GIVE ME A LIFT

The Right Tools for the Transfer

by Kathy Wechsler

Independent transfers can be made using the SureHands body support. The two-way switch allows access to two different points from the same track.

You’re still transferring independently, but you’ve fallen a couple of times on your way from the wheelchair to the bed.

Your caregiver still lifts you in and out of the bathtub, but her groans from back pain are getting louder.

It’s time to start thinking about a mechanical or powered lift system that you can use at home, and maybe one for work, too.

Risky Business

Falling due to unsafe transfers is particularly dangerous if you have a neuromuscular disease because your bones are likely to be fragile, making it easier to break them. It also takes longer to recover from an injury, and being less mobile while you’re recovering puts you at risk for joint contractures.

A lift is “really as much or more so for the caregiver, in a lot of ways, as it is for the patient,” says Jodi Bales, an occupational therapist (OT) at the Forbes Norris MDA/ALS Center at California Pacific Medical Center in San Francisco.

Caregivers can develop back pain, hernias and other injuries from repeated lifting, especially as they age.

Lifts prevent injury, to the user and the caregiver.

Making It Happen

The first step toward getting a lift is to ask your doctor for a home safety evaluation, says Bales, who has nine years of experience helping people with neuromuscular diseases find lifts that are appropriate for their needs.

Sunrise Medical's Classic Hoyer Lifter is a hydraulic patient lift that can be converted into a power lifter by adding a power actuator, charger and detachable battery pack.

This involves an OT or physical therapist (PT) visiting your home and looking at the rooms in which you want to make your transfers. Your therapist will ask if you plan on transferring independently. If not, the therapist will meet with the caregiver who’ll be doing the transfers.

Your therapist will then recommend equipment based on what he or she finds, Bales says.

The next step is trying out the equipment. You’ll find some types of lifts (mostly mobile lifts) at your durable medical equipment (DME) dealer. If your DME dealer doesn’t have an OT on staff, then you’ll want to go there with your OT and try out a variety of lifts.

The lift specialist at your DME dealer knows the details of each lift, while your OT looks at the way your body fits in the lift.

For lifts not carried by your DME dealer, such as ceiling- and wall-mounted lifts, you need to call a company that specializes in these lifts and ask to work with a local representative. Your OT should be included in your meetings or discussions with the rep. Horcher Lifting Systems, which distributes Barrier Free Lifts, and SureHands Lift and Care Systems are two of many companies that offer lifts.

Don’t forget to look at slings; you’ll need a sling to attach to your lift and support your body in a sitting position during transfers.

Many lift companies carry a variety of slings, each serving its own purpose. The standard sling has a base and back for complete support and can come with a head support if needed. There’s the hygiene sling, with a large cutout that makes transferring to the toilet more convenient. For bathtub or pool transfers, the bathing sling is identical to the hygiene sling except it’s made from material that can be easily wiped dry.

Slings that are easy to get on and off your body can sometimes be used independently. Besides carrying various slings, SureHands offers a unique stainless steel body support that holds your upper body and lifts under the thighs. If you have some shoulder strength, it can be easy to use by yourself.

Choosing a Lift

Most lift companies offer a range of choices. Besides helping you accomplish your daily personal needs, many lifts can assist in recreational and leisure activities as well as physical therapy.

For example, lifts from some companies have been used to help people mount a horse or motorcycle, lower someone to the floor to hug a dog, lift people into a pool or sailboat, and help a patient and PT work on ambulation (walking) skills for rehabilitation.

The EasyPivot from Rand-Scot braces the user's knees, and the chestpad rotates upward and forward to raise his or her buttocks.

Floor Lifts

A floor lift, also called a mobile lift, is a metal framework with an elevating mechanism and an extending arm.

It can be wheeled from room to room and doesn’t need to be installed anywhere permanently. But it’s large and difficult to use in tight spaces such as small bathrooms.

A floor lift can be hydraulic, manual or electric (battery-powered). Two main factors determine which kind of floor lift is right for you: ease of use and price.

A hole is cut in the wall so that this Guldmann celing lift can make its transition through the doorway.

With a hydraulic lift, such as the Classic Hoyer Lifter from Sunrise Medical, your caregiver operates the lift by manually pumping a lever. But sometimes the pumping action can use up the caregiver’s energy and strain his or her back.

A manual lift, such as the EasyPivot Patient Lift from Rand-Scot, is hand-cranked without the use of hydraulics.

The main reason for getting a hydraulic or manual lift is the price, which ranges from $965 to $3,500. You can expect to pay anywhere from $2,700 to $9,500 for a battery-powered floor lift such as the Diana from Horcher.

The user can move from room to room without doorway renovations with Liko's Likorall R2R.

A power lift is operated by the touch of a button and is less physically strenuous for the caregiver.

Going on a trip? The LikoLight from Liko, the Molift Smart from Molift and the Portable Transfer Aid (PTA) from Take-Along Lifts are some lightweight, foldable mobile lifts that transport easily for travel by vehicle or airplane.

Celing-Mounted Lifts

An alternative to the mobile lift, a ceiling lift may solve the cramped bathroom problem. It also eliminates the storage issue.

SureHands, Guldmann and Horcher are just a few of the companies that sell these systems. Ceiling lifts are quite expensive ($8,000 to $14,000); the cost depends on the amount and configuration of the track and the ceiling structure.

The Pontus from Guldmann is a freestanding rail system that can be easily assembled and disassembled for use in such locations as dorm rooms or apartments.

Besides making it easier for a caregiver to maneuver the user, a major advantage of a ceiling lift is that you may be able to use it independently if it has a four-way motor and you have enough upper body strength to put the sling or body support on by yourself. The four-way motor allows you to control the lifting and move the lift along the track with a handheld remote.

There are numerous options when it comes to ceiling lifts. You can have a tracking system installed on your ceiling, running the whole length of your house and taking you through doorways to specified areas such as your bed, toilet and shower in a sling or body support. Two- and four-way switches enable you to reach either two or four places from the same track.

The UNILIFT ceiling lift from Horcher is mounted permanently on the ceiling or wall to fit the dimensions of any room.

To go from room to room, the ceiling track must fit through each doorway and allow the door to close. The installer cuts into the door header or through the wall to accommodate the track so that the door can still be closed.

Want to avoid renovating your doorways? Liko’s Likorall R2R provides for room-to-room transferring using dual motors and a lift strap that allows your caregiver to release the tension from one motor and increase the tension on the other motor.

Another option is to install ceiling track only in the areas where you make your transfers — one over your bed and one over your toilet and shower. You’d get a portable motor and transfer it from one track to the other track. A portable motor can’t be used independently because your caregiver would have to push the motor along the track.

If your ceilings are vaulted or have obstructions such as heating or skylights, suspending track from the ceiling is a way to keep the track level. It’s more expensive because it’s harder to install.

You might not be allowed to install any kind of ceiling track system if you’re living in an apartment or dorm. In that case, a more portable solution is a freestanding lift system, such as the Easytrack from BHM Medical, the Lift Aid 2000 from Liftaid Transport and Guldmann’s Pontus, which disassembles and can be moved.

SureHands has installed ceiling track systems in accessible rooms in four popular Las Vegas hotels: the Mirage, Bellagio, Treasure Island and Wynn Resort.

The Wall-to-Wall lift system from SureHands can be placed between the bathtub and toilet for convenient transfers in small bathrooms. A bathing sling is made from anti-slip synthetic material that can be easily wiped dry.

Wall-Mounted Lifts

You may prefer having a lift mounted on a wall. Like the ceiling lift, it’s convenient to use in tight spaces.

It’s easier, faster and less expensive to install a wall-mounted lift. Especially in the bathroom, where the ceiling may have skylights or elaborate shower enclosures, it’s difficult to install the ceiling track. It’s also unattractive to have a track running under the skylight.

Say you need a lift in your bedroom and bathroom, and you’ve already determined that both mobile lifts and ceiling lifts won’t work for the structure of the rooms. With SureHands, you have two choices: You can either get two separate lifts, one mounted on a wall in each room, or you can put wall plates on each wall and routinely transport the whole lift (motor and all) between the two rooms.

Of course, the first choice is more expensive, but it’s more convenient. Just have your caregiver remove the sling or body support from one wall lift and place it on the other one. The second option saves you money, but the lift itself is heavy (35 pounds). The routine can become tiresome, and you may end up buying a second lift anyway.

Many types of lifts can be mounted on walls. You can expect to pay $3,500 to $8,000 to purchase and install a wall-mounted lift.

SureHands and BHM Medical offer wall-mounted lifts that have a powered up-and-down (lifting) motion operated with a hand control. These lifts require your caregiver to push the lift’s arms from side to side, making independent transfers difficult but not impossible.

SureHands and Horcher also offer a track system for wall-to-wall mounting across a room. It looks and acts like a ceiling lift, but each length of the rail is reinforced by a wall bracket.

Need more options? The Port-A-Lift Personal Transfer System from Ability Access and the Multi-Lift from Access Unlimited can be easily moved from bedroom to bathroom, provided that both rooms’ walls have mounting brackets for the lifts. Both power lifts also can be used to transfer you into and out of your vehicle, and both fold and store easily.

You can purchase the Easy-Base to use with your Multi-Lift for travel and vacations. It folds easily and is lightweight.

A Word About Funding

While most hydraulic lifts are covered by insurance or funded by Medicare or Medicaid with a prescription from your doctor, power mobile lifts are more tricky to get funded because the power component isn’t considered medically necessary, Bales says.

To get a power lift funded, you’d have to document that your caregiver has physical problems that don’t allow him or her to use a hydraulic or manual lift.

Ceiling- and wall-mounted lifts are a different story — most are paid for out-of-pocket. Sometimes your Vocational Rehabilitation (Voc Rehab) office will fund a ceiling lift if one’s necessary for you to find and keep a job.

You can also check with your local MDA office to see whether any lifts are available through the loan closet.

Silver Cross provides information on lifts and funding, and is North America’s leading source of recycled equipment such as ceiling lifts. Visit www.silvercross.com and register to get more information.