A Guide to Hoists

Mobile Hoists

Mobile hoists are very versatile, they can handle virtually all lifting scenarios providing there is room to maneuver. They can lift from beds, baths, toilets and floors. As a general rule larger (and more expensive) hoists, lift more weight higher. The Oxford "Major" for example, will lift 190kg 1.2m off the floor, high enough to clear special mattresses.

There is a downside however. A hoist that lifts a lot of weight needs to be longer and wider for stability, this can make it unwieldy. Older buildings with narrow hallways, tight corners and small rooms, lend themselves to smaller hoists with weight and height limitations.

Wheel size is an issue, particularly when the hoist needs to be wheeled under a piece of furniture. A large wheel, for example, makes the hoist easier to push, particularly on carpet, but might not fit beneath a bed.

The legs of mobile hoists can be opened to fit around arm and wheel chairs.

There are two principal ways mobile hoists lift, manually via a hydraulic pump operated by the carer and battery operated. The benefits of each are summarized below:

Manual / Hydraulic

* Low cost.
* Easily maintained.
* No batteries to charge, so they are always ready to lift.
* Ideal for occasional and emergency use
* Prices range from £525 for a small hoist to about £800 for a heavier duty model.

Battery Operated

* Easy operation at the touch of a button.
* Ideal where frequent lifting is necessary.
* Can be used in awkward corners where it would be difficult to operate a pump.
* Some clients are able to assist the carer by pressing the buttons themselves. This has the added benefit of giving the client a degree of control.
* The carer is free to position them self to move the client during the hoisting process.
* Prices are around three hundred pounds more than the mechanical equivalent.

Standaids

A variation of mobile hoist which lifts the client from a chair to a standing position. As the client needs a degree of leg strength, the knees rest against a pad, individual assessment is needed. It can greatly simplify transfers and toileting as the slings, unique to these machines, are straightforward to use.

Bath and Swimming Pool Hoists.

These are bolted to the floor, next to a bath or pool and support a chair that is lowered into the water. The lifting arm rotates around a central column which allows the client to be seated, lifted, and moved until they are over the water prior to lowering.

Hybrids

Some mobile hoists such as the Chiltern Duo & the Multi Lift from select () can be used as both a conventional hoist and standaid.

Overhead Hoists

Overhead hoists are increasing in popularity. The hoist unit hangs from a track that is securely attached to the ceiling. The client is suspended in a sling from the hoist unit and moved along the length of the track. Although the over head can only be used where there is track it is particularly useful in places where it would be awkward to wheel a mobile. Track configurations can be anything from a straight run, through complex arrangements with bends and turn tables, to the XY system which allows complete coverage of a room, such as a hospital ward.

Because they are less obtrusive than a bulky mobile they are proving popular in private homes. The lifting unit is up out of the way and two short lengths of track in the bathroom and bedroom provide a system for the carer that meets nearly all handling needs.

How to use hoists and slings

Maneuvering

Mobile hoists, particularly with a client suspended, are about as maneuverable as a heavily laden shopping trolley. However, armed with a little knowledge it is possible to make them go in the right direction.

Before attaching the client to the hoist, make sure the wheels are pointing in the right direction. When moving a shopping trolley or hoist the wheels follow the direction you pull or push. If they are facing the wrong way, as the hoist is moved the wheels have to turn through 180 (ish) before they run smoothly. Add the weight of the client and hoist to the drag of the wheels that aren't turning and you have a much harder physical task than necessary.

As the hoist is pushed under the bed or chair, give a small flick, moving the hoist backwards to bring the front wheels into line for pulling the hoist back. Then, kick the back wheels into position so they will follow the loaded hoist.

Brakes.

9 times out of 10 the brakes should be off. There is a simple reason for this. With the brakes 'on', as the client is lifted she will swing towards the center of gravity. This makes the client feel insecure and could result in them swinging into the hoist and injuring themselves.

By leaving the brakes off the hoist moves towards the center of gravity ensuring a safer more comfortable lift.

When moving the hoist towards a client, be aware that the spreader bar coming towards you at eye level can be distressing.

Unfortunately, the leg length, which gives stability during lifting, can make mobile hoists impossible to use in many buildings. Small lifts, bathrooms and tight corners can be major obstacles. In these situations either overhead hoists, or small hoists like the Oxford 'Mini Standaid' or the Liftmaster 110, are ideal.

Attaching the Sling.

An area of confusion is the fitting of the sling around the client and to the hoist. This is not rocket science and a little practice, first on yourself and then a colleague will serve you well.

Although slings vary, depending on the needs of the client, the principles of usage are similar. Perhaps the most versatile and comfortable slings are similar to the Oxford "Quick fit Deluxe" or "Chiltern Hammock". This gives ample support for 95% of clients, aids toileting and used properly, is extremely secure.

The first step is to familiarize yourself with the sling. Make sure you know which way up and which way round (handles facing outwards) the sling goes. Look at the leg supports, note that the inner straps are short and on the inside the outer straps are long and on the outside.

Have a look at the commode aperture, (between the leg supports). Irrespective of where you are lifting from the top of this aperture needs to be at the base of the spine.

The sling needs to be drawn under the client and the leg supports drawn up between the thighs so that the inner leg straps can be held together.

To help connecting the straps to the spreader bar, think of the spreader bar as the waist when it is across the body line. Leg straps go below the waist, and shoulder straps above. The middle hook found on some hoists, corresponds to some slings which have intermediate straps.

To maximize safety for the client it is recommended that the inner leg straps are crossed before feeding the outer straps through the loops of the inner straps. This is easier than it sounds. Cross the inner leg straps by feeding one through the other. Next, take one of the outer leg straps and feed it through the crossed inner strap before connecting it to the corresponding hook on the spreader bar. Repeat this for the other leg.

Connect the shoulder straps to the corresponding hooks. To keep the client in an upright position during the lift, keep the shoulder straps short and the leg straps long. Although lifting a client in this position is preferable, there is a risk of a client tipping forward, so individual assessment is crucial.

TIP: check the sling loops are firmly secured before commencing lift.