Sit-To-Stand or "I Don't Think You're Doing That Right..."

[Skayda]

We recently got a new resident in our AFH who is not weight bearing at all. She came with her own sit-to-stand machine. The caregivers, myself included, were given no guidance at all in how this particular machine works. So, the owner of the home who has no medical or nursing background, decides to ask the family what they can tell us and between them they decided on the following: This sit-to-stand sling has four straps, two long and two short. The two shorter straps go under the resident's armpits and hook to the side bars and the longer straps go under the resident's legs, one each, and hook to bar that's directly in front of the resident. So, when we pump up the sit-to-stand the resident is lifted off her feet and is dangling in mid-air in a kind of buttless sling. We are suppose to be able to remove her pants and brief, and get her onto the commode for BMs,(she has a catheter for urine), or just go from wheelchair to bed and vice versa in the am/pm using this thing. My thoughts are I thought a sit-to-stand device is meant to aide with standing up and then sitting down, not being lifted clear off the ground and swung around into place. Isn't there another device like that called a Hoyer that's more safe and effective!? It's gotten so that myself and my other co-workers will only use this device if our backs are killing us as we are too scared of injuring the resident and the owner refuses to look into getting a Hoyer because one; they scare her and two; the family has said that since insurance paid for the sit-to-stand they won't allow it to be exchanged for a Hoyer and pay for it. To me, it all sounds like a big mess and I've spoken my concerns with my boss about how this isn't right but so far all she says about it is she's trying to find someone more professional to teach us how to use the device and to just continue to transfer her from chair to bed and change her in bed and vice versa without the device until then. I don't understand why her insurance can't pay for a different assistive device; don't they realize that a person's needs may, and often do, change!? She might have been find with a sit-to-stand two or three years ago but now needs a Hoyer! Grr! Thanks for listening...reading!

PS I Also forgot to mention that there is only one caregiver at a time on shift so we have to be able to use this device by ourselves.

[mvm2]

If she is suppose to be non weight bearing how are you transfering her without the devise? I know these devise like a sit and stand, and hoyers are scarry, but i would recomend that you use the devise while transferring her to save your own butt. Because if she is suppose to be non weight bearing and you are transfering her without it and she falls and breaks something your could be in big trouble. As for hoyers they are not easy to work with, and you have to have a lot of patience to make sure that everything is correct so there won't be an accident, but when used properly they are safe for you and the client. And honestly if your boss wants to be doing this, and providing for the needs of the elderly she has to know that things like hoyer lifts should be in your facility to acomidate those that will need it. I don't know I just don't know without her having any kind of medical background how she can be qualified to run such a place.

[ChrisNZ]

For a standing hoist a patient must be able to follow instructions, weight bear and should only be for short transfers or exercising (often used in rehab for this purpose).

A patient who is non weight bearing and is hoisted using this type of hoist is at risk of injuries such as dislocating their shoulders.

My only other suggestion is contacting the manufacturer of the machine or searching for a instruction manual for the specific make and model of hoist.

[loriangel14, RN]

It doesn't sound like you are using correctly or safely.I would try to contact the manufacturer for operating instructions. With a sit to stand the person has to be weight bearing. The longer straps DO NOT go under the legs but rather cross over in front of the person (usually passing through a pair of D rings) and then attach to the bars at the side along with the short ones.The persons feet are not supposed to be lifted off the ground. That sounds very unsafe.If the patient can't weight bear then they need a Hoyer lift.

[Mewsin]

This is how we decide if a patient is a sit stand lift.

is able to keep at least one arm outside of the harness, has limited weight bearing ability through part or parts of the body, is unpredictable and unreliable in their physical and mental performance during a move, is unable to pivot or shuffle the feet, demonstrates poor balance in sitting or standing positions, is disproportionate to the worker's abilities as indicated by the worker self-assessment.

On my final for tomorrow.

[Fanie_Mae]

oops!

[Fanie_Mae]

I completely agree with loriangel14. I'm assuming a sit to stand is the same as an EZ Stand... if thats the case, then yes, you're doing it wrong. The straps should go under the arms and around the belly. There should also be a strap to go around the calf of the legs so they can't "step off" and hurt themselves. But....if the resident is completely non weight bearing, then they should definitely be in a hoyer.

[loriangel14, RN]

Yes you are right. I forgot about the behind the legs strap.There are lots of different names for them but they basically all work the same. Lifting the patient right up in the air sounds really dangerous. It could tip over.

[Fanie_Mae]

That thought scares me! I hope they get this figured out! I would definitely contact the manufacturing company just to be sure of specifics but under no circumstances is it safe to have a resident in the air on a sit to stand.

[Skayda]

Yes you are right. I forgot about the behind the legs strap.There are lots of different names for them but they basically all work the same. Lifting the patient right up in the air sounds really dangerous. It could tip over.

Oh, they had another lady who used a sit to stand but its sling only had two straps and what they used to hold the legs in place was a length of colored rubber tied to the device. And I agree about lifting the client into the air with this. I knew that we were doing it wrong but they pretty much brushed me aside since I'm "only a NAR and a new hire to boot". They forget I've worked at other places, too!

[Skayda]

If she is suppose to be non weight bearing how are you transfering her without the devise? I know these devise like a sit and stand and hoyers are scarry, but i would recomend that you use the devise while transferring her to save your own butt. Because if she is suppose to be non weight bearing and you are transfering her without it and she falls and breaks something your could be in big trouble. As for hoyers they are not easy to work with, and you have to have a lot of patience to make sure that everything is correct so there won't be an accident, but when used properly they are safe for you and the client. And honestly if your boss wants to be doing this, and providing for the needs of the elderly she has to know that things like hoyer lifts should be in your facility to acomidate those that will need it. I don't know I just don't know without her having any kind of medical background how she can be qualified to run such a place.[/quote']

How am I transferring? Very unsafely for my client and my back. My boss will come up and stand by me as I pretty much lift her from sitting on the side of the bed to the wheelchair in one movement because she has some footdrop and cant straighten out her legs very much she cant stand and pivot. So, you can understand why I want to use the device and correctly or have a Hoyer for her. As for my boss not having any medical background, to run an AFH all one needs to do is take a few provider classes and pay a licensing fee.

[loriangel14, RN]

So you need to get them to watch this video.

Sit To Stand Lift - YouTube