Patient Transfer Technologies In the Home Lori Peculis, PT, ATP Molly Boland, MS, ATP, RET Assistive Technology Unit University of Illinois at Chicago S
Transfer Assistance in the Home: Who? Where? Why? S Who needs transfer assistance? S Impaired motor function S Weakness S Paralysis S Decreased Balance S Where do transfers take place? S Wheelchair to/from bed S Wheelchair to/from toilet or bath chair S Why is assistance needed? S Participation in activities of daily living S Safety for client and care giver
Home Safety Concerns S Client S Appropriate and safe positioning of client S Decrease injuries (i.e. shoulder injuries) and falls associated with independent transfers S Provide position changes to prevent pressure sores and contracture S Caregiver S Proper body mechanics not enough to prevent injury S Transfer assistance increases ability to work longer S Improved retention and access to care givers
Transfer Aid Selection Process Solutions According to Assistance Level of Need No Assistance Needed Independent Transfers possible Assistance Needed Low and High Tech devices Dependent Patient Powered/Manual Lift with sling Selection of Transfer aid is a team process for the home setting.
Challenges in the Home Environment: S Home Modifications may be needed: S Widening doors or pocket doors S Removing carpeting S Ceiling lifts may involve relocating ceiling fans, lights, modifying door frames for room-to-room transfers
Home Modifications S Widen doorways S Shower stall S Ramps S Platform lifts S Independent transfers may require S Grab bars S Transfer board
Financial Implications of Transfer Aids S Costs: S Transfer aids and home modifications typically not covered by insurance S The cost of transfer aids are minimal compared to: S residential program fees S medical treatment for a fall or pressure sore S job loss or time off of work S Full time caregiver assistance
Home Setting Summary Special difficulties exist for individuals living in their home settings. The following issues are identified: S Workers in the home sector face unique challenges in that the home is not often designed for ease of client assisted transfers. S Home sector workers often work alone and must transfer clients by themselves. S Insurance rarely covers transfer devices. These might be the very thing that allow clients to remain in their home and not be moved to long-term care facility. S From SHARP (Safety and Health Assessment and research for Prevention)
Independent Transfers S Independent Transfers S Clients who can perform transfers without physical assistance and with good safety awareness consistently throughout the day S Low-tech or high-tech transfer aids may be used
Independent Transfer Aids Low Tech S Transfer Board S Satin Sheets S Pole or grab bars S Over-bed Trapeze
Independent Transfer Aids High Tech S Electric Hospital Bed S Ceiling Lift Systems (may provide independent transfers) S Client may be able to independently access up/down controls and lateral movement. S One type of sling Sure Hands Grab Bar System, allows for client to independently position themselves in lifting system.
Independent Ceiling Lift System: Sure Hands S Sure Hands Ceiling Lift Features: S No sling needed S Sure Hands Grab Bars lifts client underneath arms and thighs S Clients with good upper extremity and head control can position themselves in grab bar system S Remote control used to lift client up and then move horizontally to transfer
Assisted Transfer Aids Low and High Tech S Assisted Transfers S Clients who cannot perform transfers without physical assistance and with good safety awareness consistently throughout the day S Low-tech aids- sliding board, gait belt (for standing pivot transfer) S High-tech aids- electric beds, standing aid transfer devices, passive lift transfer devices
Case Studies