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Thread: We need help with transfer suggestions

  1. #1

    Question We need help with transfer suggestions

    I feel so lost trying to find the right transfer equipment. My Mother is 62 and has a rare muscle disorder (Inclusion body myositis) which causes a weakening of the arm and leg muscles resulting in similar physical limitations as SCI patients. Until 3 weeks ago, she was still living at home with 8 hours of in home care. Using a high-low bed, a wheelchair with an elevator, and an electric high-low toilet she would be assisted to a standing position and shuffle between bed, chair, and bathroom. The transfers where taking anywhere from 30 to 40 minutes.

    Due to a near fall and safety concerns with un-skilled care providers she has moved into an assisted living facility and is no longer walking. We've been looking for months for the best way to transfer from her chair to the toilet. This is our biggest transfer issue as we haven't come up with a good process for removing pants during the move. The facility wanted to have two people pick her up (one under each arm) and each pull down their side of the pants. They was frightening and painful for mom. For now the staff is picking her up and setting her on the high-low toilet. Then she raises to a standing position to remove her pants and sits down. After, she uses the electric toilet seat again to stand to pull up the pants. Next she sits back down and is picked up and moved back in the chair. The process is VERY time consuming.

    She is very week. She cannot move her legs and has very limited arm movement. 3 months ago I found a used Invicare stand lift (Reliant 350) on craigslist. I thought this was our 'silver bullet'. I ran out, paid cash, and mom slips right out of the bottom of the 'standing sling' as she has no strength (legs or arms) to assist with the lift.

    I tested a used Molift Quick Raiser 1 and was surprised to find I did NOT have to assist at all during the lift. Unfortunately we didn't buy the quick raiser and it has since sold. Because of the angle and design I think this might work for her but I'm not going to drop another 2K or more on something without testing it first. There are no dealers within a few hundred miles, that I've found, who have Quick Raiser demo units.

    So how do people without upper or lower body strength get from chair to toilet and pants out of the way? I've reached out to several local and online groups. Most folks suggest a hoyer style but even then at what step in the transfer do you address the pants? I guess I'm not asking the right people as no one seems to have any suggestions.

    Sorry for the long post, but any feedback about the process or even the Quick Raiser would be helpful. If it changes the suggestions at all, she is 5'2" 135lbs.

    Thanks,
    Nick
    Westerville Ohio

  2. #2
    This might work and a fantastic price. You could remove or pull pants down before transfering and once up cover with a towel for privacy.
    Easy pivot patient lift - $600 (central cost )
    Date: 2011-05-27, 7:41PM PDT
    Reply to: sale-kdwqz-2407013645@craigslist.org [Errors when replying to ads?]


    This machine is designed for transferring and pivoting individuals who can not stand on their own. This comfortable machine is a perfect assistant to a caregiver who transfers their patient often. With this machine neither the size, strength or agility of the caregiver or patient are a factor. It's a real back saver! With a low center of gravity and a wide and adjustable wheel base the easy pivot makes it very easy to transfer the individual to and from chairs, beds, toilets ect. The Easy Pivot pulls the individual forward into a leaning position held in place by several belts and with its wheels (with locks) the patient could be wheeled to any other area. It has high-Resiliency Foam Pads for the knees and torso. It is made in the USA from a powder coated welded steel frame. It was used for my mother who suffered from MS and was only used for only less than a year and it has been stored indoors for several months. It is like new! She payed over $1,700.00 for it. I am only asking $600 or best offer and i would like for it to go to an individual who is really in need of it. Please contact me if you have any additional questions regarding the description of this machine or if you would like to take a look at it or test it. I am willing to deliver it on my truck anywhere in the area.

    Also check out these youtube videos for more of an idea of its benefits.

    http://www.youtube.com/watch?v=XOtC1SOhv2E

    http://www.youtube.com/watch?v=104BSbi1I30

    • Location: central cost
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    PostingID: 2407013645
    Helga

  3. #3
    I am a C6/7 complete quad and my wife has done pivot transfers for 29 years. However, we have an Easy Pivot for times when either she is unable to do the normal transfers or when we have to have hired in help to assist me. The Easy Pivot is user friendly, not complicated to use and does not require getting a sling underneath the person being transferred. Once you are up in the transfer position, it is relatively easy to remove pants and underwear. The Easy Pivot does have a fairly large foot print, so you will need adequate room at bedside and toilet side and wide enough doors. The Easy Pivot takes minimal space underneath a bed frame.

    All the best,
    GJ

  4. #4
    Senior Member
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    I would suggest a hoyer lift combined with a commode/shower chair. How is she able to shower now? We use this combo with Ryan who is an Incomplete C-2 with very limited arm but decent leg strength. He cannot transfer to the toilet mainly because of the lack of space to get his power chair in position.

    When it is time for bowel program (he initiates the timing), I strip off his shorts while he is still in his power chair. I then use a sling to get him lifted to the shower chair where I have put a plastic grocery bag into the bucket. When he is finished, I clean him using baby wipes (easy on skin) and take the bag to the garbage. Transfers to and from power chair take less than two minutes and the on and off of the shorts is no big deal.

    I know that your mom needs to get to the toilet more than once a day but doing a slide transfer to the commode chair may be a whole lot quicker than getting the a confined space an doing it there.--eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

  5. #5
    Almost everyone has their own unique way of transfering because no one knows their body or movements better than themself. I suggest a doctor visit requesting a referral to physical therapy as they deal with these situations on a daily basis. Good luck!
    From the time you were born till you ride in a hearse, there is nothing so bad that it couldn't be worse!

    All fringe benifits must be authorized by Helen Waite, if you want your SCI fixed go to Helen Waite!

    Why be politically correct when you can be right!

  6. #6
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    I agree with Oldtimer, a PT is the best resource you can have for developing the method that is best for you.

    How does she get in and out of bed? That is usually the hardest transfer as the person is usually not at their strongest.--eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

  7. #7
    Several issues:

    Caregivers in a nursing home who are manually lifting her are in violation of OSHA regulations for safe patient handling and movement (if in the USA). You should discuss this with the facility director.

    A stand-up lift is really only appropriate for those who can bear weight, and are only weak, but not paralyzed in both their arms and legs. They are unsafe for someone who has paralysis, and esp. if their paralysis is progressing.

    A ceiling track lift or mobile floor-based lift with a properly selected sling would be best in this situation. Solutions for clothing management include removing slacks prior to transferring from bed, modifying clothing with zippers or Velcro to allow opening of the crotch once seated on the toilet, or changing to wearing skirts or gowns.

    There are many different lifts (other than brand name Hoyer) on the market now days. A physical therapist may assist in selection of the proper lift and sling, but the facility should have lifts already that work for her needs (if they are compliant with the OSHA nursing home regulations).

    (KLD)

  8. #8
    as the sci nurse pointed out, it sounds like different clothing choices
    would make the transfers for toileting much simpler.
    the problems of pants could be solved by switching to a dress.

  9. #9
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    I only used the hoyer name as the concept is a familiar one. The lift we use is not a hoyer brand but the concept is the same. I agree that everyone does transfers differently. A good PT will give you a baseline to tweak to meet your needs. We do not follow the method that we were taught in rehab but Ryan is safe and secure for the entire process and that is what matters. His abilities have increased and we continue to modify our method. I understand that your situation is the reverse and that your mom will probably need more assistance in the future and that is OK. Once you learn the method, you and modify it safely to meet all your needs.

    Stripping before transferring has been the key for us. Of course, with shorts on, Ryan is able to use his urinal with no assistance (other than emptying and rinsing the urinal). It is harder for women. We cannot just whip it out and go at will.

    Going commando with a skirt may be her best option. No one needs to know she has skipped the underwear. Ryan has not worn them in more than two years. Who cares.--eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

  10. #10
    Thank you all for your comments and suggestions. I’m familiar with the ‘Easy Pivot’ device. We’ve done a quick test with one however it was not adjusted to fit my mom’s height.

    Gjnl – you mentioned not needing a strap underneath the person being transported. I’ve not seen any examples of this in use without the thigh strap.

    I agree with everyone about seeing a PT. Mom is working with both a PT and OT in her facility, but they don’t have much experience with someone as weak as mom. A local Dr. within physical medicine & rehabilitation is working to get her into a 3 or 4 day in-patient stay to get her chair properly adjusted and make recommendations for her transfers. Unfortunately, we’ve been waiting nearly 2 months for the paperwork to go through.

    Until we work something else out, the facility plans to continue manual lifts for the toilet transfers. They are working to use a transfer board for the moves between wheelchair and bed.

    I did find an OSHA document which says manual lifting should be minimized, but is not against regulations:
    http://www.osha.gov/ergonomics/guide...uidelines.html
    “While specific measures may differ from site to site, OSHA recommends that manual lifting of residents be minimized in all cases and eliminated when feasible.”

    Again, she is in a private pay assisted living facility, not a traditional nursing home. I’m not sure how that effects their policies if any? I’ll make sure to discuss this with the head nurse. Thanks again for the suggestions.

    Nick
    Westerville, Ohio

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