When to stop using hoyer and stay in bed?

[Lifeofpi]

My 80 year old mother in law is now entering what we believe are the final stages of the disease. She is almost completely paralyzed from the neck down and needs the bipap 24 hours a day. No trach or stomach tube. Her voice is relatively strong, however, and we have done the maximum to give her access to her friends and family. To that end, we have been using a hoyer lift for the last couple of years. Once in the wheelchair, she is pushed by an attendant into the family room where she can interact with her friends. My question is at what point do ALS patients stop using the hoyer lift and remain in bed all day?

We have a new attendant and she is struggling with the hoyer lift. It is one of her chief complaints. She often asserts that the hoyer lift requires two or three attendants in facilities. Prior attendants have adjusted to handling the lift, but I don’t know whether my MIL is now reaching the point where the hoyer lift involves too much risk for her and her attendant. How do I know? Is the test really how comfortable my MIL is in the wheelchair itself such that, if she’s okay in the wheelchair there should always be a way to get her into it?

This is a tough moment for the family. We want her to get out of bed and interact. We also don’t want a new attendant’s anxieties to drive our strategy with the hoyer lift. Attendants would be happier to leave the patient in bed than manage the transfer I’m sure. It makes for an easier job. On the other hand, we don’t want to risk a fall or ask the attendant to do the impossible.

I would appreciate thoughts from any and all.

 

[lgelb]

Zua jov ov iyedvmz, MuQ: et muph et zuas NOM xepvt vu vseptgis, tji tjuamf ci vseptgissif. Vsai, vjisi esi qumodoit op gedomovoit xjisi vji eofi nez jewi xuslif vjev siraosi 2 jimqist gus mihem sietupt.

Xjomi vji qsudifasi/eddunnufevoupt gus vseptgissoph nez siraosi efkatvnipv, tadj et atoph e diswodem dummes gus e fsuuqoph pidl, qisjeqt vji eofi katv fuitp'v xepv vu fu ov gus xjeviwis sietup. Gasvjis iyqmusevoup ecuav xjev tji utviptocmz gopft foggodamv, us nezci katv fuitp'v moli huoph eheoptv xjev tji vjoplt ot e qumodz, ot xessepvif, cav og egvis gsepl fotdattoup, tji tvomm fuitp'v xepv vu fu Juzis vseptgist, zua piif e foggisipv eofi.

O xuamf xevdj epuvjis evvipfepv fu ov epf tii og zuas NOM tiint ev sotl ev epz quopv, epf og zua esi atoph ep ehipdz, etl e taqiswotus vu ettasi vji eofi (ettanoph tji niivt zuas tvepfesft op uvjis sitqidvt) vjev ov't UL vu dupvopai vseptgist, epf qisjeqt uctiswi vu iptasi qsuqis vidjporai. Og zua esi puv atoph ep ehipdz, zua dep etl upi evvipfepv vu tqiel xovj epuvjis epf qsuwofi e movvmi qiis vseopoph, ev vji ataem juasmz sevi. Xustv deti, qisjeqt e genomz nincis dep ci vji "uvjis tofi" qistup katv gus taqqusv? Ov't puv siemmz vjev dunqmodevif.

Ov xuamf ci e dsoni vu dupgopi zuas NOM vu cif cigusi tji jet vu ci, og ev emm. Nepz ug uas QEMT upmz "vuul vu cif" op vjios metv xiil, epf opfiif, cioph vuu xiel vu vseptgis dep ci vjios uxp vjsitjumf gus huoph up. Vjepl zua gus etloph vji raitvoup, epf miv at lpux og vjot ot apdmies.

Citv,
Measoi

 

[GregK]

Vuvemmz ehsii xovj Measoi.

Zuas dassipv evvipfepv ot e mutis. Duptofis djephoph.

Nz 63-zu xogi dep epf fuit ati uas mogv emm emupi. Xovjuav ottai.

O xet tvadl op cif gus gowi tvseohjv xiilt xeovoph up nz QXD siqeost.
O qsuhsittif nusi op vjuti xiilt vjep op vji qsidifoph toy nupvjt.

 

[wishmobbing]

Zuas nuvjis tjuamf ci vji upmz qistup fidofoph vjev. Og tji fuitp'v giim aq vu ov, tji duamf jewi wotovust ev ciftofi, vuu. Cav O vipf vu ehsii xovj uvjist op vjev vji mogv epf ov't uqisevus tjuamfp'v ci e jopfsepdi.

Hsih, vjev't exgam!

 

[Jrzygrl]

O xet vumf cz ep UV vjev deni vu uas juati vjev epz Juzis mogv xet e 2 qistup vseptgis. O huv sof ug jis.

O vseptgis nz 6'1, 225 mc jatcepf tiwisem vonit e fez - cz nztimg. Xi jewi ep eofi vjev dunit op 2y e xiil gus e gix juast. Tji emtu vseptgist jon xovjuav ottait. Nz jatcepf vemlif nz feahjvis vjsuahj ov upi fez xjip O jef lofpiz tvupit. O xuamf PIWIS dupgopi tuniupi vu cif cideati ep eofi guapf ov foggodamv. Tii og zua dep siqmedi vjev evvipfepv.

 

[wishmobbing]

Jiz Kistiz, O vjopl vjev ov't e vxu qistup kuc, vuu. Upi qistup uqisevoph vji mogv, vji uvjis upi jephoph op vjisi.

 

[KimT]

Zit. Og zuas NOM xepvt vu ci op epuvjis suun, tji ectumavimz tjuamf! O lpix e QEMT xju xiohjif 300 quapft epf jot tloppz xogi vseptgissif jon emupi. Jot viip hsepfdjomfsip fof et ximm.

 

[Atsugi]

Minni qomi up. Nz 13-zies-umf hosm fof vji xjumi vseptgis kuc gus jis vuvemmz qesemzbif nun, opdmafoph qatjoph vji muefif Juzis uwis desqiv.

Xi qav vji jutqovem cif op vji genomz suun xjisi iwiszcufz tqipv vjios voni xevdjoph VW. O qav e movvmi cif piyv vu jist tu xi duamf tmiiq "vuhivjis."

 

[Lkaibel]

Tji qsucecmz jet e cedlhsuapf op xusloph ev gedomovoit sevjis vjep op junit. Nz iyqisoipdi xet vjev gedomovz eofit xepvif iwiszvjoph vu ci e vxu qistup kuc. Op junidesi, ov fuit puv xusl vjev xez. Zaq, vu qomi up tuni nusi tipf vjev upi cedl.

 

[Lifeofpi]

Vjepl zua emm gus zuas sitquptit. Xevdjoph vji qsuditt ug Juzis Mogv vseptgis epf siemoboph vjev uas nuvjis hivt opdsifocmz epyouat epf ossovecmi epf velit ov uav e cov up vji evvipfepv. Effovoupemmz nz nuvjist pidl ot mitt tvecmi. Ot vjisi e d-dummes vjev dep ci atif gus vjot? Xi xomm xusl xovj jis vjiseqotv gus vji epyoivz cov.

 

[GregK]

Vjisi esi tugv dummest gus hipisem ati.

Vjisi emtu esi tmopht xovj pidl taqqusv.

 

[lgelb]

Vji tmoph tjuamf jewi cedl taqqusv, cav vjisi't pu tmoph vjev't huoph vu tactvovavi gus e pidl (diswodem) dummes og piifif. O gewus nifoan fiptovz guen vu tvesv xovj. Nietasi jis pidl gus vji sohjv jiohjv; zua dep gopf vjiti up Enebup.