She has been able to stand enough to transfer with assistance from wheel chair to toilet, and back- and to bed but now she's so weak she cannot stand up straight, her legs are too weak. I cannot lift her and even the gait belt is not helpful.
The hard part is over.
I'm matching you with one of our specialists who will be calling you in the next few minutes.
You are struggling to do this job adequately. I think that I would resign from this position and move onto working with another client. Don’t risk harming yourself or the client with a dangerous fall.
This person needs to be in a skilled nursing facility where they can receive proper care instead of an independent living facility.
This is the point when I fantasized about installing a lift... but it would have had to be two lifts, one for the bedroom and one for the bathroom (because a portable wouldn't have fit). But before I got to that point I came up against the reality of how much more difficult every. single. task. had become; from dressing to bathing to prepping pureed meals to feeding to dealing with incontinence and getting her medical care and more... and all that wasn't even considering her social and emotional needs and dealing with health crises.
Your client has moved to the bedridden phase, I'm afraid, and either you do all your care there, or she needs to be in a skilled nursing facility.
Call an occupational therapist, you should be able to get one to visit straight away in this situation, so with any luck tomorrow. There are various stand aids you can use for transfers from bed to wheeled commode, then you can push the wheeled commode over the toilet if there's room, or she can use the commode on its own if need be.
Has the decline in mobility been very sudden? Do you need to get medical advice as well?
If you work completely independently, call the NOK or POA yourself to report the changes & discuss.
When a friend caring for her Mother became too weak to stand & transfer safely, the family hired a lifting machine. This usually is a 2 person task in a facility but many trained & confident caregivers operate solo in a home setting (very much depends on home set up, weight of patient, strength of caregiver - no injuries etc). My friend choose not to use the lifter solo & risk injury to either, so Mom stayed in bed from then on. For meals on trays, sponge baths, bedpans & changing continence pads. A hospital bed was provided by Hospice.
Caring for bed-bound people is best done with an electric hospital-type bed - to raise to your working height for your own occupational safety.
Speak to Supervisor, NOK/POA so they can obtain the right equipment for you to continue your job.
Your communication skills will be needed here:
- To inform the person with authority
- Ensure they SEE the issue
- Ensure they ACT on it
Also to inform them of what your actions will be if they do not eg Firstly, not getting the lady out of bed if not safe to do so.
Best of luck.
In regards to a Hoyer lift make sure you measure the clearance between the bottom of the bed and the floor. Our bed was too low so we couldn’t use it.I found it also very cumbersome to use. buying a new bed was out of the question because they already had a very fancy bed where it could either lift the legs or lift their backs up for comfort.
so that’s another thing. You might get a bed that lifts their backs up into a sitting position to assist with the transfers.
I agree with others, gait belts as useless. I think it’s more dangerous to try to use it than not.
also it may be the way that you’re trying to do the transfer that works or doesn’t work. No offense meant here because I can’t see what you’re doing so I don’t know exactly how you’re trying to do the transfer.
I set up the two items that require the transferring obviously as close as possible then putting my arms underneath her arms acting as if my whole body was a machine using arms, legs, back & feet etc lifting her up just for a few moments to transfer. I usually used my arms completely underneath her arms as high as I could go because her forearm skin was too frail to hold onto.
fortunately I was strong enough to do that but I must admit it did take a toll on me but it worked
And maybe this is not an issue at all but I’m throwing it in there because my Mrs. did this. Some days she just didn’t wanna cooperate and it would go on for a few days to a week where she would just try to be dead weight. Is she having an attitude? Might need to address that as well; but anyway good luck to you!
You do not say whether you are caring for her in your home, or if you already have some type of in home care support services . If not, get some and, I suggest from your description have her assessed by a hospice of your choice for possible hospice admit. This will give you a broad interdisciplinary team support in the home and manged care for the patient. If you just want to talk to hospice and learn more about service and describe your situation, call one of your choice , they will be glad to speak with you. Then you can contact physician and tell him/ her you want hospice services and the order can be provided.
Or, get referrals from physician for another type of pt. " Level of care needs" assessment and go from there. Look into facility options as well.
Or call 911 and have her transported to ER for decline and safety reasons and your inability in provide safe care ; once there they can better assess status and you can confer with social services at hospital for referrals; possibly placement or placement in respite while decisions are made.
Take care of yourself.....
She also was completely incontinent.
She had caregivers at home and it was a matter of time before someone got seriously hurt. Mother was 5 ft but weighed 180 lbs, no frail lady.
Sister and I were not able to transfer her either.
We both had hoped she could remain at home but it was not possible with the care she needed.
Disposal underwear is used - as toileting needs happen in a bed.
I believe we need more information here to assist you -
1. is she home
2. how / how many caring for her?
4. Finances - if she isn't in a facility, can arrangements be made to get her in one?
I really do not understand the question. If a person cannot stand / move / walk with support, they are bedridden. Hoyers are very difficult to use although this is possible, depending on who is managing the hoyer. (This is how my friend in a nursing home is transferred into a wheel chair).
Gena / Touch Matters
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