Stop sliding and slumping of pals

[Tomswife]

This is becoming a big problem.
PALS has no body strength. He weighs 180 lbs.
He slumps in the hospital bed even if he starts out not slumped.
He cannot lay flat.

Someone suggested a yoga mat. But i dont want that on his skin. He is on blue/white pads cause he is not wearing pants.
The bed is foam mattress with gel pad topper. Then sheet. Then washable quilted pad (is not moving, i checked).
Blue and white pads are shifting. I can remove them and see if that helps?

I dont want to add caregivers just for this issue. But when i am by myself this is an issue. I cant pull him up by myself .

 

[Mary2]

Does he tolerate having the knee area of the bed up? I put PALS into the bed with his head a little over the top of the mattress knowing he will slide. I have to be very careful taking the mat out that he doesn't slide while I am doing this.

 

[Tomswife]

Yes. I lower him above where i want him with the head down ish. Then put him down while i raise the head. Raise the legs. Have a box at the end of the bed to stop his feet.
His torso is slumped and i think it is uncomfortable. But he does not have the ability to sit straight.
And. He wants me to fix him.but i can't. This is really stressing me out. I want to care for him at home. But i cant solve this issue.

 

[Mary2]

If he had the Bi-pap do you think he could tolerate laying back and expanding his torso more? I still do adjusting with the slip sheet/draw sheet, but PALS has gotten so heavy I can no longer pull him up the bed. Are you using a draw sheet? I am not sure you could use a draw sheet to lift him higher because of your injured shoulder.

 

[affected]

This kind of position should work

I used to then have a pillow down each side of Chris from should to hip, snugged in a little to keep him straight. Sometimes another pillow alongside hip to knees to rest his hands on.
I also kept a pillow at the end of the bed across the bed for his feet to rest on.
He did not slide down significantly if I hoisted him in right and did the pillow dance carefully.
I hope that helps.

 

[lgelb]

As Tillie illustrated, after the transfer, you do want to lower him to the bed that is set in a sitting position and then recline the head. Sounds like you may be doing the reverse, which can shift his torso forward a bit.

As you say, you don't want any layers that shift. If he needs a pad underneath, you can put it under the fitted sheet. We used a slip sheet with handles underneath the fitted sheet with the smooth side down; we could pop the sheet corners for access; it was for pivoting/sitting him up in the morning for the lift, but it could double as a light incontinence layer and will stay put if it's the right size.

It's better to have all layers under the sheet rather than any on top, since the sheet fabric is better for skin and the layers beneath are held in place.

 

[MupstateNY]

I was sliding down until someone told me to raise the knees.

The pillow ideas sound helpful.

Is there a neighbor who could stop by in the morning to help with positioning? Please don't be afraid to knock on doors or put something in a few mailboxes.

 

[lgelb]

Yes, the sitting position I referred to, that you can transfer him into, like the graphic posted by Tillie, includes having set the frame in advance to "bent" knees. After we reclined the head and he was settled into the "hole," we rested the elbows, forearms, and feet on foam/pressure boots respectively, and stabilized the hips with a foam belt.

 

[affected]

Yes, good point by Laurie to add to my post that you need to have the bed in a sitting position before lowering him into it from the hoist.
What I used to do was get him over the spot, and lower him close. I would stop lowering then GENTLY swing him a little, just a little. When he was bam on the right spot (might be on the second or third small gentle, slow swing) I would then finish lowering. It really took no physical effort.

The key is to do everything really slowly. Take your time. Get the positioning right, then lower him in.
My Chris had a lot of spasticity so his shoulders were frozen, he had injuries from falls that never quite healed. Slow and steady was the key.

I always wished we had done another video later when Chris could not do a standing transfer at all. At this point he could stand to transfer chair to chair. But we could not get him into the bed without him getting all scrunched up. His core was ok still but you can see he can barely use his arms.
The key as I said is go slow. Communicate with your PALS. I would check each step. Chris couldn't speak but while I talk a lot in this video to demonstrate, usually I would just do a step, look at his face and he could indicate 'yep'. He could feel if things were right that I might not see.
Notice I would do each bit slowly, methodically. Every ... single ... time.

The exact way I did this may not work for each of you as every PALS has different body shapes and areas of progression that change things. As I say, I wish I had videoed again later on when I would put the sing on him in the wheelchair as he could not stand. We did all those steps that day for the purpose of demonstrating a few transfers.

BTW Chris was having a very hard time at first and we had to keep starting again as his EL would send him into peals of laughter.


View: https://youtu.be/6DpnQZFbw3M

hope it helps

 

[Tomswife]

Affected. Loved the video! Thank you so very much. So very kind of you to share. And your courageous Chris.

I will remove the pads and just put him on the sheet and try that.
I will put pillows on the sides. Dont have them now.
My lift is different and may be an issue.
I will lower him with bed head raised. I have been doing it flat and raising as i go down to get him as far up on the valley as possible.
I do go really slow.

 

[lgelb]

Lower him with both feet and head raised. Put his butt in the middle. Then alternate lowering the head and lowering the legs so he doesn't slide, until he's in position.

The type of lift you have shouldn't matter. Let us know if you need help.

 

[affected]

No worries Tomswife, we made it to share and help others.
But all lifts are a little different, but hopefully you can get some concepts from that which help you work out your own method.
I was always changing methods a bit. You might have also heard me mention that I had this whole wardrobe filled with pillows. I would buy all kinds of shapes and sizes and one configuration would work for a while, maybe days, maybe weeks and things would change.
I would go back to the pillow room and throw some in the wardrobe, maybe pull some back out, maybe buy another one or two to try.
In the last months I would have anything up to a dozen pillows of all sizes and shapes (from small sofa square ones to long log rolls) in the bed with him!

 

[affected]

Oh and I often had the hoist remote in one hand and the bed remote in the other. It was a bit like being a puppeteer!

 

[Tomswife]

Yes. I do work both remotes alternating.
I removed everything but the sheets.
The side pillows made a big difference and he liked them.
Photo is sling that i have to get all the way down his back. It is a toiletting sling. I have to be able to pull his torso forward to shove the sling back down behind him. His torso is very heavy and he cant help. It hurts my shoulder and arm to do this. I tried once leaving sling in place but it is slippery fabric.

 

[Tomswife]

Photo of lift holding sling. Looks ok but when Tom is in it he is not sitting uo straight. He is slumped and curled in on himself.