Hoyer lift use in homecare - how much training is required?

[jm_emt]

Hoyer lifts are sometimes used in home care nursing but lack of space, heavy pile rugs, difficult storage, and untrained or too few caregivers are often challenges to home use. So many total care patients may remain bed-bound even if a hoyer lift is available.

Since most patient lift manufacturers strongly recommend two trained caregivers be present during transfer, a home care CNA and a family caregiver together can sometimes do the hoyer transfer working together.

However the family caregiver should be trained in the use of the lift to prevent patient falls or injury. The questions are:

1. How much training is required?

2. Who does the training?

3. Where is it done?

4. How can it be determined if the home caregiver is strong enough to be of assistance and adequately trained in the use of the hoyer lift?

[Libby1987]

Home health physical and occupational therapists train caregivers in safe and proper use of equipment.

[Dusty Trail]

I received no training and learned by asking questions and watching videos. The Hoyer arrived the day before my Mother was released from the Rehab Facility. I did have her PT nearby during her scheduled visits if I needed assistance but I did it alone so that I could get the hang of it. The HHA sent a NA that didn't know how to use one then after I complained they sent someone out to train her for 1 hour. NA was told that it wasn't necessary to spread the Hoyer legs open. After the hour ended I told the NA to always open/spread the legs to prevent the Hoyer from tipping over. I did not keep that NA for long because she couldn't do a Velcro brief either! While it would have been very helpful to receive instruction I unfortunately didn't have any beforehand and learned by patiently slowly practicing. There is a real need for Instructional Classes for Family Caregivers but I didn't have that option and I'm still learning.

[AMN74]

As a home health nurse, if I see that a patient needs a hoyer lift..if there is space to use/store a hoyer lift, if there are people that are teachable in the home, then I will order a hoyer lift. But I always order a PT consult to have them teach the patient and family the proper way to use the hoyer and hazards if hoyer is not used properly.

[jm_emt]

Thanks to all for their comments. It seems like there is no standard for training in the use of lifts. However when it is done, PTs are the best sources of training. But not all people that leave a hospital or an in-patient rehab facility are assigned a home-based PT.

It would be interesting to know if PTs and nurses routinely request Hoyer lift rental in the home if the patient cannot bear weight or cannot provide the caregiver much assistance in moving from the bed. But then they would also be responsible for doing the training themselves.

[Libby1987]

I would imagine, with the pressure to reduce re-admissions, that most facilities transferring a patient new to requiring hoyer lift transfers are referred to home health. Certainly all a family needs to do is request a referral as hoyer lift training is reimbursable, even the different MediCal programs don't require pre auth for a PT/OT eval

[Not_A_Hat_Person, RN]

At my current job, Hoyer lifts were part of orientation. At my previous job, I learned from the family. I've only used the lifts alone. The vast majority of my clients have ceiling lifts, but 1 or 2 had the old-fashioned Hoyers.

[jm_emt]

Libby1987 - I have never heard of reimbursement for Hoyer lift training in the home for primary caregivers. I thought the DME delivery company that rented/sold the lift did what little training there was. If reimbursement were available, ideally a PT would do the training however I assume home health care nurses (LPN, CNAs) could also do it.

In either case, I think the hospital release coordinator (or the case manager at the home health care agency) would be responsible for requiring that two trained caregivers (2 family members, or a nurse and a family member) were present when using any lift that they authorized for home care. If a patient got hurt without the two trained caregivers present, the hospital or agency could be held liable.

I personally have had dealings with one of the larger internet sellers of lifts who supposedly have salespersons with an average of 10 years experience. The salesperson I talked with had no idea how many people were required to use the lift even though the literature at the site strongly recommended that two caregivers be present. It seems that people who buy lifts on the net will not get much information or support about how to use them. They will need to depend on medical professionals for that.

[Libby1987]

It's not that there is Hoyer lift training reimbursement per say, but that transfer training with new equipment and/or patient with new/changed condition is a qualifying skilled service under the CMS (Medicare) guidelines.