Tillie and Laurie, thanks for thoughtful suggestions and some moral support. I sort of feel at my wit's end with this. I'm really hoping the OT will have the experience to fine-tune our hoisting. If she's more comfortable, then that leaves a lot of options open for maybe trying bedpan as suggested (great idea), or quick commode transfer and back for a wee. Slippery Sally looks great. Lord I wish I had someone who knew 50 things to do with a slide sheet. I'll also see if OT knows anything about that. I will definitely write back after that appointment.
All these comfort issues, so hard to know how and what to do, so much trial and error. For my Mum, really hard because for some reason, she just can't articulate if something feels good or not. I'm a Pisces and I'll tell you before something happens if it's going to bother me, and 9 times out of 10, it will. I just stand there blinking when Mum says, "I don't know if it's better or worse." Pillows, plumping, pillows to fat, too firm, too soft, over filled, not filled enough. Positioning...argh! And I'm thinking mattress is not right either. News at eleven. Or in a few days.
Hi Katalin! We come in with the hoist to the bed at the same angle that you do. For the commode, we don't actually turn Dad. We slide the commode in sideways with him still sideways to the hoist. (You have to gauge where he'll land because he moves away from the post as he's lowered.)
We do turn him on the hoist in order to get him into a PWC. For that, I lift him all the way up on the hoist and move him away from the bed. Then I lower him in the hoist, because it moves him away from the hoist frame. I turn him while he's in the lower position - to have the widest margin for his legs. Once he's turned facing the hoist, I lift the hoist all the way up again, widen the hoist legs, then load him into his wheelchair.
There is one trick that has made the commode way more comfortable for him. A friend recommended cutting the butt out of a pair of sweatpants. We put them on him while he's still in bed and put on the hygiene sling. So he comes off the bed with a bare butt, but he has some fabric to sit on while on the commode. (Also, the first hygiene sling that we got was terrible and basically lifted him by his arms. The latest one cradles him completely, except for an open butt.)
For moving him in bed, we have the turner with handles that is in the video. My Mom is way smaller than Dad and has a bad back.
Thanks,ThisPresentMoment! JUST yesterday I twigged to try NOT turning her right away, as I was trained to do. I did it as you suggested, pulled her over the bed in the direction she was lying, and then lowered her so I could move her without bungling her legs around the centre post. I did it again this morning, and the PSW understands it too, so she'll try it next time. Thank-you!!!!
I love your idea about the sweat pants. I'll propose that to Mum. But at the very least, it's another great idea for the sling: just cut the thighs off of a pair of thick comfy sweat pants and place them over the thighs. I was bungling around with towels to protect her legs from the sling, but it didn't work. Was thinking of sewing velcro on the towels to make it easier to don and doff. Just having a tube of soft material will help. Some might tell me that there are slings with padded legs. The mesh slings she prefers, and are more comfortable for her, don't have padded legs.
Good to hear that the turner with handles worked for you. It doesn't seem super slippery, like the Slippery Sally type...do you just leave it underneath all the time, as a sort of super-long soaker pad?
We do leave the turner underneath him most of the time. (We had a friend make it shorter so it's from his shoulders to waist.). One side is more slippery, but maybe not as slippery as Sally!
I'm glad that moving her away from the post before turning is working for you! I know how overwhelming it is to try to figure everything out. I worked in a nursing home at one time - but that was high school - and now I'm a grandma. It seems like there's some new challenge every day. You are doing a great job for your Mom! Hang in there.
We struggle with the same issue, Katalin! No issue why, exactly. It is incredibly difficult, and dangerous, for one person to be hoist a PAL in bed. We also use a chuck underneath. We have met with PT and OT about this, but no one has found a sustainable solution. We raise our PAL's knees to limit slipping, but eventually we wait for a time when there are two people there, usually around shift change. I don't have a solution for you, but you are not alone!
Libby, I see that Slippery Sally is made of polyester tafetta (sorry Slippery Sally, but you're too far away and too expensive for this experiment). I'm going to get some and sew a long tube. It could go the whole length of the bed. It won't have silicone on it, so it won't slide, likely, as nicely as the real thing, but it will be worth a try. It may be a plus if it doesn't slide so super easily, because there won't be that danger of sliding to quickly and bonking a head on the top of the bed, or sliding sideways too quickly. But the tube can be pulled out so easily by gripping the bottom of the tube and pulling. I figure one or two log-rolls of my Mum and she'd be on the sheet. If her heels are on it, I won't have to worry as much about sheering or skin damage. I'll make it longer to begin with, and if it's too unwieldy, I'll make it smaller. I'm hoping to work on that next week. Will let you know how it goes.
To me, once you have her on a chucks all the time, she is either slipping on it, or it's slipping down on the bed -- two differently-sized layers do that. And of course an air loss layer is less stable than foam overlay on a foam mattress.
So I would just consider that you can bring a small pad when needed and keep a mattress-size one under the fitted sheet for any larger spills even on top of a slip sheet with handles where you can pop the sheet corners and use the handles for any extreme maneuvers. Or you can reverse the order if you have a spare slip sheet when one needs washing.
Also, I don't know what kind of fitted sheet you have, but something like pima cotton isn't too slippery but creates fewer wrinkles than cheaper cottons, absorbs minor moisture, etc. Low or no-friction sheets are nice when someone can still move around somewhat, but are counterproductive to a stable position in a hospital bed.
Thanks Laurie. I was thinking of just putting the tube under her when I needed to. I agree it sounds very dodgy to leave it underneath all the time, she'd be slipping around like jello on a piece of glass.
I found this video online, you can search it by googling Sally Tube from Tollos - Slide Sheet Place & Remove Method
What I find is that the small pad (is that the soaker pad?) is kind of hard to place and it's rougher and bunches up when she's lying on it. And if I pull her on the smaller pad, her heels will drag and I don't want to cause any skin sheering. I don't use a draw sheet right now, (never heard of them!) but it looks like a smart idea, because it wouldn't add too much thickness or layers to the mattress surface.
This seems really important if you're using the perforated air feature on the fancy mattresses. And thanks for that suggestion of yours for the pima sheets. I have to say the fitted hospital sheets are terrible, not deep enough, and certainly rough and crappy. We ran out of sheets the other day, and I used a king size flat sheet. It was much better really. It stayed put. Man. It's a steep learning curve.
When Dad was in the hospital last week, they didn't have fitted sheets under him at all. They had a thicker flat sheet with loops all along the sides. When they put him in the Hoyer lift, the sheet was the sling they used, (except for toileting.). It was pretty slick, but I think wrinkles would be a problem with all that loose material.