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OT insisting a hoist is used for mum

Discussion in 'I care for a person with dementia' started by Ardlife, May 19, 2014.

  1. Ardlife

    Ardlife Registered User

    Jun 9, 2013
    Little different to most posts, am not asking for any more help (not yet anyway)
    I am classed as 2nd carer for mum after a spell in hospital left her unable to walk or stand by herself (6 weeks and they never got her to walk up and down corridor to keep things active)
    She currently uses a rotunda to wheelchair then rotunda again to bed/toilet/lounge chair. I do the lifting and weightbaring (mum can hold onto rotunda for few seconds enabling me to position her) and the main carer from agency does personal care, washing dressing etc. I don't ask them to weightbare as they are not allowed.
    Everything has been fine, no falls or anything but for a few months now OT have been pushing for a hoist. I believe if you don't use it you lose it keep insisting that I want her standing via my help and rotunda.
    Came to a head 2 weeks ago when OT wanted to come out after I wanted to return knee protectors on rotunda so someone else could benefit as they were unsuitable for mum. OT came out and SW sneakily came out hour before his arrival claiming she mixed up times but am sure she did it to watch morning routine (which is fine) and look at carers notes and district nurses notes (mum has sores from scratching at night). Anyway end of visit OT started on about dangers of rotunda and if I refused the hoist again he would remove the rotunda anyway. Gobsmacked I asked to clarify that he was blackmailing me with leaving mum effectively bedbound and he confirmed that she would be bed bound without a hoist. The SW just sat there and said nothing. So I agreed to a one off trial run with a hoist as my concern is mum's reaction to being swung in a sling as with dementia every time in hoist will be her first time.
    The hoist turned up last Thursday and OT rang, I told him I thaught after last visit he was not impartial and asked for a different OT. He rang back and said his manager says "no" as he knows the case. I asked to speak to manager, not available, I asked for manager to call me, didn't happen. Left 4 messages for manager to ring me and never did. If the original OT and that SW (they tend to come together) turn up on Wed for this trial run I will refuse them access.
    So my question is can they really do that? If I refuse to use hoist they can take away rotunda and leave mum bed bound?
    The thing is I am saving them thousands by being 2nd carer as I will NOT use a hoist so they will then need to pay for 2 agency carers each visit
    I have seen the courtcase from 2003 and NHS guidelines on manual handling and possibility that denying lifting of patients could be illegal and possibly a breach of human rights on dignity and privacy but a little info can be dangerous.
    Any thaughts?
  2. Merrymaid

    Merrymaid Registered User

    Feb 21, 2014
    Sorry can't help with advice, but thought I would respond to agree with you that you are being very reasonable about how you care for your Mum. There has to be someone above this OT who you can approach to discuss this sensibly. I would ask the SW for some advice on who to contact, perhaps send and email so you have a paper trail of your willingness to discuss. This attitude of 'My way or the highway' smacks of bullying and does not appear to be taking into consideration the main person here - your Mum. :rolleyes:
  3. Tilly Mint

    Tilly Mint Registered User

    Jun 14, 2011
    Been through the same thing.

    I contacted OT as I needed something to help me change and toilet mum. OT came out didn't do a proper assessment but decided off her own bat that we needed a profile bed and a hoist and a sling.

    I wanted to try mum on a standing hoist first as her upper body strength is incredible. They wouldn't agree to it. I was going to bring in a company to demonstrate a standing hoist and see how suitable it was and check my usage of it and if it was suitable they were going to leave it with me for a trial period to see how we got on with it.

    I had a call from SW who asked how the OT's visit went and I said not very well and the SW blasted me down the phone saying the OT is good at her job, been doing it for over 20 years etc etc. Totally over the top as I hadn't said anything more than I wasn't happy with the visit. I wasn't even asked why.
    When I hung up on her because I was frustrated and upset due to recently being bereaved the SW came back at us with all guns blazing and had mum and I tested for everything. All kinds of experts were brought in. Many times I felt I was being set up to fail.
    I got told that they were going to call at 9am and if I didn't let the SW and the OT in they would deem it to be something and return with carers to remove mum and take over her care.
    On top of the bereavement I don't know how I stayed in one piece.

    They bombarded mum with questions and made her cry, they tested her with different slings and made her cry out in pain. I was told many times that they thought I should have carers in yet mum and I had both said we didn't want anyone else.

    All the checks and tests found no faults at all. The GP's and nurses they brought in all said mum was well looked after, her skin was brilliant and mum was happy apart from when the nurses checked her over and she became distressed which was what I'd told the SW and OT and why we didn't want carers in.

    We were under attack from October to January. I was forced into accepting the full hoist and sling. Wasn't allowed to even try the standing hoist. They said that it would be deemed as dangerous and me putting mum in danger after their OT had said it wouldn't be suitable. This was despite the OT not testing mum's upper body strength.

    I ended up discovering carers advocates and brought one in to represent us. They know our rights and the one I had shot the SW down in flames.

    Apparently when the OT and SW didn't accept what we had said about not wanting outside carers, they were breaking the mental health code of conduct.

    When I requested a different SW towards the end she back pedaled like there was no tomorrow. On the phone as I was requesting a different SW she began saying in a panic "well you don't have to have outside carers if you don't want them".
    I hadn't even brought that up in this particular conversation so she must have been wetting herself that she was going to be found out.

    So we now have a profile bed that mum never uses but the hoist and sling are a help.
    However a physiotherapist we saw a while before all this told us that mum should do as much for herself while she is able and this was overruled by the OT and SW when they didn't test mum and decided what she should have.

    The OT told me that we'd need a full hoist so I eventually had to agree as we weren't allowed an alternative but when the hoist was delivered the OT said she had to come and show me how to use it and then told me when she walked in that it would need two people to use it.
    Another attempt to get me to accept outside carers. I printed off the HSE booklet about this hoist and in it it says that there are more accidents when two people are handling it.

    I could go on and on with all that was said but getting a carers advocate was a blessing. Never heard of them before this nightmare.
  4. copsham

    copsham Registered User

    Oct 11, 2012
    I can understand not wanting to use a hoist unless a real last resort. I have seen people in hospital and in my mums nursing home really hating being hoisted, one lashing out because she was so scared. Bad enough without dementia but worse with.

    I don't know the rotunda but can a new one be bought? Or a secondhand one? If you have your own I guess they cannot stop you using it.

    Can you check whether the SW and OT are really qualified. THe HCPC is on the internet and individual names can be checked. They both sound very unprofessional!

    It is so unfair - I was at loggerheads with the system whilst my mum was in hospital 18 months ago and it is ridiculous that you become the "baddie" after all you have done. I hope you have some answers on TP from people who are hoisting or have found alternatives. Good luck!
  5. copsham

    copsham Registered User

    Oct 11, 2012
    Oh no! I looked on ebay and now know what a rotunda is. Looks useful but £400!:eek:
  6. Lady Phoenix

    Lady Phoenix Account Closed

    Feb 8, 2014
    OK, Im speaking as a paid carer so my view point may be different

    Until I read your post Id never heard of a rotunda so I had to google it first and look it up. To me it essentially looks like a Transfer Turntable except that it has a framework for your mother to hold.

    Is you mother able to lift herself without aid from a perseon? If not it looks like the rotunda isnt suitable. however, Im no expert and Id be inclinded to go with whatever the OT says.

    A hoist is intended to save your back. If its been issued then there is an obvious risk to YOU.

    Now, in my experience 99% of people dont like being lifted by a hoist and the other 1% just tolerate it. When I did my lifting and handling training I was lifted up in a hoist and I felt so unsafe, so I can sympathise with your mother.

    However, let me pose a question to you.

    You are probably fine lifting your mother on a daily basis. However, if you arent doign it "properly" then one day you WILL damage yourself. When you have a damaged back who is going to look after you and your mother?

    However, there is a flip side to it.

    I strongly believe that mobility should be preserved for as long as possible. If you mother has any mobility then she should be using it. You already know that if its not used she will lose it. Even if its standing up for a hug (Which also aids pressure sores) for a minute thats great.

    Personally, from your post it sounds like its lifting and handling training you require (If you havent already had some)

    You will be able to learn how to lift, whats safe and whats not and most importantly you will learn to evaluate the situation before attempting to make a lift. There may be times when a manual lift will be fine and you may only need to use the hoist once or twice a day.

    Sorry if that doesnt help
  7. Lindy50

    Lindy50 Registered User

    Dec 11, 2013
    I think you make some good points Lady Phoenix. Moving / transferring someone is a bit like mental capacity. It can vary from day to day and from hour to hour.

    I really feel that the system should be enabling you to care, Ardlife, and to carry on with this as long as you choose yes, it does sound as if some positive, helpful training might be useful. Have you ever been offered this, I wonder?

    Also I wonder what the care agency's view is?

    I am sorry you are having such a horrible time. You should feel supported, not attacked :(

    All the best

    Lindy xx
  8. Jessbow

    Jessbow Registered User

    #8 Jessbow, May 19, 2014
    Last edited: May 19, 2014
    basically , you say you are lifting her onto the rotunda, Yes?

    in which case, please don't- you WILL damage yourself or your mother.

    Its hard when things start to fail, specially the ability to mobilise independently.

    Please try the sling/hoist method.

    Problem is, if its loan equipment and you are not using it correctly ( or deemed innapropriatly) then yes, I guess it can be taken away
  9. Pickle20

    Pickle20 Registered User

    Feb 19, 2014
    I'm an OT (please don't hurt me!) I'm sorry you have felt let down by an OT. Of course check they are HCPC registered and you can always make a complaint but I would speak with their manager if you can.

    In terms of moving and handling a Sam Hall Turner (called different things by different people) is generally only used with people who can stand independently or with some assistance they need to have the strength in their legs to stand for a period of time and tolerate the turner to be turned. They also need to have upper limb strength to get into standing and hold on with two hands (or one if unable). If the person needs to be held up in standing then the turner may not be the best equipment to use. It is fine to have the upper limb strength but this needs to be equally matched by leg strength specifically quads.

    Yes a full sling hoist can be very scary and if the sling is not fitted right can pinch the skin when hoisted up. I think what the OT has failed to explain is that they are wanting to also look after you as your mums care, and also protect your mum too.

    When moving and handling you should always use central key points, ie shoulder, back, buttocks you should never drag lift someone into standing specifically putting an arm under their armpit and lifting this can cause great discomfort and injuries like brachial plexus nerve injuries -very painful.

    I agree in what you say if you don't use you lose - ideally lower limb strengthening exercises will help. There is also a standing aid I'm not sure if this has been mentioned by the OT's it is a big jump to go from a turner to a full hoist unless there has been big change in mobility or a risk to career or person. A standing aid wraps a piece of cloth with handles around lower back and hooks up to a machine which brings the person into standing, the main difficulties can be that the machine can be fast and can take over the stand, the person needs to be able to use their lower legs to assist the stand. I don't know if this would be suitable

    In terms of them taking the equipment away I don't know we're you stand is the equipment property of social services or is it your mums (in my work we use prescriptions and the equipment becomes the property if the person who requires it).

    Generally it is best to have two people more to check that everything is set up right and assist if the person needs help eg with a hoist one on the controls the other helping the patient making sure the bar is out the way that feel comfortable.

    I have no idea if I have helped or not but any questions please ask. Also I would let the OT and Social worker in and ask for their clinical reasoning for the hoist.
  10. Pickle20

    Pickle20 Registered User

    Feb 19, 2014
    Also is the OT from social services specifically for equipment sometimes they miss the bigger picture and fail to see the affect on independence by providing a piece of equipment. If they feel that your mum is unsafe to use a piece of equipment and you decline what they have offered then I suppose they could take the turner away as it would be deemed a risk to use. Very difficult situation. Unfortunately it could be your mums mobility is deteriorating and this can be very difficult to understand and also see. My grandad has dementia and I can see things that other family members can not. I hope you get what it is best for both you and your mum x
  11. Ardlife

    Ardlife Registered User

    Jun 9, 2013
    Thankyou for all replies.
    Firstly I checked and the OT is on HCPC register which is good to know
    I AM having to drag/lift mum into standing position on rotunda but once up she grips well and like I said I can position her and move to get the wheelchair under her while she is holding on. This has not changed since she came out of hospital last year but for some reason the OT is not happy with it now. A couple of months ago had a meeting with OT, and SW and care agency manager and district nurse and discussed a standing aid but it was felt that mum would not remember to keep holding onto the straps which could cause her to slip through the straps.
    I admit to sometimes lifting via underarms but have seen vids about transfer belts (gaits belt in US) which I feel would be safer for mum and maybe for me too but no-one has mentioned this. It is my choice to lift and put my health at risk (or my daily work out as I call it)
    Maybe I am just being stubborn but this time last year she was walking to the end of drive and going to daycare, now after a spell in hospital she cant walk at all and spends her days infront of TV thinking that the TV is a window and the people are actually in the room even asking them if they want a cup of tea or commenting on the bad weather as the sun shines through the real window but on TV it's raining.
    I have the trial run on Wednesday and who knows she may be ok with the hoist but I do not feel that OT and SW are treating my mum as an individual, offering advice or alternative options and just wants her off his list and keeps saying his "manager thinks" when the manager has never seen mum.
    I have discussed the hoist with 8 or 9 carers that mum has and all bar 1 has said at the moment there are too many negative points to going down that route, we will see.
    Thanks again for replying my main concern was the threat given by the OT and if nothing else I have learnt about the Carer's Advocate which I may request but whether the manager bothers to contact me before Wednesday or not the original OT guy will not be coming into the house
  12. Lindy50

    Lindy50 Registered User

    Dec 11, 2013
    Ardlife :)

    I am sorry that your mum's condition has deteriorated so quickly. It must be very distressing and obviously you want to help her maximise her abilities for as long as she can :)

    Do look after yourself in this situation though!! If you injure yourself you will possibly not be able to do hands-on care at all, which would be very sad for both of you :(

    If only the OT had given you the confidence that he was treating your mum as an individual....this just shows how important communication skills are for professionals, as well as technical knowledge :eek:

    I hope the trial goes well on Wednesday, whatever you decide to do :)

    Lindy xx
  13. Pickle20

    Pickle20 Registered User

    Feb 19, 2014
    The handling belts you refer too are not often used in the UK, some care homes use them but as OTs we generally don't use or advocate the use of them as it is the risk of bank injury to both the lifter and the person being lifted. I would suggest that if your mum is able to hold onto a turner a standing aid would be the same idea, the strap needs to be positioned correctly but no body should slide out.

    This might seem a daft question but has the OT actually stood your mum up themself? Or is this off them observing you?

    You are well within your rights to get a second opinion. Also has your mum had any community or inpatient therapy/rehabilitation? This may be the route to go down, just because your mum has dementia does not mean she can not have any rehabilitation - it is worth a try even if it gives your mum a few months more of mobility and maintain her strength.

    This I think will be your problem the drag lifting - it is ok for you understand the risks associated with it but your mum does not and there is the problem. They will look at the manoeuvre and see that it is unsafe for you both (I understand your reasons for doing so with all the best intentions). There is a technique you can use which is much safer the OT should be able to show you, if stood on left side of your mum use your right hand on her back with your left hand on her shoulder and assist the stand this way her is video which shows you, ideally I would say have your hand further down the back than this shows but that's my opinion, if two people doing it you would cross your hands over your mums back. the video is for people with a stroke but the principles are the same. Maybe give a try and see how you and your mum get on. Hope all goes well x
  14. purton

    purton Registered User

    May 20, 2014

    strangely my case is the exact opposite. My dad cannot stand, his legs just don't support his weight anymore, and even with my grown up son we cant manage. We are having problems with a hoist. We have the hoist but the slings do not allow us to put him on the commode, wash him or wipe his bottom. We may have to put him in a home if something doesn't get sorted soon - which he doesn't want.
  15. Pickle20

    Pickle20 Registered User

    Feb 19, 2014
    Contact social services OT's and ask for a toileting sling and a shower sling they should provide them this will make it far easier for you. The shower sling is mesh material with holes in so it dries easily. Hopes his helps.
  16. Ardlife

    Ardlife Registered User

    Jun 9, 2013

    Finally the manager called me back, went through the spiel that the OT was very good and would not act/say what I heard and he should continue as he knows the case but I explained all trust was gone and I would not let him in the house. She would ask a colleague to come out instead. That colleague phoned me later and then again outside work hours as time of first call was difficult. +1 to carer for being prepared to call outside of work hours.
    New day and new OT.
    What a difference, she listened!
    Still not tried the hoist as she wanted a fresh look at how we were doing now. Downside was today was 1st morning using a new care company and thus new carers following enforced swap-over because council have swapped contracts over because I did not want to go direct pay.
    Typical, mum was worst day for while, refused to weight bare so transfers were messy.
    So I had resigned myself to hear the news, but no, she wants to ensure the change to hoist to be as easy as possible and for me to be happy with it, so although she doubts it will help she is ordering a stand aid to try as it's all about getting the clearance for her bum on transfers NOT that she need to stand upright and she is willing to work with me to make transition easier.
    I am more prepared now, thx to your replies and thx do a different OT. I do feel hoist will happen but I have been assured they will monitor and tweak it to work what's best for everyone.
    Thx again for everyones replies
  17. Tilly Mint

    Tilly Mint Registered User

    Jun 14, 2011
    Just wanted to add while I still think of it.... I had the SW and the OT bringing up the 'talking to the manager' and the manager always agreed with them and I could never talk to them directly. It just felt so strongly like a ploy to add power to their elbow.

    I didn't believe they ever spoke to a manager. I imagined them getting back and laughing about who was going to play at being 'manager' today. Just so they could say it without actually fully lying.
  18. Tilly Mint

    Tilly Mint Registered User

    Jun 14, 2011
    I use a hoist and a toileting sling. It can seem awkward until you get into the method that works best for the situation and your mum.
    You can check out various slings online. There are many of them, made of different materials, different sizes and different attachments depending on the type of hoist it is made for.
    They tried mum on another type that was supposed to go right underneath her but they hurt her and the two OTs who came out made a right pigs ear of it and hurt mum in the process. Even bashed her foot against the end of the bed (something they'd previously told me to make sure I didn't do).

    In the end I called a halt to it and said that this was far too unworkable and they could only agree as the two of them, trained as they were couldn't do it. So i got to keep the one we had been given previously and which works brilliantly.

    Mum is fine going up in the sling. She is used to it now but I began by doing it very slowly so that she wasn't going quicker than she felt was safe. Plus she holds on to one of the dangly loops just to reassure herself even though it has no effect on anything. It's just something for her to hold on to.

    Now that we are used to it it really does help a lot. Previously I was having to get mum to try standing and leaning over a table after being on the commode while I cleaned or changed her. There is far less strain involved now.

    I also don't push her across the room from bed to chair or commode etc. I'll lift her onto the wheelchair and move the wheelchair to wherever and then use the hoist again. I'm not taking any risks as mum is far too precious to me. :)
  19. Ardlife

    Ardlife Registered User

    Jun 9, 2013
    #19 Ardlife, May 22, 2014
    Last edited: May 22, 2014
    Update No2

    What an amazing OT !!
    Standing aid arrived at 6.15pm (same day)
    OT arrived at 8.50pm (yes 8.50pm)
    OT explained to 2 new carers what she wanted them to do for the night call
    Then the FUN commenced, got mum into wheelchair via stand aid (eventually), into toilet and there was no room to maneuver the standing aid so I was then required to transfer mum in my way with the rotunda to toilet. Bless her, mum did her part, she was absolutely ditched, bowels opened during the day (very loose, liquid) and was coated front and back. The 2 carers then tried to clean her up, a major struggle, tried lifting her to clean back and front but her feet were slipping on the stand aid so once again me and my rotunda were called in. Ended up still not clean, transferring her to wheelchair (my way) then into bedroom where standing aid was tried again but again her foot was slipping so my way was implemented again to get her onto bed where carers proceeded to finish the cleaning.
    Finally nearly 2 hours after starting we were done and this was a 30 minute carer call!
    So tomorrow OT is once again coming for the evening call to try the hoist with numerous slings and hopefully a commode on wheels that can go over the toilet.
    It is still work in progress but my new OT is fantastic.
    A hoist is gonna happen but get the right OT and the transition is so much easier
  20. Pickle20

    Pickle20 Registered User

    Feb 19, 2014
    Great news, I'm pleased they gave tried and you can see how the equipment works/doesn't work in practice. Well worth asking for a second opinion. Hope you are mum ok and good luck for the future - not all of us OT's are the same =) x
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