Mechanical Lift to move a patient

We have a Hoyer manual lift 6 years, since 2006. It is rented from a medical supply house through Medicare, and AARP picks up the difference. At the time we received it Husband was recently out of the hospital from dehydration.  He was very weak.  I used it a few times in those 6 years, but it was more for a secure feeling knowing I could move him if I needed to with no one else to help.

In 6 years I have used it to get him off the floor a few times as I have told in other blogs. I started using it regularly about 3 months ago to put him into bed.  I had been transferring him using the gait belt, but his legs were no longer able to bear weight and a few times we both nearly wound up on the floor. Using it those few times in the past was good practice for now when I really need it every day.

In the last few weeks I use this lift to get him out of bed and into the wheelchair for breakfast at the dining table. I use the Skid Seat to pull him back into the wheelchair. Then from the wheelchair into the recliner where I then use the Bed Sled to pull him into position in the recliner. This is why I make these products, I use them myself.

Later in the day I use the lift to get him out of the recliner to the toilet, with a side trip to the bedroom to remove his brief and loosen his pants. Back into the lift and to the toilet where we maneuver the lift around the toilet getting him positioned over the seat and lowered into position. Our bathroom is not large and there are grab bars installed wherever they were needed. (The bars serve little purpose now). To remove the sling and get him released from the lift means climbing into the bathtub.

Tight Bathroom

Once lowered onto the seat Husband uses the the horizontal bars on the lift to hold himself forward and keep from leaning.  The legs of the lift reach the wall behind the toilet keeping it from moving back any further and makes it pretty stable for him to hold on to.
While he holds onto the bars I am able to assist him and hook up the sling again when finished and ready to get up. Then back to the bed to put on a fresh brief and his pants.  Depending on the time of day he may return to the recliner or sit in the wheelchair waiting for bedtime.
I am so glad this lift is here.

This blog offers 2 suggestions:

1. 1. Have a lift in house BEFORE you need it if possible. This will give you time to get comfortable with its operation. The few times you use it before conditions worsen will get you familiar with its limits for working room, how tight a space you can work in.
2. When using the lift on bare legs, like after using the toilet when pants have been removed, place cloth ( a washcloth will do) under the patient's legs where the sling will be wrapped to prevent the sling from irritating and cutting the skin. I try to keep Husbands pants on his lower legs while on the toilet. Then I pull them up over his thighs enough to allow the sling to go under the cloth.  It is clumsy but more comfortable than having the sling in contact with the skin.

How I got into “this mess”(his words)

June 23, 2012...He is groggy this morning, looking like he could fall back to sleep at the table. He is feeding himself his banana, but needing help with the oatmeal. 

Between spoons of oatmeal he asked me" how did I get into this mess”, spreading his hands over the dining room table.  I was not sure what he meant, still not sure I do.  I asked him to explain.  He said about the house, and all the hassle, was it all worth it.  He did not say specifically his condition. He asked if I own the house. I told him yes.  So I am not sure he knows who I am or where he is.   He finished his oatmeal, and his eggs and bun and juice. He took to his woodworking magazines and seemed absorbed so I went to the computer.

He is still subdued, drowsy. Maybe he will sleep at the table for awhile.  He does that sometimes for a few minutes, sometimes for hours. I have been sitting in my office  for a while now and he has not called me. So he is probably sleeping. I will check on him in a few minutes.  

I have mixed feelings when he sleeps.  I get some “free” time but I cannot go anywhere. I cannot do anything that will disturb his sleep. I can’t get involved in something that requires a commitment of my time and attention because if he wakes and calls me I must drop what I am doing.    

It's time to check on him and maybe go see if there is any mail.  It's a beautiful day, not too hot or humid.  Maybe we'll go grocery shopping later.

Getting Out of Bed is More Difficult

My helpers are here Monday through Friday, so Saturday and Sunday I am on my own.

This being Saturday, I had no help to get husband out of bed.  He wanted to get out of be right away, not waiting for his pills to kick in. The last few days I have needed help to get him up and into his wheelchair. This morning I am on my own.  

This morning he seemed strong enough to help himself a little.  I use his ability to grasp and hold his assisting bars to determine how much strength he has. I got him sitting on the edge of the bed holding onto his support bars.  From this position, on days when he is able, I shift his body sideways onto his wheelchair and  he uses his legs to raise  himself to clear the side arm of the wheelchair. I tried to get him to his chair like I normally do when he has some strength to stand.  I got his tail bone to the chair with him still hanging on to his bars.  I could not get him to stand nor could I leave him alone at the front of the chair while I went around back to try t pull him in. So I tried to push with my knees against his, but he was not able to hold himself up any longer and started to slide to the floor.  I told him to let himself down easy as I pulled the wheelchair out and away from him.  When his tail was on the floor I pulled the chair out the rest of the way and lowered his head to the floor onto a pillow.  

Fortunately I have had to get him off the floor on a few occasions so I knew how to use the Hoyer lift ( a mechanical lifting device) to get him up. I got the sling under him and jacked him up. I jacked him high enough to get his wheelchair under him and lowered him into the chair. We went the dining room table for breakfast.  His pills kicked in about 30 minutes after he was into his wheelchair.  Some days it can take an hour or more for the pills to start working. And sometimes they don’t seem to work at all.   He has been taking these same pills for 14 years. We were told in the beginning that the pills will lose their effectiveness after about 8 years.  So I guess we’re lucky they still work for him.  When they work.

corner filed off so Hoyer can get in

I have been wondering how soon I would be needing the Hoyer to get him out of bed.  I guess it’s pretty soon. I have been using the Hoyer to put him to bed for about a year. And the last 2 weeks I am using it to get him onto the toilet during the day then back into a wheelchair for the remaining hours until bed. Maneuvering in our tight bathroom is the hardest part.  I recently sanded off the corner of the sink cabinet to allow the wheels of the Hoyer to get in alongside the toilet. It helps but it’s still tight. 

He’s reading now. I have the air conditioner on. The cats are running around because it is cool enough to be active. (when it’s too warm they sleep)  I hope he doesn’t decide to go to the shop to do wood working.  Although I might be a good change for me to work at something other than sewing or getting votes for the grant.

Update May 2012

This past month has been scary.  Don has been quiet, polite, subdued.  But drooling has been really bad for nearly week.  Swallowing is very difficult.  Choking not an issue because the food does not get that far.

Friday morning he had his normal oatmeal, banana, juice, eggs, and bun. He could not eat his lunch or dinner. Saturday he ate 2 small pancakes and a little juice.  He normally would eat 4 large pancakes, a banana, and juice.   Again he could not eat or drink his lunch.

After lunch that he did not eat, we went shopping to purchase more patches for the tissue box holders.  He sat quietly the whole trip.  He did not want anything to drink.  I’ve been concerned about dehydration and now I was starting to really worry.  In the past two days I don’t think he drank 8 ounces of liquid.  But he was still losing all that fluid in his drool.    I know this has been playing on my nerves and my conscience… was I the cause – neglecting or missing something?

I have been giving him additional Ropinerole or Carbidopa/Levadopa a half hour before dinner hoping it takes effect before I serve the meal and he will be able to eat.  Lately that plan has not been working. Considering his state I decided to give him a larger dose, it could not/would not do any harm.  It took 45 minutes but finally it took hold.  He wriggled and danced in his wheelchair which I know he hates, but it signals the drug is working.  I got him to eat… and boy did he eat!  4 large eggs, sausage, potatoes, 3 pieces of cake, left over pie, soda, juice.  Made up for not eating all day, and part of day before. 

I guess we are back to a larger dose again until he gets maxed out with hallucinations, irritation, demands, confusion.  Might be only a few days, maybe a week and I’ll be cutting him back again.  At least I get a momentary reprieve from worry about dehydration. 

It’s amazing how much he can change from day to day, even hour to hour.
You can tell markedly, when his medication wears off, even though his condition is such that you would swear it was not working, if that makes any sense. That’s where the worse becomes worser.
These past couple weeks, he has been so very weak. Eating less. Drinking less. Waking during the night wanting cold water.
Mornings are best, after I get him washed up and dressed from bed. I give him his medications before he gets out of bed so they have time to start working before he gets to the table. I can tell pretty well by how much assistance he needs to get out of bed, how the day will go. Lately, he needs a lot of assistance. I sometimes have to call the daytime assistant to help get his wheelchair under him because I can’t let go of him long enough to do it myself. If he is strong enough, I am able to support him myself while I reach for the wheelchair.
Depending on his condition he may need to be fed. On good days he will feed himself. Yesterday started off pretty well, he fed himself at breakfast. Later, he wanted to putty the floor in the sun room. He was too interested, too determined. He tried to do it from the wheelchair which I knew would not work.
I helped him down onto the floor onto foam pad. After the episode of getting him off the floor using the pneumatic lift (see previous post) he was quiet the rest of the afternoon. At dinner he could not stop yawning and soon fell asleep half way though his meal. This has happened before but usually he can hold out until later in the meal. He woke about an hour later and we watched TV until it was time for me to feed the kittens about 8 pm. (See other blog story)
We went back to feed/watch the kittens and he indicated he wanted to go to bed. I got the kittens back into “their room”, my bathroom off the bedroom, and got him into bed. Not without difficulty. He let me use the pneumatic lift to get him off the floor, but won’t let me to use it to get him into bed. My back tells the story more times than I can count.
He fell asleep immediately. Slept soundly until 3 am when he called out for cold water. Then his legs starting jumping and he wanted medication. I don’t normally give him meds at this hour, but I did and adjusted his dose at breakfast. Afterwards, he was restless in bed, wanted to get up. I got annoyed telling him its only 3 am. He got angry and said he can’t help it (which made me feel guilty for being annoyed).
I got him up and dressed not knowing how long he would be up. We went to the table. He had a sweet roll and tea. Considering he ate only ½ of his dinner, this did not surprise me. What was unusual was his getting up at this hour. He was back to bed by 4:30 am. Years ago when his disease was diagnosed and we were trying to get his medications figured out, this was an every night event. I hope this is not an indication that those late night wake up calls are coming back.

On the floor? He's trying!

These past couple weeks have been difficult…in many ways. Husband’s condition has been worse, varying from worse to worser. Some days he is nearly a zombie, no speech, little movement, and little interest in surroundings. Getting to the toilet or bed from the wheelchair requiring a gait belt transfer with much difficulty. Other days like yesterday start off fairly well.
We are (I am) finishing a “sun room” addition added on last spring to accommodate an elevator wheelchair lift. The lift was installed this past April and is used every day, sometimes two or three times a day. He has not been able to use the stair glide for nearly a year. We waited more than 6 months for this elevator because we used assistance from our County Area Agency on Aging. The construction was put on hold until the elevator was installed so the contractor would know where to install the entry door. The room is now able to be finished inside, paint, trim, flooring, etc.
I know a little about working wood from building fancy doll houses years ago, so I was able to put up the window, door, and baseboard molding. Some of it was tricky because the addition was made to fit under the front porch roof so there is not a standard room height or door height. Everything is shorter 6-12”. Anyway, the trim came out looking pretty good. The painting is now complete.
The vinyl flooring is next. The unfinished plywood floor is nailed or screwed to the support joists. The edges of the plywood are not level to each other and there are dimples or holes from the screw holes that will show through the vinyl. These need to be filled so the vinyl will lay flat. This part of the project was put off until the walls and trims were painted.
Husband wants to help - Husband insisted he would do this part of the project, using wood putty and a putty knife. It meant he would have to bend over while sitting in his wheelchair to reach the floor to apply this putty. He could not reach the floor. He wanted to get onto the floor so he could do it. No matter what I said I could not convince him he could not do this.
Getting him off the floor…If anyone had seen him they would have asked if he fell. No, I put him down on the floor, dropping him onto his knees onto a foam cushion. He insisted he could do this. I knew better. He landed on his knees, sort of. Then slid onto his side and lay straddling the cushion. I went to get a pillow for his head. I got him into a reclining position, which, because of the small size of this room, could not have been too comfortable.
He wanted to sit up…impossible. He could not stand to get out of bed without assistance; no way could he sit unsupported on the floor, legs out straight. If we did not have the pneumatic sling lift I would not have given in so easily. I’ve used it before for the same purpose, getting him off the floor when he would not hear otherwise.
I told him to lay there for a while to get his breath and gather his strength to get up. He lay for about 2 hours watching me while I continued to work around him on the sun room. Finally he wanted to get up.
Rolling him from side to side, I was able to get the sling under him and get him lifted enough to get him away from the walls. Fortunately this room was made to be ADA compliant for size so I was able to maneuver the lift so that I could get his wheelchair under him again. I should mention husband weighs about 110 lbs.
Once in his wheelchair he sat and watched as I got down on my butt on top of a cushion and scooted myself across the floor to fill the holes. It took about an hour to fill the gaps and holes, moving his wheelchair from one side of the room to the other as I moved across the floor.
Comical? I thought of taking a picture of him on the floor to show him and his daughter later. I did not. I don’t think he would not have seen the humor in it. I give him credit for trying!

Disabled Elderly - Caregiving and coping

I have been caring for my disabled elderly husband who has Parkinson's Disease for 12 years. He has been a wheelchair patient for six years. As sole family caregiver I have to find ways to do things that work.

We are married 32 years, so there were good times before he became ill. I have no degrees or titles than enable me to offer these tips for Parkinson's care except that of being the family caregiver to my husband. For the last 11 years we have lived with this disease. In the beginning he was only mildly affected but over time his disease has progressed to him being a wheelchair patient. For the first 6 years I was his sole care giver, living with and getting to know his limitations that changed from day to day. He was 71 years old, I, 22 years younger, was 49. (He is now 82, I am 60.) My "career" came to an abrupt halt as I stayed home to be the family caregiver for my husband.

In desperation I searched frantically for assistance to cover his medications and help to adapt the house to his needs. Everywhere I tried, either there was no program to help us or we were only dollars from being eligible. Finally one day I made the right contact at the Pa Dept of Public Welfare Department of Senior Services for our county. I had tried there the previous year and was told there was no program to help. I called there again and again every few months. On my last call I coincidentally timed it at the beginning of a new program and was able to get my husband enrolled. The program was not for Parkinson's disease patients only, but for any senior that might otherwise be placed into a nursing home. The goal of this program is to keep the senior patient in their home, out of a facility, as long as possible. We have been enrolled 6 years. This program has been a life saver, life changer.

I am still the family caregiver but this program has given us caregiving help, a Certified Nursing Assistant (CNA) to help me care for him and enable me to regain a few hours a day of my own. It has helped us make adaptations to our home so he can use the bathroom and stairs. It has given him prescription coverage. I strongly urge you to seek help from this agency if you are have a senior that needs assistance. There are other agencies that may be able to help in different ways. Keep knocking on doors, making phone calls.

Please visit my web site www.caregiversaide.com to see my Patent Pending Skid Seat(R),

my reusable bed pad and related items you may find useful in caring for your loved one. Thank you.