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I usually ask him to put his feet under him and make an effort at standing up while I grab under both arms with my right foot planted between his feet. He is getting more sluggish and less helpful so pulling him up off the chair (he weighs almost twice as much as I do) is nearly breaking my back. I am afraid that this will be the cause to have to place him in extended care and have permanent damage to my spine. Any suggestions would be helpful.

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Quick fix for getting him up out of a chair is to buy a chair that lifts him up electronically. My mother has a recliner that puts her into a standing position. Wheelchair is locked and ready for her to transfer to it.
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There is no doubt that what you are trying to do is one of the basic keys to all nurses at the bedside. Safety for both is critical and maybe more practical, for sure, if another assistant were available. But if they were you probably wouldn't be asking the question here. You have definitely got the basics right. Most nurses like the use of gait belts around the waist, on a lift I never used them; only during ambulation would I consider them. Planning your lift is critical. Making sure the subject is ready and understands what is about to happen. The higher the sitting position the better. Encouraging them to use the strength in their legs is very important but often not overly effective as many simply lack the strength, but every bit helps. You can save your back by bending your legs as much as possible. Your back can still be straight even if you are at a 45 degree angle. The position of your feet, as you say seems right to me. Make sure the surface of the floor is secure and doesn't have something in the way. Fluids, dirt or anything that can cause you to slip. If you have a wheelchair as a destination point try not to have it more than one turn away. Meaning if the chair is in back of you, your feet will cross themselves and create instability. Lock the chair. I like to support the pt from under the arms and as much around the back as possible, although most pt. are too large for me to have my hands clasped behind me. Either way, keeping the center of gravity close to me gives me more control and requires less effort upon that initial lift. The initial lift should be a combination of rocking backward and a leg push at the same time. The strength in the lift needs to come from the legs, this takes practice as our natural sense is to use our backs. In order for this to be most effective the height of your head should equal that of the pt. Always announce the lift to the pt so they are ready. Keep a phone close by for back up.
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There are special lifts that can be rented to move a patient from the bed to a chair, etc, They look like a sling and you crank the handle to get the sling to lift up and then it swivels to the spot you would like the person to be placed in. I used one of these for my husband who was in a wheel chair many years ago. I cannot remember which group, either the Lion's club or the American Cancer society, but both of these groups lent me hospital items to use in then home. I hope this helps.
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I've read over and over on this site about caregivers using the Hoyer Lift. I googled: Using a Hoyer Lift. And there are lots of YouTube videos showing how to use it - from the bed to the wheelchair, etc... Warning though, from what I saw on the first video, the repetitive of you cranking that lift would cause you shoulder damage. I used to pull my mom up from sliding down the bed. Doing this 3 times a day for years, I now have pain on my knees (from leaning against the headboard to help me to pull her), my back (from bending low and then pulling her back to me) and my shoulders/neck (used those muscles to help me pull her up.) So, when I was watching the video below, I immediately recognize the repetitive movements. I figured to give you a heads up so you know this before it's too late.

youtube/watch?v=DinUBHOBlWU
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Dave, I had watched several YouTube videos on how to get a person off the floor. My dad, when he was still walking, was dead weight. His legs couldn't even hold him up. After watching the videos, I decided that it's not possible for me to do that. I'm under 5 feet, and at the time, only weighed about 90-94 lbs. My dad was double my weight. But, I will say it was very helpful to see those videos.
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I would recommend looking for a patient lift. If you can get him to exercise his arms and legs he might retain some ability to transfer. There are transfer boards for a patient to use also but they need some ability to use their arms to move across the board. I found my father could do this in a limited way because by later in the day he was too weak to use it. I found a wheelchair with a drop arm assisted the transfer. There are bedside commodes with drop arms too which can make moving him to the commode especially during the night better. The rising recliners can help if he can participate with the move.
I agree with getting the patient involved with the move. I always started with "Lets move you to X to be more comfortable" "Dad I am thinking we can do this if I do X and can you do Y?" He would repeat what we would try to do together to move him and then we would do it. It made him aware and wanting to help with the move as best he could.
I would have as much equipment in the home as you ever might need to conduct a move. You need options because methods used successfully in July may not work by September etc. The patient's ability to assist will fluctuate.

Be careful. I was able to move my father who was 6'3" without having to place him in a NH. However, you have to work smart. Otherwise you are correct you will injure yourself. Lifts can be a big help as the patient's strength declines. I used them almost exclusively the last year of my father's life. They can be very safe.
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You may need to get an in-home Hoya Lift to get the patient up.
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A lifting recliner, also a bed that lifts to a higher level will help your back, and what's helped me the most in lifting is a gait belt. As women are strength is in our legs and hips really, not our arms so much. Men are usually taller, lifting a man up by his arms is difficult. A gait belt would allow you to lift him up and support him at his waist instead, so no tugging on his arms, you'd have more control over moving and lifting him with the belt and you'd have something safer to hang onto in case he starts to fall. You can also use your knees and feet to guide him and even use a knee as extra support while he transfers to keep him from slipping to the floor or falling. I assist my dad with a gait belt, he's 6'1, 170 lbs., I'm 5'6", 110 lbs. You can also get a "triangle" for the bed, so if he can move himself at all, he can pull himself up in bed. It attaches to the side of a bed and then rotates to different positions and heights and you lock it. Good luck.
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Every patient care worker is taught how to lift a patient without damaging themselves. Check U Tube, I'm sure they'll have a demo.
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Medicare will usually pay for a MANUAL Hoyer lift, but I bought an electric Hoyer, as you can use it without a second person helping. They were around $1500 a couple of years ago. Need only the all purpose sling
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You need special training to use a Hoyer and some patients are frightened by the the movement and therefore complicate the lift process!
If he is weight bearing you could try training to use a gait belt, but patient needs to cooperate with that too!
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So true! My father would never go on that hoyer. He has this great fear of falling. When I was watching the YouTube on it, I was getting nervous seeing that woman dangling from those poles. I think it's scary, too.
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If you don't have a "gait belt" you need one. It's a canvas belt that goes around his midriff that allows you to help him up from behind or the side rather than pulling on his arms. Put a walker in front of him...use the gait belt...and maybe that'll be enough. (Don't let him use the walker handles to help himself up. That's risky.) If you haven't had an Occupational Therapist involved with your husband, honestly? You don't know what you're missing. It's paid for by Medicare. You can ask your doctor to prescribe it.

Beechgirl has an excellent suggestion. Check Youtube. Here's a Youtube video for using a gait belt to help someone stand: youtube/watch?v=i2nJ3roEyD0 If this doesn't create a link you can click, copy and paste the whole thing into your address bar and hit enter.

I can't emphasize enough how helpful an occupational therapist can be in your life. Ask your doctor.
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These are all good suggestions above, and I would definitely recommend getting an occupational therapist and looking into home health care. It sounds like he should be a two person lift at all times. With Alzheimer's/dementia, he may not understand how to help you help him and he may not understand what is going on.

You mentioned moving him to extended care. Do you think it is time for out of home care? Have you and your husband talked about this? If you haven't, it's time to start the conversation. Bless you and your husband.
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I go to the gym and lift weights. Strong muscles and proper technique have kept me from injury so far. My Dad also exercises even from bed. This helps enormously.
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If you buy chair make sure you have a phy order and you go to Medicare approved provider. I was told that if you buy from furniture store Medicare will reimburse lift portion of cost. Not only is it a ton of paperwork Medicare denied after submitting twice. Go to medical supply where they do the filing with Medicare.
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Alpha, you have to be very deliberate as you help him stand or transfer. Be very specific about what you're doing, describe what's going to happen, and verbally cue him through each step. Here's how I help my mom get out of bed and transfer to the bedside commode: "Mom, we're going to take both of your feet off the edge of the bed, and then I'm going to prop you up to a sitting position. Then we'll get you up." Then I proceed thru THOSE steps with her help. THEN, I tell her, "Okay, let me put this belt around you so I can help you stand." I do that, and then, "Now, I'm going to help you stand up. You're going to put your hands beside you on the bed..."(I wait until she does that)...and on THREE I'll help you stand." The walker is right there for her to grab onto once she's standing. I remind her to grab onto it. Then I might say, "Okay, mom, now side-step/side-step/side-step. Look at the bedside potty; that's where we're going." Etc. I think you get the idea. Step-by-step. Slow, deliberate and patient.
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I used the Hoyer for my husband with Parkinson's for his last 16 months as his leg strength slowly went to mush. Without it I never would have made it to the end keeping him at home. It still means putting your own body in safe positions. Also used a Bed Sled to move him around in bed and to get him into position to get out of bed. Adding to Boomer61 comment - the all purpose sling is good to start but as conditions deteriorate you may need to go to the U sling for getting to the toilet or potty chair. The U shape is also easier to put in place and/or to remove from under patient so he does not sit on it all day.
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Many of the comments so far has been from utilizing information without the actual use of a patient lift. I hope the following information will help you. My wife has Parkinsons and dementia and was having trouble getting up and down by herself. She went from walking on her own to using a walker then to a scooter and finally to a wheel chair. She slowly lost her ability to use her legs and I ended up assisting her each time she needed to be transferred to a chair, bed or potty. Eventually I found myself lifting her many times a day which took a toll on my shoulders. I mentioned to her primary doctor of the situation and she sent someone to assess the situation. The suggestion was to get a patient lift. One was ordered through Medicare. There are several types of lifts available. One is for assisting the patient to stand up when it is difficult to go from a sitting position to a standing position. The other lift, which is the one I have, lifts the patient in a sitting position from a chair, bed, wheel chair and transfers to another chair, bed, etc. The lift is hydraulic which has the capability of lifting around 450 lbs, if memory serves me correctly. I have a manual lift which is very is to use. If you have a shoulder or arm injury which prevents you from using a pumping action of about 10 to 15 lbs then a motorized one is available. There several types of slings available. The two prevalent ones are the transfer sling and the toileting sling. Flooring is a consideration. Hard floors work best with the patient lift.
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My sister and I went through this with our mom. What you are dealing with is dead weight. If your husband is on Medicare ask his Dr., to write a script for a lift. Mom's Dr. did that for us and it saved our backs and made it safer for mom. I hope this will help you. God bless, remember to take care of yourself as well as your husband!
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I am unable to lift my wife when she she falls, as she has done about twice a year.But a 911 call to ask for has been a great help in the fairly rural area where we live. I'm careful to specify that only a lift is needed and the fire brigade crew are usually on the scene in less than 10 minutes. If a possible injury requires medical attention then the 911 operator will also dispatch an ambulance.
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Another thought about the lifts. Wheel size! - When the lift was first delivered several years ago I found it would not fit under the bed - the wheels were too high. The larger wheels could not get under the bed. The medical supply company exchanged the lift for one with lower (smaller) wheels. The smaller wheels were a little harder to move over the carpet but they fit under the bed correctly (not a hospital bed) and around the handicap toilet in the bathroom.
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It hurts to even think about what you are up to- and it is only a matter of time before something bad happens. I won't recommend a Hoyer unless you absolutely have to because a person being slinged is likely losing muscle tone and be harder to handle. Definitely consider gait belts, liftchairs, and proper lifting techniques from therapists. On the equipment side I would love to offer suggestions to help you- Superpoles, Friendly Beds for the bed, a "liftchair for the toilet" I know about (probably a key problem as well). Just helped someone (6'4", 320#) with a 110# wife- he couldn't bed transfer/reposition (Parkinsons) and she sure wasn't the solution. If I can help please let me know- I see many new things at national tradeshows, etc. .
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Thank you, Alpha, for raising this issue and also thanks to those who have taken the time and care to respond. My 96-year-old mother is in rehab after hospitalization from a fall and the discovery of pulmonary embolisms. She is able to walk but does so only when a therapist is working with her. Before all this she walked on her own but frequently pretended she couldn't and sometimes just let herself fall. I've been nervous about how to handle her when rehab is finished and the comments here are very helpful.
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Thank you very much, all of you, for your very helpful suggestions. I will try everything, first go to youtube, then check out our local Red Cross for rentables. I hope something will work. Thanks again.
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Alpha3:

I share your anxiety at the difficulties and dangers of lifting a heavy person and having to provide 90% plus if the lifting power. You are correct in thinking that you could suffer permanent damage to your lack and knees and hips.

My wife used to be capable of transferring from the bed to the wheelchair, but since breaking her hip this has become virtually impossible [she is 78 and weighs around 180lbs - I am 80 and weigh the same].

She is an above knee amputee and her remaining knee is extremely arthritic, almost worn away, so she has constant pain and cannot bear her weight on it without suffering from excruciating pain.

I have to support her when getting from bed to wheelchair, and from wheelchair to transfer bench to shower, etc. It is advisable to use a gait belt to assist in transfers, because you can get a much better grip on a belt than you can by trying to hold on to a person's body or underarms. That is dangerous for you both because of the potential for a fall or a collapse.

I don't know whether your husband would be able to use a transfer board. If he can, or if he can learn to use one, this sliding transfer is a much safer and easier way to transfer from one surface to another.

If he is unable to slide along the board from one surface to another, then you may need to ,invest in a patient lift. I bought one from eBay for $200.00, though they cost a great deal more.

If your insurance will cover it, have your doctor write an order for in-home Physical and Occupational therapy. Please do not continue struggling without searching all options, or else you will quite possibly damage your spine permanently, backs are notorious for not mending themselves, and then you will need looking after yourself.

Do you have younger, stronger neighbours that could assist with moving your husband? Any help you can get that removes the strain from your own body will be of infinite help in maintaining your own health.

Most Hoyers come with a sling as part of the outfit. What might be useful is a sling with a commode cutout.

You do not say whether your husband's condition is treatable and whether he can be expected to improve. However, I gather that since you sayhe is becoming less able to stand unaided that his condition will gradually reach the point where he will be complete bed-ridden. I am sorry, for that, but there are aids that will take the danger to you as his caregiver out of the equation, or at the very least, will minimise that risk.

You need to get all the help you can from all the sources available to be able to care for him as well and taking good care of your own health and well-being.

We have a bedside bariatric commode with drop-arms, and have it as high as possible to assist her getting from it back onto the bed. We have raised the bed by 4" so that when her leg goes over the side, she is almost nearly almost standing. It helps me make the transfer because she does not have to be lifted from a low position.

Someone mentioned a chair with a lifting seat. If it is a high-chair to begin with, a lifting seat is a great idea. Can he walk when he is on his feet? If so, you can either get a lever activated seat lifter or invest in an electric powered lifter. Like most things we cannot live without these can be pricey.

I have put a 5" high density foam block in my wife's wheelchair and that giver her a start when she has to transfer. The bed risers do the same for our bed. Our bed if a foam mattress, so there is a lot of give in it when she raises herself from it to slide or change position. Life is full of challenges for those whose capability to rise to the challenges of illness and age have largely gone walkabout!

Wrecked backs are almost solely the 'blessing' of geriatric nurses and caregivers. Proper lifting of a dead-weight patient should NEVER be attempted alone. That's one of the first things nurses are taught.

Unfortunately, those of us that live alone with our darlings do not have the luxury of a second person in attendance when they are most required. So, we have to be smart and use whatever contraptions are needed to stop us from taking to our graves prematurely.

I wish you and your husband the very best, and hope that some useful information is found in these answer that will make a difference in both your lives.

CG99
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My heart goes out to you as this is a difficult situation to be in. My mom was in this situation for about 8 years until my dad finally became bed bound. Unfortunately, your husbands condition may worsen and as he does, it will become more difficult and harmful to you. First of all, get an order from your Dr for home physical therapy and ask them to show you how to get him up, exercise him for strengthening and give you the devices that will help you. Take the time to exercise. I now help my mom take care of my 260 lb dad and I make it a priority to attend muscle conditioning classes at the YMCA several times a week and recently found that swimming really helps me feel better. Also ask Physical Therapy and the trainers to show you proper ergonomics to protect your entire body. I have strained my shoulder, elbow and knees by not using proper ergonomics. Also we only change his diaper twice a day by using XL pads in the diaper that are easier to change. We also have a hydraulic lift to get him from the bed to the chair and he has always had a recliner that lifts him up. Please, please, please, ask for help when possible!
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Lots of good suggestions. Your husband sounds like mine....he was able to walk around, then not so far, and finally now that he is in an assisted living home, he cannot walk nor stand. When we go to the wound doc each week, I am the one who lifts him and then I put him on the table. But it is getting harder, he has alzheimers which is progressing quickly now. Before he would put his arms around my neck like we were dancing, and hold on. Now, the arms are there but he doesn't know how to hang on. I get him around the chest/under the arms and hold him close. I turn and put him on the exam table. I quit work a year ago but worked in a grocery story, we were required to lift 50 pound cases, many 70 pounds. I think this helped. But be sure to use your legs, not your back.
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A reclining motorized chair has been a God send to help my dad get up. The bed that raises his upper body is not of help because he can't lay down due to difficulty breathing so at this point he sleeps in the recliner and if you lose power it runs on batteries. I haven't gotten to a lift yet but vna coming in and I'm curious as to what they will suggest. The chair has saved my shoulders (dad is twice my size) and it helps keep him moving. Medicare will psy for the motorized part but you have to pay the rest. Hope our tips help! Hang in there!
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Renting may be more expensive then actually buying a chair check both options out.
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