Old 07-13-2017, 07:53 PM #1 (permalink)
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Default Hoyer Transfer to Toilet

I'm having trouble getting my husband on the toilet correctly with the hoyer lift and U sling. I can get him up out of bed and roll him over the toilet (equipped with a bidet seat), but when I go to lower him, he ends up too far forward. I have tried grabbing the hand-holds in the back and pulling up to get him more upright, but he still ends up more toward the front than is optimal.

Right now, we have a manual hoyer. Once I hit the lever to lower him, I don't seem to have much control over how quickly it lowers him. I wonder if an electric would allow me more control - then maybe I could get him positioned better? Any thoughts from those who have them?

I had hubby email the OT to come out and help, but she responded that "Mike (PT) and I feel that it is unsafe to complete a hoyer lift transfer from the wc to the toilet very unsafe, and can not recommend it." I have read many posts on the forum where the PALS is transferred to the toilet. Is this really a big problem? I'd like to allow him to continue to use the bidet seat rather than have to have me wipe him (another blow to his dignity). This same OT told me that any hoyer transfer should only be done by 2 people - even when I told her that 99% of the time, it's just me and my PALS.

Am I out of line here?
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Old 07-13-2017, 08:13 PM #2 (permalink)
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Default Re: Hoyer Transfer to Toilet

It can be done, my husband used to lower me onto our bidet toilet with the electric hoist while we were waiting for our shower chair. It was awkward and not very comfortable, but lowering in stages was essential.

With a shower/commode chair that has a recline function it's much easier to be safe and comfy. You can get ones that are designed to fit over and activate the bidet toilet so that he can still have control of the cleaning function.

My one is a freeway t80 auto used over a geberit toilet with bidet function. It's very good, but there are other makes out there.

I really think instead of critiquing on a situation you have no control over your o.t should have tried to help you with a solution. When I have carers in they use two people. When it's just family we have no choice but to do it with one person. I am a large lady but with a good electric hoist and a decent shower commode chair even my daughter who is a tiny dainty little thing can manage it easily, and with a strategically placed sheet and the bidet remote firmly in my grasp I can maintain my dignity.

Wendy
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Old 07-14-2017, 11:29 AM #3 (permalink)
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Default Re: Hoyer Transfer to Toilet

After taking JimInVa's advice, I finally sprung for the Liko High Back Hygiene Sling (Model 55), and am now able to get my 240 lb PALS back onto the toilet/bidet. (We'd been using a reclining-back shower/commode chair with bedpan under because our first sling kept him semi-reclined at best.)

I hadn't wanted to go to the expense for this Liko sling, but it's been worth every penny! My husband can no longer sit up, but this sling gets him into a sitting position, fully supporting him, and I can lower him onto the toilet, keeping him in the sling to support him while he sits. (And he is having no bowel problems either since using this sling, I think because it puts him in the optimal position to go.)

We have an electric lift and with him in that sitting position, I've found pushing his knees back while lowering him onto the seat works much better than trying to pull him from the side or back. I push him until the small of his back is right against the back of the toilet as I lower him. (That also keeps me in front so I can see to it no tender parts get sat on or pinched.)

Our PT and OT worked with me until I could use the lift by myself for everything we needed it for. Our reality is that I'm alone with him, so they worked within those constraints to ensure safety for my PALS and myself. I think a good OT and PT will do that. Most CALS do not have the luxury of having a 2nd person always available. So while that's the safest, a good OT/PT will help us find the safest for our situation, not just write us off.
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Old 07-14-2017, 12:25 PM #4 (permalink)
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Default Re: Hoyer Transfer to Toilet

You are truly a saint.

Few people know the lengths we CALS/PALS have to go through just to accomplish a simple Activity of Daily Living.

Just thought I'd say "thank you" for your efforts with your husband.
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Old 07-14-2017, 12:30 PM #5 (permalink)
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Default Re: Hoyer Transfer to Toilet

JRZYGRL, you are certainly not out of line. Your OT and PT have failed to help solve a very real problem. And they didn't even try!

An electric Hoyer is SOOOOO much better. I wonder if there is a way to get one for you.
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Old 07-14-2017, 01:14 PM #6 (permalink)
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Default Re: Hoyer Transfer to Toilet

Everyone should have an electric lift and realistically most of us were/are doing one-person transfers.
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Old 07-14-2017, 01:38 PM #7 (permalink)
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Default Re: Hoyer Transfer to Toilet

Having a sling designed for that purpose is a large help. The one we had was made of a mesh material, with a hole for...the business end...but most importantly were the straps for lifting...it had many several ways of looping the straps that gave different angles...you could grab close on the back loops but long on the leg ones to create different angles, a more sitting position, or long on the back and legs for a laying position. I used a manual lift the whole time. To let down slowly, you just have to barely crack the loosening screw...barely crack it a little bit for slow action. Maybe this'll help a little.
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Old 07-14-2017, 02:27 PM #8 (permalink)
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Default Re: Hoyer Transfer to Toilet

Thank you all for taking the time to help out. Right now, I have a U sling with 6 loops, but he is still reclined enough that it is difficult to position him on the toilet, no matter how many directions I push or pull. The Liko Model 55 sling looks like what I need. Now to try to find it at a reasonable price! (Or see if insurance will cover another sling, since they already paid for one.)

I am also going to see about an electric lift. The manual one I have seems to have a problem with one wheel, so I have to call the DME anyway.

Peace!
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