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My 83 year old mom is currently in a SNF after a 3-month stint in rehab after a stroke. She is utterly miserable and desperately wants to go home. Her apartment is completely wheelchair accessible. The only issue is that she currently needs two people to transfer her from bed to wheelchair. She needs 24/7 care and obviously I can't hire two aides to be there at the same time to do the transfers. I know that there are Hoyer lifts that can be operated by one person. That seems to be the only way she can go home. Does anyone have any experience with a home aide who can operate one of these alone?

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My mom's MLTC aides could do this by themselves (NYS). And I could do it by myself but my mom was very docile. It's pretty easy.
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YES! Check with the regulations in your state, but when my uncle was in the rehab center, they are required by Washington state law to have 2 aides to transfer by hoyer. But I worked for a In home agency for 10 years and I had several clients that I moved using a single assist hoyer lift. I am now at home with my uncle and he STILL uses the hoyer for transfers and I move him by myself ALL THE TIME!!!! He has a tilt in space wheelchair and that makes it REALLY nice when I put him in it...all I have to do is tilt the wheelchair back and put him in it. Gravity does the rest to make sure that his back and bottom are all the way back and he is positioned the way he needs to be! As long as you are using the hoyer in a private home....a hoyer can be a single person transfer!
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I am a 73 year old wife of a husband that needs transferring from bed to chair. I have done it all on my own for about 5 yrs. Our is not electric. Its a challenge on occasion but I always manage to get it done. So a healthy young person should have no problems.
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You make sure they are repositioned every two hours. You use a Roho or similar cushion on the seat. You are hypervigilant about examining her skin every day.
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If the person is in a wheelchair all day, how do you ward off "bed" sores from the chair?
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@LisaSaline do you have an attorney?? You really really need one. Where do you live?
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Good aides can operate the hoyer alone - when I'm there, I generally assist but have not done it on my own

There are times when I have to tell the aides to pay better attention as they are busy looking at the remote and not seeing either the bar pressing into mom or her feet getting caught

Thankfully, mom has been accepting of it, but it does give me pause to see her hanging in it until she's over her bed
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We use a Hoyer lift rented from the same company we rent my dad's hospital bed from and it is fine. My sibling and I are able to operate it alone without any problem. When he is in bed, we tuck the sling under him when he is sitting up with the head of the bed up, and we just slide it in behind him, etc. 

We did get quite a lot of training and practice using it while my dad was at spinal cord injury rehab (and he was there about a month). Both OT and PT helped us learn how to use it for getting in and out of bed, into the wheelchair, and lowered onto the commode. When my dad came home from rehab, the OT and PT visits we had at home included making sure use of the Hoyer was going OK.

Basically, it's not hard but you want to be trained on it by a pro.
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We used a hoyer for years with my father. All my siblings and I were trained and all caregivers we hired from Home Instead were trained before they came to the house. We had a hydraulic lift which one person could operate. The difficulty was getting the sling under him. That was brutal at times for me and my sisters, though I went on youtube recently and learned that there was a new hoyer sling that was easier to use.
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I'm revisiting this post after a long while. Since returning home almost 2 years ago, my mother has never needed the Hoyer. A single aide has had no problem transferring her from wheelchair to bed. She was probably close to 200 pounds (5' 6") when she first got home, and is now more like 130-140, due to infections, hospitalizations, losing her appetite, aging, etc. We have a Hoyer in her room, but no one has ever used it. It's definitely an SNF rule to have two people and a Hoyer. It was excessive in my mom's case, but I can see that the transfer of a very tall and large person could be problematic.
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We had both a Sit to Stand and now have a portable lift. My husband weighs over 300. I’m not a weakling, but I can tell you that most lifts have a mind of their own. You can be pushing with all your strength in one direction and either it won’t move or it rolls in the opposite direction. Ours is a hydraulic, and if I am having a bad shoulder or back day, forget it. Hubby is better now, but he could be known to yell and hyperventilate.

If your Mom is of normal weight and size, I would think it would be much easier. If you’re at home alone with her, nursing home rules don’t apply.
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Re Hoyer lift -- my husband is 250 and 6'5". I recently asked his neurologist for the lift as it is becoming more and more difficult for him to stand for any amount of time at all and transferring is getting harder. We have been using it to get up in the morning and for transferring to bed. I was trained by the PT who came to the house to evaluate the situation and then to train me about 3 times. It is not an easy job but doable by myself. I have also used it to get him off of the floor after a "fall". The caregivers are using it but am not necessarily happier with one of them following my directions. After a bad couple of days am looking at the next step -- whatever that will be. Probably using for toilet and showering -- not sure how that will work. My husband cannot stand for more than a second or two then screams that he has to sit and just sits -- wherever -- with me holding the gait belt. Not a good situation. Good luck --
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What makes me sick is that if my brother hadn't taken all this money, and had put it in savings, dad would have had plenty for his care now.
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Please help. Don't know if this is still an active thread. Xinabess, how much does your mom weigh? My dad weighs 230 pounds and is a tall man. He is currently in the hospital with pneumonia. We just moved him from California where my brother was emotionally and psychologically abusing him and took between $250,000 and $350,000 from my dad over a 5 year period. Dad has an income of $7,800 per month. Up until recently, his care costs were around $3,000 to possibly $4,000 per month at most. My brother was spending all of it, plus some of his savings. I tried several times to intervene, talked to dad's elder care lawyer (who was useless and also making money off dad) but no one would listen. When dad began requiring two person transfer, my brother put him in a horrible board and care home in California. As soon as I saw the situation, my husband, who is a contractor, started making renovations to our home so we could bring dad here. I'm hopeful he will be strong enough after rehab to use a sit to stand lift. We may need a hoyer. Not sure. It is a mess. Any advice from others on lifts? Before the pneumonia, he was able to bear some weight on legs for 30-45 seconds or so.
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Update on the transferring issue: Both of my mom's aides (who split the week, so they are never there together) can transfer her by themselves without the lift! We have the lift, but so far no one's needed it. So clearly the 2-person/lift rule is something specific to SNFs and doesn't apply to home care. Phew.
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I would actually prefer that the care was divided into shorter shifts. I don't know why they do it this way. They will have one caregiver there 24/7 Mon-Thurs and another one Fri-Sun. My mom doesn't get up in the night, but since she can't walk or do anything for herself, we can't just leave her in bed alone and hope nothing happens.
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Pam, the OP is talking about New York City which does have access to 24 hour care by law. Here is website talking about the new regulations that were set up after Dec 2015 when a lawsuit was settled.
"NYS has two types of 24-hour care available when medically necessary. The definitions of these levels were just amended by regulation effective December 23, 2015. The amendments were adopted in part to comply with a settlement in Strouchler v. Shah, a lawsuit that was settled in federal court in Oct. 2014, after the court issued a Preliminary Injunction against NYC HRA in Reducing 24-hour Split-Shift Medicaid Personal Care Services (Sept. 4, 2012 ). The regulation published Dec. 22, 2015 is the final version after the State Dept. of Health issued a series of emergency and proposed regulations since 2011. Here are the new definitions effective Dec. 23, 2015 - also see GIS 15 MA/024 - Changes to the Regulations for the Personal Care Services Program (PCS) and the Consumer Directed Personal Assistance Program (CDPAP) (PDF)​
https://www.health.ny.gov/health_care/medicaid/publications/gis/15ma024.htm
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I am in NY. The cutoff is 8 hours per day. One aide only. Honest. As an Ombudsman, I am working with a case right now where a woman wants to go home. She also needs a hoyer lift. Unless her housemate gets the training and is willing to change her diaper every 2 hours, she's at a real roadblock.
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I rarely hear that Medicaid will cover in home care around the clock. Like Jeanne mentioned above, it is far cheaper for the State to place a person into a skilled nursing facility. If this is available in New York State, you are lucky that the taxpayers are willing to handle this cost. Thank goodness Medicaid is available in any event.
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Medicaid does not cover 24 hour home care in Minnesota, simply because here it is far, far more expensive than a care center. They will pay for a certain number of hours per week, but it will never be 24 x 7.
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Freqflyer, home care in NYC is actually almost half the cost of the SNF. I can't imagine why, but it is. With the help of an elder lawyer, we are putting a large chunk of my mom's assets into an irrevocable trust. The rest will have to be "spent down" until she qualifies for Medicaid, which pays for SNF or 24/7 home care. My mom lives in a building that is subsidized for performing artists. She has a wonderful apartment on the 29th floor overlooking the Hudson River for next to nothing. So she has no property taxes, lawn mowing expenses, utilities, homeowner's insurance, etc to worry about. She is extremely lucky in this respect.

Does Medicaid not pay for home care in other states? I am wondering why so many people in NYC end up in nursing homes when home care is covered by Medicaid.
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Xina, does your Mom understand that having caregivers 24/7 from an Agency is going to be expensive?

Here in my area when I had 24/7 care for my Dad, in his own home, the cost was over $20k per month [yes, per month] just for the caregivers. He still had the cost of maintaining his home, utility cost, property taxes, homeowners insurance, groceries, lawn mowing costs, etc.

It wasn't long until Dad moved to Independent Living, and is now in Assisted Living/Memory Care and he cut his cost in half. Whew. Now his savings will last much longer.
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cwillie, no, once mom lost her left side, the only option was a hoyer lift, from bed to wheelchair or toilet, (suspended over toilet) and back again. A ceiling lift will get them from bed to wheelchair, but then you would need a second ceiling lift over the toilet and possibly a third for the shower.
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I hope she feels more at ease in her own home, but I'm afraid she is probably miserable about her loss of independence and the betrayal of her body and there is no fix for that.
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Well, I have made a decision: My mom is going home with 24/7 care. My elder lawyer recommended a great home care agency that gets fabulous reviews. I spoke with the care coordinator today and she is lovely. She sent me a questionnaire and we spoke. She is coming with me to the SNF to talk to my mom about all this on Friday. From there, we will go to her apartment for an assessment of equipment needs.

My mother is MISERABLE at the SNF, talks about going home all the time. But she has lived alone for 30 years and lives in a large one-bedroom apartment (i.e. not a lot of space). To have someone there 24/7 is a HUGE change. She is upset and not even able to accept that she needs so much care. So there are challenges ahead. Sigh.
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You talk to the sw about them getting the roomate a headset. That's what we did.
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According to the Nursing Coordinator during the last care plan meeting, she is medically stable for now. Her main issue is her lack of mobility due to paralysis of her left arm and semi-paralysis of her left leg.
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Xinabess, have you had discussions with your mother's medical team about her long term prognosis?
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Ugh. This is so stressful. As of today, I'm thinking the ideal compromise would be for my mom to have a private room in the longterm care unit where she is now. She has a roommate who watches TV at a high volume ALL day. I can't even believe they allow that. She keeps asking for a private room, but from what I've been told, those are reserved for private-pay patients, not Medicaid-pending ones. I feel stuck between a rock and a hard place. Home care is not ideal and complicated for numerous reasons, and SNF care is undesirable too. I just want to run away!!
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Well, I will just make it clear that if she gives the home health aide a problem, she'll go right back to a SNF. It's just so horrible to be in this position, as so many of you know. My mom still refuses to accept that she even needs this level of care. It happened overnight, with the stroke.

Believe me, it would be a hundred times easier for me if she was in a SNF. That was my plan until she was transferred to longterm. It's so depressing and I can't bear how miserable she is. So she's going home one way or the other. I've become horribly cynical and of course I love her to pieces, but being "safe" in an SNF might be worse than being at risk of a problematic transfer at home. No one lives forever, after all, and 90 percent of the folks in the longterm care unit seem to have no life at all.
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