Hoyer pep talk?

nona

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I am juuuust about at the point of needing to use the hoyer lift. Most of my caregivers can still stand and pivot me but I know my stepmother won't be able to for much longer. I don't know if she'll like the hoyer though. It seems like a lot of steps and finagling for one person to manage alone, but I know many of you have done it. I have an electric hoyer from the local ALSA and a couple of different slings. This morning the OT came over and showed my caregiver how to use the sling and hoyer to get me out of bed. We got me up but it took a lot of adjusting and understanding of body mechanics and I'm worried that not everyone will get it. So that's my first concern: understanding.

My second concern is that the OT recommends leaving the sling under me in the PWC all day. I can see why, but I barely made it three hours today before I felt the mesh dig in, and the bottom interfered with the Roho seat cushion. I know that won't work for 12+ hours a day. Right now they can stand me up and pull the sling out; is that how I'd get it back under me? What is realistic?

My third concern is what to do with a wet sling after a shower. Do I have my caregiver put me down on the bed to swap out the sling for a dry one? I can't get back in my chair with a wet sling. I don't really want to get my bed wet but it seems like the better option.

This all leaves me feeling daunted by the hoyer, but I know that it's a crucial tool that many of you have mastered. Please tell me how you did it. Many thanks.
 

lgelb

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You should not have the sling under you all day. It's a risk to your skin, for injury and impaired circulation. And it cancels out the seat cushion benefits, as you say.

To put the sling on, they would lean your torso forward and put the sling behind your back first. Depending on your strength, it can be easier to do this while holding you and letting the wheelchair back recline a little, then bringing it back up.

Then you lean back against the sling back and your legs are lifted in turn, to put the crossed legs of the sling under your thighs and then connect the sling to the Hoyer.

Of course, you should not get back in the chair with a wet sling. We transferred Larry into a shower chair without a sling but with a seat belt. Some shower chairs come with a more advanced, comfortable belt or it can be swapped out. A lot of people do that (the slingless shower), so I'd give that a shot first. Then the sling is placed into the shower chair after you/the chair are dried, for the transfer into the chair or bed. It might get a little damp, but not wet, and again, you shouldn't stay in it. It can be dried in the dryer (low/medium heat) if needed.
 
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affected

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Oh definitely no sling under you all day!
I really wish I had made one more video showing how I got the sling under Chris in his wheelchair.
It is all a bit fiddly, but I learned that if you always go slow, it's quite simple, just methodical.

Is it possible your OT can do another demonstration and someone film her so everyone can watch it?
We did that a lot, it made it so much easier to train people.
 

Bestfriends14

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I'll third the no sling under you all day. Its super easy to get a sling under my hubby and swap it out on shower day. As affected said, you'll need to have the caregiver go slowly, not rush and make sure to cross the slings loops under your legs to ensure you don't fall right out once you're in the air.

As for the hoyer, I've been using it for just 6 months but have never sworn more in my life when using it. I can give a truck driver a run for their money. Its big and awkward, but I'd rather have that than try and move my hubby on my own. If you'd like me to take a video of how get the sling under my hubby while he's in the chair, please let me know. I can take one tonight.
 

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I found the hoyer so easy as I spent some time having disasters trying to get Chris into bed and settled comfortably.
The main thing I found was going slowly as if I rushed I ended up taking twice as long.
My Chris also loved the hoyer, and he resisted and hated most equipment. But to easily lift and place him precisely without pain and with dignity was awesome.
 

Jrzygrl

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It's like most equipment, takes time to get used to it. That said, it is a much better option when transfers are dangerous (to both the PALS and CALS). I listened to what the OTs said/did then figured out what would work for us. The first OT we had could not even get DH in the sling and out of bed. After 2 appointments that were unsuccessful with her, out the door she went. Second OT was better, but when I contacted her about help with toilet transfers and she insisted she could not/would not help me, since "every transfer has to be 2 people", out the door she went. That just was not our reality. The 3rd OT got it and helped us adjust our routine and it worked til the end. There is absolutely NO WAY I would allow the sling to stay in place all day. And no reason for it (and no reason it can't be taken out for a shower too). It takes a little getting used to, again, for both PALS and CALS, but it eventually becomes routine and safe. As Tillie said, take it slow. In this case, patience is definitely a virtue.
 

KimT

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Jessie,
I just checked YouTube. There are dozens of training videos on the proper use of lifts. Some of them are very well done.
 

MToole

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Find a comfortable sling.
The sling should be relatively hassle free putting on and taking off in the wheelchair.
It is much tougher lying down.
I'm not sure what the big deal is about having the sling on for prolonged time. If you have clothes on. There should be no direct skin contact.
I sleep on mine all night long.
We put reusable bed pads or towels on the bed to keep it from getting wet after a shower.
 

lgelb

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Even under clothes, the sling can cause heat buildup and pressure injury. And whatever air cell, gel or contoured surface you are sitting or sleeping on, like a mattress topper or wheelchair cushion, it was not designed to be under a sling. It is not just skin, either; it's about postural support.

I would really reconsider sleeping on any sling. In the morning, it can be reapplied for your first transfer when you are in a seated position, by raising the head of the bed, tilting, changing the leg angle, etc. If there is no room behind the head of the bed, the CALS can do a pivot turn using a low-friction slip sheet with handles underneath the fitted sheet, after popping the corners of the sheet, so that your head ends up where there is room to apply the sling.

If you must sleep on top of the sling, at the very least, I would have it under a very low friction fitted sheet (e.g. satin on top, cotton on the bottom for thickness) and drag the sheet out as you are transferred.
 

MToole

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We have a nice comfortable mesh sling for general transfers and bathing. It is fairly thin.
I mainly sleep (with my clothes on) in my recliner chair.
We have been doing this for almost 3 years with the sling.
You have to find the best solution that works for you and your caregiver.
These are my transfers for a typical day;
-recliner chair to bed
-bed to shower, hang in sling for shower
-shower to bed
-bed to wheelchair, take sling off
-wheelchair to toilet with different sling
-toilet to wheelchair take sling off
put mesh sling on when ready to go to bed
-wheelchair to recliner chair
 

Jrzygrl

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By the way, Nona, once you start using the hoyer, it is not uncommon to have more than 1 sling. We had 2. One was a traditional U-sling that I liked for getting my DH in and out of bed. For everything else, we used the Lyko Highback Hygiene Vest that @JimInVA suggested. That one was a great help in getting DH from an upright-to-upright position and for dressing. For toileting, it enabled me to get him on and off the toilet or commode in a more upright position. With the traditional U-sling, he was too far back. The Lyko also allowed me to get his pants up and down while suspended in the sling. We used it to get him in the shower chair too. He also didn't feel as "squished" in that sling. Unfortunately, some of these things are trial and error. You will figure it out!
 

affected

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@MToole general rules are just that, and generally most slings would not be good under a person all day. But rules are also made to be broken and if you have used a thin sling this way for 3 years, you have obviously got the whole strategy working perfectly. Thanks for chiming in. One of the things I love most about this place is that no one person has all the answers - the collection of what everyone has done and does do, gives a much bigger picture for each person to make their choices from.
 

JimInVA

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We had 3 slings. The first was a silly mesh thing with a hole in it. Darcey immediately disliked being held by it and I searched out a different one. The next was a type of toileting sling... but it just didn't work as we'd hoped. The 3rd and last sling... and the only one we used thereafter (May 2014 thru Oct 2020)... was the Liko Hygiene Vest High Back (Model No. P3555116). For us, it worked for any and all instances that we needed a sling. [Note: that the Liko comes in different sizes... and the model I included, above, was for the Large size.]

Darcey kept the sling on during the day while in her PWC. She said that it didn't bother her and was pleased that it made it easier on those of us who cared for her to get her "slung up". She did not leave it on in bed for extended periods of time... and certainly not overnight. Where she really didn't notice it when sitting up, it wasn't comfortable for her when laying down.

With the Liko sling, once Darcey was returned to her PWC, I'd pull each leg strap out from under its respective leg and pull it alongside her. As that was the only part that she'd actually "sit" on, she was comfortable. The remainder of the sling was behind her back... and she did not find that uncomfortable. I suspect that we all might different tolerances and opinions as to what was "comfortable". Regardless, leaving it on only saved the step of pulling the sling down her back to put it on. The Liko worked wonderfully for us and we'd have bought another one had we needed to. Know, however, that I did know of two other PALS who tried the same Liko and didn't like it. I don't know if they had the wrong size, didn't know how to use it correctly or it simply didn't work for them... as I wasn't in direct contact with either of them.

My best...

Jim
 

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Jim that's why we have so many different slings to choose from - even one that is fantastic for one person doesn't suit another for whatever reason. And again why I love this place because we can get a rounded perspective, there is no one 'right' answer, just lots of great experiences to draw from. thanks for sharing how that sling worked for you again, it's good to bump it up to current conversations again.
 
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