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She agreed to TRY the lift. She tried it, says it's hurts and she wants to go back to being transferred by 2 CNAs. Nursing home now refuses to do transfers any way other than the lift. She hasn't had a bath in 2 weeks because neither side will budge. What is the law in this situation?

My money would be on the law's supporting the NH. They can't be obliged to carry out manual handling they have assessed as unsafe for their staff and their resident.

For now, Carol can be bathed in bed - not a bath, but fine for hygiene purposes if it's done properly.

But speaking of done properly, in a perfect world I should have liked to observe the trial transfer with the lift. What hurt, exactly, did she say? What bit of her, and what was causing the hurt?

Old bones and unfamiliar movements could mean that the 'hurt' was nothing worse than mild discomfort that a person could be encouraged to skip over or even just get used to for the greater pleasure of a nice bath.

But. Those strong straps' edges burn if they're accidentally pulled across skin. If the sling isn't carefully positioned, the person can be skewed sideways on being raised, which could be really unpleasant for an arthritic back and hips. Neurotic amateurs (who me?) may have hours to spend aligning every conceivable moving part and double checking every inch of skin, but CNAs on a tight schedule - and especially CNAs talking to each other instead of looking what they're doing - don't. Speed and efficiency are the name of the game.

Now. You obviously cannot march in there and demand to verify the skills and performance of any CNA who might have contact with Carol.

I wonder if you might suggest that Carol is encouraged to give it another try, on the strict condition that a PT or senior staff member is present to see where "Carol's" - cough-cough - difficulty is.

Being placed in a sling, whooped up into the air, dangled and plonked down again is a bit more excitement than an elderly person necessarily likes, and yes it does take a bit of getting used to. But it *shouldn't* hurt. And if it did, there's something wrong. I should work on the NH to investigate more closely.
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angelaK Oct 18, 2018
There shouldn't be any plonking down.lol..its a very smooth movement if the staff is skilled.The machine has a hydrolic breaking system and can be controlled so it's a slow steady descent.
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What are the facility's policies and procedures regarding transfers?  As previously stated, some nursing home facilities have a "No Lift or Transfer" policy which means that if the person cannot bear weight on their legs, then they HAVE TO be transferred with a Hoyer lift.  If a resident can bear weight on their legs but cannot walk or pivot safely, then many facilities require that a "Sit-to-Stand" or "Easy-Stand" mechanical device be used for transfers.  This to prevent job-related injuries to the nursing staff and to prevent the resident from sustaining injuries if the nursing staff cannot properly support the resident or if the resident and the nursing staff fall to the floor during the transfer.

Please encourage Carol to try the Hoyer lift again and have a nurse manager supervise this transfer so that she/he can make sure that the Hoyer lift is being used properly and that the sling fits Carol as comfortably as possible.

Having worked 20+ years in nursing homes where there were few Hoyer lifts and no "Sit-to-Stand" or "Easy-Stand" mechanical devices, I can tell you plenty of stories of transfers that "went wrong".  And many of those "wrong transfers" resulted in injury.  As a result of these injuries, I am in constant pain and I cannot lift more than 50 lbs. (a common requirement for most jobs).  Do you or Carol want someone to get hurt while transferring Carol?  Because that is what might happen if the nursing staff has to transfer Carol without mechanical devices.
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She sounds like total dead weight and nursing homes are becoming "no lift" because of injuries to staff. she can still get a bed bath. Bed bound patients are very common--so unless she is refusing bed baths I can't imagine her not getting bathed. Since human bodies are quite heavy a hoyer lift is the only way to get them up if they are unable. I can't imagine getting a dead-weight person up without a hoyer lift. Even with two people helping--say a person weights 200 pounds, that is 100 pounds per person. She is hurting? How about the staff and their probability of injury. Most people can't lift that much. I can't blame the nursing home using a hoyer lift. Hoyer lifts are NOT "more painful" -- pulling a person up manually would require more possibility of injury to the patient as well because your are pulling on the arms
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angelaK Oct 18, 2018
Absolutely! I have seen more patients accidentally dropped or bruised and knocked when manually lifting a person. I have to talk her through every step when transferring her with a hoyer lift...every step...every time as if it's the first time.If she says oooh too much it hurts..I ask her it hurts?or squeezea and it's not comfortable?she says it squeezes ...it's literally only about 2 minutes from when she is in the lift to where she is being transferred.reassuring her through talking and distraction helps.I have had back injuries and missed work because of people insisting on no hoyer lift .Never will I listen to that again.I am happy to give the family member a demonstration of how it feels if they worry so much.
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Nursing homes have a responsibility to maintain a safe environment for their employees. Having a hoyer lift is a way to assure this. Maybe as Carol to try the lift again? As her what hurts when they transfer her. It can’t hurt anymore than 2 people pulling her up under her arms or shoulders to transfer her. They are trying to prevent an injury to both parties. What if Carol suffered a fall when the CNA’s transfer her? Please ask Carol to give it another try & if she can understand, explain why. Good luck.
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Reply to Shane1124
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It is much safer using a lift. We had a nurse taking care of my sister at home. The nurse dropped my sister and broke her leg. I don't blame the nurse because my parents had a lift and my mother didn't want the nurse use it. It was my mother's fault.
There were no problems after we all started using the lift.
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Invisible Oct 18, 2018
My Aunt was also dropped by people in the shower and she passed away within the week.
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Hoya lifts are typically terrifying for any patient- especially if there’s any dementia involved. I refused to buy a lift for my mom even though some of the agency caregivers wanted it. We used a PT “lift/gait belt” and also a transfer board which are far simpler to use and so much more comfortable and safer for the patient as many caregivers don’t know how to use a Hoya lift properly. We had mom’s MD write a note saying that the lift was not appropriate to use for my mom and that there were several very accceptable alternatives other than the Hoya. Good luck as those lift devices can physically hurt patients. Your mom is right!
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There are different slings that can be used. If one isn’t comfortable, maybe the facility could try another that wouldn’t be so uncomfortable for her. I have a mesh one that’s supposed to be for shower use. It looks like it would be more comfortable.
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People have said on this forum that some facilities have a no transfer rule. If she can't use her legs then she is dead weight. Even for 2 people, it is hard and a liability to the facility if a CNA gets hurt. She is just going to have to let the CNAs do to get her bathed. They can do sponge baths.
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Reply to JoAnn29
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Mom has been immobile for more than a year, and although I thought she would balk at the lift, she is quite calm about it

occassionally she says it hurts her back, which is painful anyway from compressed vertebrae

previously, mom had at least three "assisted falls" when staff was bathing her when she could still assist with transfers

naturally, observe and make sure her feet are not being bumped or her neck is caught in the sling and then encourage her - a shower would be a treat for her
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There are different types of slings that can be used with the Hoyer.
There is a mesh sling with a commode hole, I used this one to get my Husband into the shower wheelchair to shower him.
After getting him into the shower I would remove the sling and shower him. After the shower I would dry him off and slip the solid split leg sling around him and transfer him to bed so I could put the briefs (tab type not a pull up type) on and then he would either stay in bed or if it was a good day I would transfer him back to the Broda Chair for breakfast.
In addition to the mesh sling and the solid sling with the split leg there is also a solid sling with no split. It might be easier on her to try another type of sling.
Also I always made sure there were no wrinkles in the sling and that the loops were all at the correct position. The color of the loops will position a person differently. Placed one way the person is sitting up more move to a different loop and is is a slight recline, move another loop and the position changes again. You might want to see how the loops are positioned to see if that makes a difference.

I think there are now rules that prohibit 2 person transfer when a person needs that type of care the use of equipment is then necessary. for the safety of the patient as well as the staff.
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