Toileting help/Sling advice

Ruth33

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Hello you all,
As you can imagine, I have been too busy to write.
But now I come back asking for help.
We have been doing pivot transfers from bed to PWC to toilet, etc, but it is time for the next step.
I do use a Hoyer with a U shaped sling to get him off the toilet. But then once he's back in the PWC we
need to stand him up (leaning heavily on a walker) to pull up his pants. This is getting difficult and unsafe.
I ordered various types of "wheelchair pants" with the back flap and side zippers, and side snapping underwear, but could not figure out
how to get his pants up without him standing up again.
One PT suggested a urinal and wearing a skirt which we are not ready for.
Another PT said it's great how he is dressed (button down shirt and sweat pants) and suggested a sit to stand lift for toileting.
We got the Best Stand 400 from the Loan Closet.
The sling it came with is too small, so I tried shopping for a sling.
I watched some videos related to this model and I got confused.
For toileting, do I want the Stand Assist sling or the Sani Sling?
Does one go around the chest and one around the waist?
Will I be able to pull his pants up?
TIA for any advice.
 

lgelb

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If he is leaning heavily on a walker to stand, I think the Stand Assist sling would be obsolete fairly soon. The Sani sling doesn't look like it has enough support. I believe depending on your cradle type (look at the diagram on the BestCare site about which slings work best with which cradles), you would want a "Universal" or "Hoyer Replacement" sling, with the choice about head support based on his level of neck weakness. The padded legs are more comfortable but more difficult to pull under his thighs. When in doubt, if you can, you want to use a sling that you can double up on the hooks for more stability, like a double-stitch.

I never mastered pulling up pants in the sling; my husband weighed 250# and was a pear shape. We did that with side snap pants on the bed, or used a blanket in the wheelchair/around his legs in lieu of pants. But there are people who have threaded the sling legs through the pants, so I will defer to them on describing that.
 

JimInVA

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Ruth,

I used a High Back Hygiene Sling for Darcey. We bought it primarily for toileting, but Darcey felt so secure and comfortable in it that we used it for every and all "slinging" events. Here's one comment I made that touches on our process of sling selection - Hoyer pep talk?.

If you do an advanced search and type in "Liko" for the keyword and "JimInVA" as the author, you'll see other posts that I've made.

I still have Darcey's Liko Hygiene sling. It is a Large size. I would be glad to send it to you to try. As you are also reasonably close, I'd even be willing to make a day trip if you and your husband would like some hands on instruction. Some of us can do well with videos. But others of us need to see it "in person" with verbal "how and why" it is done a certain way. We used this sling successfully for the better part of 5 years.

Darcey's ALS ran a month shy of 8 years... so I have a little bit of experience. And I'm quite willing to share some of that experience if you think it would be a help. Just let me know.

My best...

Jim
 

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What I found the best when learning the hoyer was the OT demonstrated it first on ME. That way I got to actually experience all the feelings of the sling, straps, going up into the air etc. It really helped me understand what I was doing with Chris. Jim if you deliver that sling maybe you can demonstrate on Ruth, then be there as she does the first lift with her PALS. 💚
 

Jrzygrl

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I got a Lyko Hygiene sling after reading Jim's (@JimInVA) postings about it. It became our go-to also. It worked best for us especially for sitting-to-sitting transfers ( PWC to toilet, shower chair, etc). I would highly recommend one!
 

Jimi

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My caregiver can get pants or boxers on/off without me ever standing. I only wear one or the other, it's a pain to do both. I sleep in my lift recliner. I use a U sling (butt is open/free). Trip to bathroom from lift chair goes like this:
- raise chair to lift position, pull pants a third of the way down and place sling behind the back
- lower chair to seated position and place sling under legs
- lift. While in the air pull pants down another third
- Once on the shower/commode chair the last third down
- pulling back up is just the reverse. Basically each part of the transfer the goal is to move the pants as far as you can without using excessive force. Definitely need to use loose fitting with preferably not too thick a waist band
 

Ruth33

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Thank you all for your replies. All your advice is helpful and appreciated.
Jim in VA, that is a super kind offer, I'll contact you privately if we decide to take you up on it.
 

JimInVA

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Ruth,

I'm glad we were all able to help a little bit. It is always good to have options and choices! What is right for each of us, will vary... but by having good choices to consider, one has that opportunity to determine that which might work best for them at that time. And few choices, not selected, will disappear... so use what feels and works best, today.

My best...

Jim
 

JimInVA

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Ruth - If you do reach out and find that you cannot create a private message (now called "converstations"), reach out to one of the moderators and they will work to get you in touch with me. CONVERSTATIONS are not a granted privilege until you've reached the appropriate number of posts. Again, our Moderators are awesome at bridging that gap if you so desire.

My best...

Jim
 

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Jim if you approach Fiona she will pass your email address along to Ruth if you want to help privately. Fiona has often helped me with new CALS in the past 😊
 

JimInVA

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Tillie,

We've given Ruth and her husband information and choices. Like you, I know that if feels good to provide options that might help. Thank YOU for always being such a person of "HOPE AND HELP!"

Much love!

Jim
 

BarrCarr

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You may also consider the LiftSeat Powered Lifts for Home. Google it. When it got difficult for me, we purchased this. It was around $1,500 so I know not all can afford it. It lifts to stand from toilet. Mine even has a bidet which gives me independence for another 6 months so far. It is not a permanent fix, however. I can still stand and wall walk.
 

Ruth33

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OK, I ordered the high back Liko Hygiene Vest.
I will let you know how it works out.
Thanks Jim and everyone.
 

Ruth33

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Ouch!!!
I am so discouraged.
After waiting a week, the Liko high back sling finally came.
I ordered a medium based on his weight and it barely fits around his middle and the straps don't line up because it is too small.
We tried it without crossing the front straps which is probably unsafe. It worked to lift him on and off the toilet. Getting his pants up and down was not so easy, but maybe with practice...
Totally exhausting for both of us.
Frustrated because it was a $600 experiment.
And the nighttime caregiver cannot stand him up to pivot transfer anymore, it has become very unsafe. I was hoping to train him on the hoyer tonight.
I can't do that if it's unsafe and not exactly easy. Will have to train him on the old sling which requires him to stand up after being placed on the wheelchair just to pull up his pants.
Jim, I appreciate the recommendation. I believe this product can and will work, if only I had gotten the right size. This was a disappointing setback.
The PT said I can try the sling from the failed sit/stand with the regular Hoyer. Maybe I'll try that.
So many slings and lifts and so impractical to try them out till you get it right.
 

JimInVA

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@Ruth33 - You still have my offer to try out the larger one that we have. If it works, I'll let you keep it. You can then list the smaller one in the forums as it will likely sell. I can mail it, tomorrow, and you can have it by the weekend. Let me know! Okay... off to dinner with friends. :)

My best...

Jim
 
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