Hoists

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Clinical rationale

A mobile floor or powered ceiling hoist may be required:

  • when a person is unable to transfer due to level of injury or function, increasing age, decrease in upper limb strength, shoulder overuse injuries, carer limitation, increased weight, frailty (of person or carer) and presence of pressure injuries
  • to decrease human cost and increase quality of life for the user
  • to help preserve upper limb function and reduce the risk of developing shoulder overuse injuries by reducing the number of transfers that a person performs each day
  • as a substitute for care or to maintain independence – some people with low level paraplegia can transfer themselves independently using a ceiling hoist. It is essential that they can insert and remove the sling or body support system safely without damage to their skin.

Individual characteristics

The type of hoist and sling required is dependent on the following.

  • Level of injury or function
  • Age
  • Height and weight
  • Skin integrity
  • Pain and spasm
  • Falls history
  • Psychosocial needs
  • Ability to comply with usage
  • Personal comfort and positioning when using hoist
  • A standing hoist or transfer aid may be appropriate for people who are medically cleared to weight bear.

Other considerations

Environment

  • Is there sufficient circulation space in the area where transfers take place?
  • Is there clearance for a mobile hoist under the bed?
  • Is there clearance for a mobile hoist around equipment (e.g. power wheelchair) ?
  • Is there height clearance for all transfers?
  • Is the mobile hoist able to be manoeuvred easily on floor surfaces where transfers take place?
  • Is the hoist suitable for all transfers, including picking a person up from the floor?
  • Can the ceiling structure support a ceiling hoist if this is being considered? A structural engineer will need to complete an assessment of the ceiling.

Carers

  • Is care available?
  • What are the workplace health and safety requirements?
  • What is the carer feedback when trialling a hoist?

Cost

  • Cost and available funding.

Options commonly prescribed

Hoists

  • Mobile hoist with standard yolk or pivot frame attachment
  • Standing hoist if able to weight bear
  • Ceiling mounted or free-standing gantry
  • Vehicle – driver or passenger
  • Safe working limit will vary along with hoist size and type.

Slings

  • Type of sling determined by hoist used; general purpose slings with or without head support are generally used.
  • Various sizes are available.

Fabrics

  • Generally polyester, nylon or mesh are used.

Custom slings

  • Alternatives and modifications to regular commercial slings:
    • Use of silk or sheepskin sleeves inserted over the leg sections of the sling to minimise cutting or rubbing of the skin.
    • The addition of extra handles to assist a carer to position the person in the wheelchair.
    • Parachute silk sling – for people with fragile skin or whose carers have difficulty inserting or removing a sling. It must not be left in situ whilst the person is in their wheelchair, and handles may need to be added to assist with positioning them in the wheelchair. Size may vary from conventional slings.
    • Made-to-measure custom sling.

Further information

Clinical guidelines and information

Clinical practice tool

Consumer resource

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