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.
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.
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.
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.
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.
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.
How would you get your mother downstairs if a problem arises and she is homebound on the second floor?
See All Answers