¶ Introduction
Patient lifts are devices that are used to transfer an individual from one seated or lying position to another, such as from a bed to a wheelchair.
Slings are used in conjunction with patient lifts to support the patient. They come in a variety of styles which are optimized for different positions and uses, such as toileting.
An individual with ALS will need to use a patient lift to transfer between beds, wheelchairs, and so forth once they have lost the ability to perform such transfers independently, or with the assistance of a transfer board or another person.
The need to use a patient lift is often a significant milestone in the course of the disease. It is common for individuals to resist the use of a lift for a variety of reasons, such as concerns about safety, unfamiliarity with its operation, or resistance to accepting that the use of such equipment has become necessary.
Lift transfers can be performed relatively quickly if the equipment is kept organized, and the assistant is well-trained. In some cases, lift transfers can be faster than complex alternative methods, such as a slow trip across a transfer board with many breaks taken along the way.
¶ Patient Lifts
¶ Types of Lifts
Patient lifts come in a few different forms:
- Floor models with wheels, sometimes known as a Hoyer lift
- Overhead with a sliding track, either fastened to the ceiling or freestanding with large columns
¶ Comparison of lift systems
It is advantageous to use an overhead lift that is fixed in position (i.e., a ceiling track lift) in indoor environments. Setup time for each use is significantly reduced as the lift is essentially part of the room. Transfers can be done more quickly and safely as a result; the floor can be marked with ideal positions for wheelchairs or other transfer destinations for quick repeatability.
Floor lifts use a great deal of floor space. Most models have features that allow retracting the legs to reduce how much space they use, however, this does not completely alleviate the problem. Further, they can be difficult to push if the wheels are worn or if the patient is heavier. Often, the wheels of the patient lift will interfere with the wheelchair or bedframe during transfers.
Ceiling lift tracking varies in complexity from simple, straight bars, to intricate systems with curvature, and the ability to transfer from one track intersection to another. Intricate systems can be of significant benefit to people with spinal cord injuries that still have good use of their upper body; such a system would permit them to have a great deal of autonomy within their own home. ALS patients may see less of a benefit from such a system, as eventually they may require significant assistance from an attendant anyway.
| Table: comparison of patient lift systems | ||
|---|---|---|
| Lift type | Benefits | Drawbacks |
| Floor lift |
|
|
| Overhead track lift, mounted to ceiling |
|
|
| Overhead track lift, freestanding |
|
|
¶ Mode of Operation
Patient lifts are operated in one of the following manners:
- manual operation, using a jack or crank handle
- electrical operation, using rechargeable batteries
Electrically operated models are desirable as they allow any operator to lift any patient relatively quickly; manually operated models are far slower and become more difficult to use with increased patient weight. Manually operated models are significantly cheaper, and do not carry the risk of running out of electrical power during use. Electrically operated models typically have an emergency descent switch that allows lowering the patient down to the floor, or whatever surface they are floating above at that moment. They do not have a way to manually operate them to raise the patient higher than their current position.
| Table: comparison of patient lift drive systems | ||
|---|---|---|
| Lift type | Benefits | Drawbacks |
| Electrically operated lift |
|
|
| Manually operated lift |
|
|
¶ Considerations
- Verify that the lift system is able to lift high enough. A lift may not be capable of lifting the patient high enough to get out of a bed or wheelchair, depending on its maximum height, and the height of the surface that the patient will be departing from. Measurements should be taken before selecting a patient lift system.
- 🚧
¶ Slings
¶ Toileting Sling
🚧
¶ Safety
Patient lift systems are generally safe to use when properly set up, well-maintained, and operated by competent individuals.
-
Use slings that are properly fitted, and suited to the patient's physical abilities. Some slings require a moderate amount of strength in order to be safely used. For example, toileting slings often require that the patient has some strength in their arm and back muscles to help support some of their own weight.
-
Verify that the sling is properly positioned, and adequately latched to the lifter bar. Most slings have multiple loops which can be used to connect to the lifter bar; sometimes, the wrong loops can get caught in the lifter bar latches. Further, a loop may appear to be properly latched, but may not be.
-
Verify that operators are sufficiently trained and permitted to use the lift. Regulations or home care company policies might mandate that lift operators be formally trained. These policies could require the involvement of two people. If the individual being lifted can operate the lift buttons independently or if an occupational therapist determines they have sufficient bodily control to oversee the lift, they may be counted as the second operator. If this is not the case, a household member, such as a family member or roommate, may be required to be the second person.
-
Do not use the brakes on a floor lift during a transfer. Floor lifts are fitted with brakes on the wheels. These brakes are intended for preventing the lift from rolling away when not in use. The brakes should never be used during a transfer because lateral movement of the patient may cause the lift to topple over. It is a common misconception that the brakes are supposed to be used during a transfer since it seems intuitive to do so. A small amount of movement of the lift during a transfer is not a problem, so there is no benefit to setting the brakes.
-
Use the patient lift system for direct transfers only. Patient lifts are intended only for transfers between origins and destinations that are right beside each other. They are not intended to be used to transport a patient down a hallway or into another room. Wheelchairs and stretchers are the only transport devices suited for such a purpose.
-
Do not push or pull on the patient significantly during landings. It is to be expected that the patient will need to be moved and adjusted slightly to help them land in the correct position at the destination of a transfer. However, the amount of adjustment should be kept to an absolute minimum; large adjustments can cause lift systems to topple over.