ELLIE'S BLOG on Living Well with Disability

I was reminded the other night how much I have changed. How my priorities and my sensitivity to certain issues are not quite what they were 10-15 years ago.   I was out last night to wonderful fundraising event for our our local nursing home Wesley. I don't go out that much in the evening due to fatigue from MS. But now that I'm in this long remission with a few mild relapses I'm taking advantage of getting out at night.  So when my husband mentioned that he would love to have me join him in going to the Wesley fundraiser which was for transfer device's it was a perfect event!

I loved being out and talking to people which I have missed a lot over the past years but what I want to talk about in this blog is dependency.

I talk a lot about accessibility in my blog because that has been a continuing problem for me.  Having a disease like MS which has been functionally progressive in my case meant that to be out and doing I had to change my assistive devices and become more aware of my environment.  But along with the accessibility changes to make my life easier and fuller it was equally important to me to be able to be more independent.  I began to really  appreciate what Franklin Roosevelt said when he started the  March of Dimes, "anyone who has not lost the ability to physically do something can never understand what that little bit of independence to do it yourself means to someone".

I could have had my husband continue to push me  in my manual wheelchair or help me out of chairs and out of bed but that wasn't me. And I have become so much more aware that dependency rob's a person of the very essence of who they are.  That doesn't mean there aren't times and situations in which help is needed or help is something that makes what you want to do just so much easier.  Or that doing things with someone together is the best solution.

 

As a physical therapist seeing patients from the late fifties to the mid nineties I have had a certain bias.  When I was assessing or teaching patients or aides proper transfer techniques with or without a Hoyer lift my main concern was for the safety of the person doing the transfer and of the patient.

   At the time I thought I was being sensitive and that I had some understanding of what a patient might feel when they were told they needed more assistance which could include a Hoyer lift. But now after having had my own problems with transferring I am very aware of the emotions involved when more help is needed.  So when I saw the trac ceiling  transfer device being shown at the Wesley fundraiser my mind traveled to all the people I saw in nursing homes and home care when getting out of bed or a chair was a problem.

The safety of patients and health care providers transferring  patients have improved very slowly over many years. Even though as far back as 1898 the importance of safety in transfers was part of a nurse's curriculum. Since that time the use of proper body mechanics has always been stressed.  This was highlighted when the documentation of the musculoskeletal hazards to nurses' became apparent after world war II.  At that time early ambulation was shown to be advantageous to the soldiers returning with injuries.  And a walking program for the soldiers who were extremely unsteady was put in place. This increased the awareness of the important of body mechanics to prevent injuries when working with patients.  It was a specially apparent doing transfers for patients to be able to get them up to increase their endurance and strength to progress to being able to ambulate .

  However  statistics showed that body mechanics alone were not enough to prevent injury transferring a patient.  Actually nurses have been identified in the top 10 ranked occupations a work related Musculoskeletal disorders.

Before WW II many different ideas for transferring patients were tried out.  Like a patented shifting device.  This consisted of a thin flexible rollable platform which was placed under the draw sheet of a patient to assist them to transfer by sliding over the platform to a second support like a stretcher or wheelchair. Obviously it was very limited.  But with necessity being the mother of invention one of the ideas which finally was appropriate was a transfer device we now know as the Hoyer lift.

The Hoyer lift to the right is also called a sling lift. It was patented in 1955.  This has been used since then with some modifications over the years. This lift uses slings which can be placed under the patient appropriately  then attached by hooks and chains to the lift.  The patient is raised or lowered

manually by pumping the lever using  hydraulics to lift the patient. The platform on the bottom of the lift is widened or narrowed as needed to position the lift to raise or lower the patient. Then the lift is wheeled to the spot where the patient is being transferred to and repositioned to safely lower the patient.  Over the years these lift's have become smaller and easier to maneuver. Now there are battery assisted Hoyer lifts. A detailed history of transferring devices including the Hoyer lift and more modern lifts can be found on wikipedia  http://en.wikipedia.org/wiki/Sling-lift 

The latest transferring device  the Ceiling Track Systems {which is shown above at the fundraiser} that Wesley has purchased also use slings which are similar to those used in the more conventional lifts.  The advantage to this latest system is the ease with which the transfer may be done.  There is no positioning and repositioning of a large Hoyer lift.  The ceiling track is placed appropriately to allow the safe transfer.  One nice advantage is that the patient can use the control to transfer themselves.  This device can also be used in Home Care just like a regular Hoyer Lift can.  Again it is also a step up for the caregiver and the patient.

As I stated above when transferring a patient every bit of safety for the patient and caregiver is essential. But the patient's emotional needs should not be forgotten in the process. Finding ways like using the control goes a long way to decrease their feelings of dependency. 

Many kudos to Wesley! !               ellie

To know