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TRANSFERRING TO A HIGHER TARGET SURFACE

A common maneuver in the home or elsewhere is a wheelchair-to-higher surface lift and transfer. Here's a typical transfer for a person with severe leg weakness, who can't stand on her own, but who has fairly good upper body control.

Make sure everything is out of the way. Position the wheelchair at a 45-degree angle to the target surface (the table). If possible, remove the arm of the chair nearest the target surface. As you lift and transfer the person, shift your weight from the front to the back foot. Move your feet to reposition yourself. Don't twist at the waist.

As you prepare to lift, bend at the hips and knees and put your arms around the person. Stagger your feet, and keep your weight on your front foot. Move her to the front of the chair, with as much assistance from her as she can give. She should put the arm nearest the target surface on the target surface and the other arm on the armrest of the chair. (Here, the liftee has her arm around the caregiver. Some people find this comfortable, but you get more leverage by pushing against a firm armrest, and there is a risk of injuring the caregiver if the liftee holds onto her.) After the person has been transferred to the target surface, help her to stabilize. Keep her close to you so that you don't hurt your back.

USING A MECHANICAL LIFT

If you can afford it, a mechanical lift can save a lot of wear and tear on your back. There are many types now on the market, ranging in price from about $1,200 to several thousands of dollars. Private insurance companies and Medicare will often cover all or part of the rental or purchase of one of these lifts. (You can also check with your local MDA office to see whether any lifts are available through a "loan closet.")

Mechanical lifts come in a variety of models. This is a floor model lift with a sling seat made by Barrier Free Lifts Inc., Manassas, Va., (800) 582-8732; http://bfl-inc.com.

First, you have to get the person into the device (see "Using a Sling").

It's not as hard as it looks, and the manufacturer will provide you with detailed instructions, often including a video. The retail dealership should also provide you with expert help, including showroom or in-home demonstrations, and, of course, you can consult with a physical therapist or nurse for more help.

For a completely immobilized person (someone in the advanced stages of ALS or Duchenne muscular dystrophy, for example), you'll have to use a rolling maneuver to help him into many types of available slings used in lifting devices. (Some slings come in two parts, and those are a little easier to use.)

Many people with weakness from neuromuscular disease can manage to wriggle onto a sling from a lying position, or at least can assist you as they move onto it.

For the person who needs help getting into a one-piece sling and has very limited muscle power, the technique shown in "Using a Sling" is useful. You'll need either a bed with siderails or a second person stationed on the other side of the bed.

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