Care home say they can not hoist dad safely

[Shambler]

Hi all, dad has advanced dementia and has been in a care home for a few months.

The care home are now saying that they can't hoist him out of bed because he sometimes won't sit still and could damage his legs.

They say they are unable to hold his legs because they are not allowed to restrain patients?

It's not too bad at the moment when it is cold but in the summer I would like to get him into his wheelchair so we can go outside in the garden.

Has anyone else had this experience and any way to resolve it?

It's a dementia nursing home so I can't understand how they don't have a solution.

 

[Rayreadynow]

Ask for a needs assessment.

 

[Shambler]

Hi Ray, I believe he has already had one.

 

[Rayreadynow]

Oh, I think it should detail lifting / Hoisting.

 

[Bunpoots]

Welcome to the forum @Shambler

My mum was terrified of the hoist but somehow the staff managed to get her safely into her wheelchair so we could take her into the garden on sunny days. Sorry I don’t know how. I presume they took advantage of her calmer days.
Was it an occupational therapist who did the assessment?

 

[Shambler]

Welcome to the forum @Shambler

My mum was terrified of the hoist but somehow the staff managed to get her safely into her wheelchair so we could take her into the garden on sunny days. Sorry I don’t know how. I presume they took advantage of her calmer days.
Was it an occupational therapist who did the assessment?

It's strange how when he was at home the carers hoisted him 4 times a day, 7 days a week.
One carer would operate the hoist and the other gently hold his legs but the care home say this is restraint and they aren't allowed to do that?

The assessment was done by NHS staff so I assume occupational therapist or similar, I wasn't able to attend as I live several hours away.

@Rayreadynow​

I'll check what the assessment says about hoisting.

 

[Weasell]

Hi all, dad has advanced dementia and has been in a care home for a few months.

The care home are now saying that they can't hoist him out of bed because he sometimes won't sit still and could damage his legs.

They say they are unable to hold his legs because they are not allowed to restrain patients?

It's not too bad at the moment when it is cold but in the summer I would like to get him into his wheelchair so we can go outside in the garden.

Has anyone else had this experience and any way to resolve it?

It's a dementia nursing home so I can't understand how they don't have a solution.

I am so sorry for the situation you find yourself in. It must be making you sad.

I think the problem is a people get older the skin thins and becomes delicate. If you damage the skin it can be very problematic to heal.

If I was doing the risk assessment I might conclude the risk of physical harm, outweighed the pleasure to the garden might bring?

If he had capacity a test he might be able to use the garden but I strongly suspect that is not the case.

The answer to your question is ‘ drug him up’ because then he wouldn’t kick and could go anywhere. But of course that is a terrible outcome and no one would do that.

I would try and accept that if he hurts himself he could be in constant pain? That would be so sad.

The other reason is that to hoist might take four staff to do safely and they don’t have the staff to do this. To coordinate four people to be free simultaneously is a big ask,
If homes conclude they cannot meet people’s needs they sometimes ask they move elsewhere?

I hope you manage to negotiate a solution.

 

[Shambler]

Thanks Weasell, when he was at home he was hoisted 4 times a day 7 days a week by carers.

His behaviour hasn't changed so not sure why the care home can't do this.

 

[Rayreadynow]

Yes, I suppose if you don't have enough staff then that could mean not meeting someones needs. Unusually there are no staff to resident ratios.

 

[Shambler]

They were moving him to start with using 2 carers.

It does seem like they are very short staffed but deny this is the reason why they can’t continue to do it…their reason is that they aren’t allowed to restrain people but I’ve checked the HSE guidance and this says it’s wise to restrain someone’s legs when hoisting to prevent accidents.

 

[JoannePat]

Hi, Have you been there when they have tried to hoist him, I know you live far away, but just wondered what you had witnessed. Is there a friend or family member that can be there that can gently hold his legs. Like someone mentioned his skin is probably quite thin and no one wants to tear.

Certainly sounds like there needs to be an assessment done again.

I trained to be a home carer (years ago), and part of the training was to try the hoists ourselves, I must say I had a mini breakdown and had to walk away for a while, its quite a scary sensation. But like you say he was being hoisted at home this isn't new for him,

I hope everything works out ok, keep us updated

Jxx

 

[sdmhred]

Mums legs are gently held to stop them hitting the hoist, but she is still when in the hoist. I can see it being a safety issue if legs are being thrashed around…..but if you say things haven’t changed since home, maybe it is an issue of willingness or staff availability 🤷‍♀️🤷‍♀️🤷‍♀️

Perhaps if you are able request an OT assessment or ask to go in and watch and see what they are talking about.

Mum’s hoisting is limited due to her fragile skin as @Weasell mentioned. But it does become an issue of life quality v quantity.

I

 

[Jessbow]

Its possible that someoe else in the home can had an accident with a hoist, and someone has realised that they need to cover themselves

 

[Collywobbles]

Surprisingly, sitting in a chair can take a lot of different muscles, effort, coordination and concentration. It could be that even if he could be hoisted, it wouldn’t be possible for him to use a standard chair or wheelchair without being heavily strapped in. That would be very uncomfortable.

My Granny’s care home stopped trying to move her to a chair during the day, because, as they described it, “she just slid off again”. Even when gently wedged with all manner of cushions and foam pads, she still moved down the seat, her upper body flopped over, and found the process very distressing. She no longer had the physical resources to keep herself seated and it was better that she remained in bed, relatively comfortable.

For now, maybe it’s the right thing to do.

 

[helpingpeggy]

Hello Shambler, assessing people’s manual handling needs is my day job. I’d ask for a copy of the OT’s assessment to understand what their concerns are. I wonder if the sling being used is different and he feels less safe and hence more agitated? He has the right to spend time out of bed if it felt to be in his best interests, he might need specialist seating to achieve that. I’d be happy to advise further once you’ve got the OT assessment

 

[helpingpeggy]

Also, supporting or guiding someone’s legs whilst they’re being hoisted is not restraint!

 

[Shambler]

Thanks all, they are arranging for a specialist to come in and do an assessment.

 

[ckuk69]

I'm just getting a hoist review with the local council OT. They carry out a risk assessment. So I'd ask to see that initially. Also recommend checking out the CQC page on Moving & Handling...unfortuantely this site won't let me post the link because I've only just joined.

Also attaching the Hoisting Health & Safety Document (From the above link).

 

[Shambler]

Time goes on, still waiting for an OT assessment!

 

[SeaSwallow]

That is awful @Shambler have you contact the OT to remind them that the assessment is outstanding.