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My mother, who is 86 and lives with us, has had her mobility dramatically decrease over the past 3-4 months. It got so bad at the end of October that she became homebound in her bedroom on the second floor with us down the hall in another bedroom, as I cannot get her to walk short distances. We have been "handling" things as well as we can, and started to develop a "routine" to deal with her limitations, as she could get out of bed and into a wheelchair, and she could stand up briefly in the bathroom. But things are getting worse. She is having more trouble getting out of bed and into the chair, and have trouble sitting up in toilet, even when gripping the sink and with a lot of lifting help. I am starting to get troubled at this point that maybe we are getting over our head in terms of care, and I am concerned I or my wife are going to hurt our backs, which is has been happening to me. When my mother gets confused, she decides to sit on the floor, and that makes it impossible to get her up. I am thinking of getting a Hoyer Lift, but I don't know if a person with such advanced Alzheimer's will handle this. I also was looking at a "Stand Assist Power Lift," which seemed more practical, but wouldn't be of any help when she decides to sit on the floor. (I am also not sure if I can get a Hoyer Lift into the house.) Any of you caring for advanced Alzheimer's Disease patients at home, how are you handling this? It is totally a different issue when they can't walk anymore. Please only looking from responses from those caregivers dealing with this type of issue. Thanks.

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There are chairs that look like recliners but work to assist in having the patient stand up. I forgot what they are called. I have seen them used with patients that have swelling in both legs and to stand up independently causes a lot of shortness of breath due to the exertion. A transfer board is another option- a piece of wood that can be wedged under the patient's buttocks and creates a surface to gently slide the patient from the bed to a chair.
The transfer belt discussed above is another good option.
Lifting her from the floor to a chair is very difficult to do. You will definitely eventually hurt yourself and would hate to see that happen.
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Jane - we just moved from a home with 15 stairs and after an incident, I found out that you can call 911 if there is a fall and ask for LIFT ASSISTANCE. The fire department will come out and help! They were wonderful!! Also, never try to lift your loved one if they are slipping to the floor. Just gently guide them to the ground, and call 911. Provide a pillow, blanket if necessary, and just wait for help. This information provided such peace of mind for me! Hope it helps someone else out there!
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My husband is in bed 100% other than when I can get him out and into a wheelchair. He is in late stage Alzheimer's. Incontinent, and needs assistance, eating and drinking. However, I do get him up and in the chair at least once a day. I was fortunate to have some very good home health therapists who recommended a safety pole. This pole is anchored from floor to ceiling with tension. It can be easily moved around if necessary. It has provided a safety method for my husband to grab on to when sitting on the edge of the bed. He then can lift himself to a standing position with my help. No more stress on my back! He is 185 lbs! Here is where I found it so you can see what it looks like. It has saved my back and more! This with an electric hospital bed has made a total difference in my caring for my husband. On Amazon Stander security pole transfer guarantee
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I commend you and your wife for all you have done and continue to do for your mother. I have seen these hoyer lifts used in facilities, frightening to watch, and to this day I remember the fear demonstrated. Like many dedicated caregivers I know we tend to investigate all options, not wanting to let go of our loved one, relinquishing the job of our caregiving we do so well and with the best of intentions. A hoyer lift is a serious responsibility, facilities do use backup personnel as a human checklist so to speak, there is a protocol that must be followed by rules and regulations. Think of your stress with this responsibility, you and your wife's health and your mom's, especially with her memory impairment. I have heard that change and any type of trauma is not the best for ALZ. As a caregiver to my brother with ALZ, yet ambulatory, I am starting to see fear in his eyes with the simple tasks, too many to mention, he once could handle alone. It's sad to know he can't and see his fear when at one time his attitude was a "can do, don't need anyone". I am sorry I don't have an answer. A question, when is our when, we all ask. God Bless
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jeffrey20832
How would you get your mother downstairs if a problem arises and she is homebound on the second floor?
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Jeffrey20832, I have been using a Patient Lift, of which Hoyer is a brand name, for over 5 years. Previous to the lift, I was lifting my wife 8 to 10 time per day for transfers from bed to chair, chair to potty, etc. As her ability to partially stand declined I took on more of her weight. I do have shoulder problems because of this daily routine. I agree with Sandra2424 and get an evaluation of your situation. Here are some things that you are probably wondering about. The lift has two widths, a wide one for fitting around chairs and a regular one for transporting through doors. I have used the lift for picking my wife up from the bed and once when she was on the floor. The sling is an important part of this transfer process. The ones provided by the insurance coverage was virtually not acceptable. I found one from Invacare and is a high back toileting sling which is nicely padded and has a waist belt for extra security. Since insurance wouldn't cover this sling I paid for it and it is worth every dollar spent on it. There are times when my wife is afraid of the lift when she is having an "off" day but most of the time she is okay with type of transfer. I use this lift with a portable potty which can be moved around. Most of our home has tile flooring while the bedroom has carpeting with no pile. Granted it is difficult to roll on but is done all the time with no major problems. When there is a chair to chair transfer it is best to raise the sling just enough to clear the chair and move to the other chair and adjust. If you raise the sling too high and transport you will create more body swing. Moving slowly will also decrease any body swing. Positioning the potty or wheelchair is a lot better than trying to move the lift into a chair. Locking your lift wheels is very important when doing the transfer to another chair or bed. Here's hoping things work out for you and your family.
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My parents used an Arjo Trixie Lift for my sister who had dementia and was paralyzed. The Trixie Lift was smaller and easier to maneuver.  There also was carpet in bedroom.  It was so much safer for my sister and us.  We never once had a problem transferring my sister from the bed to the wheelchair or back to her bed. It was easy to connect the sling. You raise up the sling and if see a problem you stop, lower the person and fix it. I think the lift could lowered to the ground also but we never needed to do that.  We only used the lift in the bedroom. I would rent a lift before buying one to see if it works out. You could try using the lift in bed without transferring your mother to see if see how she feels and if she gets scared. Just raise her a couple of inches off the bed and get her used to that before you try to do a full transfer.  The lift was expensive but worth every penny. We were able to keep my sister at home because of the lift.
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I am a physical therapist. I would recommend that you get a referral for home P.T. They can evaluate your situation, recommend assistive equipment, and instruct you to assist with transfers.
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A "Sit to Stand" would be a first step before a Hoyer.
A Sit to Stand works well, I used on with my Husband for about 2 years. As long as he could hold on and support his weight it was great.
You place a belt around the persons waist then hook the straps to the Sit to Stand. You then either pump a lever to raise the bars or push a button to electrically lift the supporting bars.
The persons feet are on a platform and the knees are up against a support. Once they are upright you can wheel them to bed, another chair or I used this as a way to change my husband. I would raise him up pull down his pants then strip off the soiled brief (tab type) then put on another and pull up the pants. Worked great until he was unable to support his weight and keep weight on his feet.

And a side note. When my husband would begin to slip off the edge of the bed or slide down in his chair I would help him safely to the floor or support him with pillows and cushions then I would call 911. They are trained to lift someone safely. As long as there is no transport there was no bill.
Do not be afraid to call them, do not be embarrassed to call them. This is what they are trained to do, this is their job.
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My husband who has FTD (frontal temporal dementia) age 61, is unsteady on his feet but is able to walk yet with help. I have a TRANSFER BELT that he must wear when going up and down stairs, and at times walking. Got it from AMAZON. It has loops that you can grab and hold on to him with. He was ill in Dec and unable to hardly stand for a couple wks so I had a rollaway bed for him to sleep on, on the first floor of our home. The transfer belt is work its wt in GOLD! When the time comes I will get a bedside commode and he will have to stay on the first floor, no more stairs. I have a walker that he holds on to, to sit on the toilet. I have been thinking of a bedside commode that has arms and can be put over the toilet (while he still walks), then when he can not, just transfer from bed to commode. I have a caregiver for him the hrs while I work. If walking is too dangerous, he will have to be bedridden and turned every 2 hrs or so to prevent bed sores. He has fallen and I use the transfer belt to get him up. I have put a chair near him and try to lift up so to sit on it enough then he gets the idea to stand. If I can not get him up my neighbors will help me get him up. I do not know about the power lift. Watch out not to hurt your back. I wear a abdominal binder/back brace when moving him. My husband weighs about 130 lb but is "dead weight". If she is so unsteady maybe she needs to be bed bound? Having a bedside commode or chair right by the bed to transfer on to if she can bear weight and transfer works. There is a transport wheel chair also that has 4 sm wheels not the 2 big ones on the back. With my husband I want him walking and moving around, sitting in the chair, etc to keep his strength up until this is not possible. I plan on keeping him at home with hospice in the future, no nursing home if possible. I am a RN so all that training helps for sure. Any physical therapist out there to suggest ways to get a patient up of the floor when fallen? God be with you, this is the hardest thing I have ever done.
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I couldn't have managed my mother at home without the lift - she was post-stroke and paralysed down one side. She also had vascular dementia; but it sounds as though your mother's advanced Alzheimers means that you're concerned your mother might be frightened by the lift, to the point of fighting you, which of course could get very risky?

If you have a friendly PT or occupational therapist, see if you can get some training and trial sessions in using the lift. Be the "patient" so that you get the hang of how it feels when the sling is positioned correctly.

None of it is actually difficult or hard to understand, assuming you have basic spatial and mechanical aptitude, but you do have to be seriously obsessional about the method: you can't afford a single mistake, and you can't afford to hurry - better to clean up an accident than risk missing a strap fastening. Plus, the more confident and capable you are about fitting the sling to your mother and operating the hoist, the less panicked she is likely to be.

If you and your wife are concerned about damaging your backs (and you are right to be cautious, and it will help nobody if either of you slips a disc), you must stop lifting your mother - it's that simple. Get a caregiver in, get an OT in to teach you better techniques, but do *something*. If God forbid one of you is injured in mid-lift you could seriously hurt not only yourself but your mother too.
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I hope you'll get some more responses. Apparently, Hoyer lifts in the home aren't that popular. I found this old thread from a person who said it was not working for her mom. I'd ask the doctor about whether fractures are a risk from the pressure that is applied to the body during the lifts.

https://www.agingcare.com/questions/mom-experiences-pain-uses-the-hoyer-lift-175831.htm

'I'd also be afraid that she would be frightened from the lift. I think that I would even be intimidated by it. And, I'd be prepared that it might not work. I don't know the price, but, I suppose you could resell it, if it didn't work out.
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If you type "hoyer lift" in the site search bar you will find several threads mentioning them, maybe you will find what you are looking for there.
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FOUND THIS ON INTERNET:
The more trainings I take about caring for people with dementia and the more I really try to see the world from their eyes, I see how scary and unsettling life is for them. A very simple example of this is the Hoyer lift we now have for Mom.

A Hoyer lift is a large device with a sling attached to it that lifts a person who can not walk and allows you to transfer them. We had a few new caregivers at the house to help train them on how to use the Hoyer lift because it is very easy to get bruised or dropped in the lift if it is not used correctly. Dad and I let the caregivers practice transferring us in the lift. Let me tell you, it is pretty scary.

You sit there while the people around you communicate with each other checking to make sure they have the right colored loop on the right hook so you do not fall out of the lift. They were just about to lift me once when I noticed one side of the lift was not attached and I was able to tell them before they lifted me. I was imagining what it was like to be Mom and maybe see that the lift was not correct, but not be able to speak to tell them. How scary!


Then they lift you up and you are suspended and swinging in mid-air while the device rolls across the floor taking you to your new destination. Someone has to watch your forehead so it does not collide with the metal bar at the top of the lift and another person holds your legs so they do not swing and hit the metal pole that is the center of the lift. You would think you might feel like you are wrapped in a cocoon but you really feel like you are swinging from a crane like a fish caught in a net that could drop at any time.

I can see how this is terrifying for persons with dementia. No wonder many of them get agitated during transfers.

Here are a few tips that might make something like this easier:

1. Always tell the person exactly what you are doing at every moment. "Carol, we are going to move you from your chair to the bed. We are getting the lift ready. Now we are going to raise you up."

3. Each caregiver should check to make sure the other got all of the loops on the right hooks as a safety measure. Say out loud that everything has been checked so the person can hear you and feel a bit more safe.

2. Reassure safety: "Carol, we are going to raise you up. The lift is safe and we are here for you."

No matter what, much of life is going to be scary for persons with dementia. Even if you think they cannot hear you or understand, they probably can, so the best thing to do is communicate a lot with them. Always tell them what is going on around them and what is happening next. And in every situation try to see it from their perspective in order to understand their needs better.
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k3kerr and cwillie - thanks for listening and your responses. I will try k3kerr's sheet "sling" concept tonight, it may help us, because grip belts really do nothing in that situation. I can get her to sit up in bed, which is positive. Our problem is her overall weakness and confusion in trying to stand.

I really have three primary challenges (today): 1. consistently transferring her from bed to commode chair, 2. getting her off floor if she decides to sit down on the floor in bedroom, 3. getting her off floor if she decides to sit down on floor, when she stands to get her pants off in bathroom. Thankfully the bathroom is small enough (an ironic "benefit") that last item is infrequent. I am thinking maybe if we move to "side zip" pants, that will be less of a struggle due to her mobility challenges. I am still thinking of getting a Hoyer Lift for the bedroom only, as a contingency for the bedroom transfers. I have plastic "office chair" style floor coverings in the bedroom area (to allow ready clean up),  so the bedroom area is more "flat" and smooth than otherwise.

I would really like to know if there is any caregiver who has used Hoyer Lifts with Advanced Alzheimer's patients, and if they are able to handle that without panic.
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My mom has been on the brink of being totally bed bound a couple of times so I've done a little research into lifts and alternatives.
A portable hoyer lift is really only portable in a facility because they can not manoeuvre over carpet or through the doors and halls in a typical home or even begin to fit in a bathroom. When it comes to lifts a permanent track lift may be a better option, but it would not be cheap and using one would come with a whole new set of problem. Our occupational therapist said that often families opt to lift manually even after installing lifts because they are such a p-i-t-a.

So what are your alternatives?

Work on increasing your own strength through exercise, and get some training in transfer techniques.

Accepting total incontinence and opting to change her while lying down in bed. (youtube has good training videos of this)

Getting some physical therapy so she can regain the ability to help with transfers, but even then you have to understand that you are merely delaying the inevitable, the time will come - may have already come - when she simply can't do it any more.

Look into low tech devices like transfer boards, tuning disks etc. An occupational therapist can go through your home and give you specific options that may help.

Accept that you have reached you limits and look into finding her placement in a nursing home.
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As I'm not currently in that position yet, I'm not really able to answer, though I would assume that as with any new thing, we, as caregivers, can assist with encouraging, coaching and soothing as the new experience is performed (and of course with Alzheimer's this would mean every time). I know from previous experience, that most durable medical equipment can be rented or purchased. Perhaps contact a local DME company about renting one for a short term period to see if it does work before purchasing one. DME equipment can typically be rented on a monthly basis, but perhaps could be rented for a shorter period, as well.

Another idea for a quick test of the "sling" concept would be to have you and your wife use the "draw sheet" method. Take a sheet and fold it in 1/2 (end to end, thereby making it shorter). Lay it across the bed and have her lay on top of it. (If she is in the bed, you can roll her to one side and put the sheet on 1/2 of the bed, with the half to go on the other side "bunched" next to the patient, then roll her over the "bunched" sheet and then spread it out on the other side of the bed, then have her roll back to the center of the bed (hope this makes sense--easier to show visually than with words..LOL) With a person on each side of the bed, lift the sheet with her on it, and you can try moving her from the head to the foot of the bed and see her response. This is the method that nursing staff use in hospitals to move a patient in the bed that is unable to move on their own. Of course her weight may be a factor as well. My MIL is 125 lbs but that is challenging for me to handle on my own without hurting my back, if she becomes deadweight and I'm not prepared.
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k3kerr - yes to all of your questions. My mom is getting at an advanced stage of her Alzheimer's that she is confused even about standing. I have a commode chair for her, so it is designed to wheel over where we used to have a toilet seat on her toilet. You get her to stand up briefly, remove the cushion and bottom and it has a hole in the chair which is over the toilet. That has bought us a few months of time, but she continues to go downhill on mobility, and standing now is becoming more of a problem. She used to be able to walk to toilet back in September, but now by January, different situation, she was degrading over the summer to the point by October that walking wasn't an option anymore. Now by January standing is becoming difficult. They have what they call Hoyer lifts, and a very clever, but very expensive idea of an Emergency Lift Cushion (over $2K). I should have got the Emergency Lift Cushion last summer when this started, but by now it would be overtaken by events. What I am not sure is, with her Alzheimer's confusion, will she tolerate a Hoyer lift, and us putting her in a sling?
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I'm following this one, because I am starting to be in this same boat, at times, when Mom decides she wants to sit in her chair to soon and causes me to pull the muscles in my back, in order to not have her fall, or the times that she decides she can't stand up because her legs don't work. She is unsteady at best anyway, but we "walk" together from her chair to the toilet, etc.

Do you have handrails for the toilet? Our connects to the back of the toilet where the seat screws are located, and we have a raised toilet seat, as well. For the shower, I have a transfer bench to assist with baths.

If she is sitting on the floor in a certain location, perhaps a chair there that you can help lower her to, to prevent the potential fall for her and strain for your back??
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