPS, Certified Aging-in-Place Specialist. This guide is general safety information, not medical advice. If you are recovering from surgery, follow your own surgeon’s and therapist’s instructions, which take priority over anything here. An occupational therapist can watch you get in and out of your own car and tailor the technique and equipment to you.