Hi,
I'm a handquilter for hire so I do it in all kinds of ways. If I am using a handheld frame I just turn the frame quilt and all to a more comfortable position.
I have two floor frames. Both are about the widith of a chair. I usually baste with safety pins or have a long armer baste it for me. One thing that works really well for me is to have lots of needles going at the same time. If I am cross hatching I might have a needle in each row. When they are all completed from edge to edge of the frame I either turn the hoop to allow me to go the other way or unhoop and move the whole quilt. I also learned long ago to use both hands. It makes it much easier to reach. Any one who played the paino or even is used to typing should be able to master both hands fairly easily. It just takes a little practice. I do use a thimble on my left thumb as I push with the thumb when I am using my left hand. They make a little short black leather one I prefer for my thumb. I use the longer deer skin one on my right middle finger.