The Ups and Downs of Hygiene Slings

by Bill Norman on Mon, 2010-03-01 10:50
Victor hygiene sling in combination with a portable lift.

When nature calls, a hygiene sling may be just the right answer for many with ALS.

Like standard slings that are used to transfer, transport or reposition patients, a hygiene (toileting) sling is suspended from a patient lift that can be maneuvered to the toilet on wheels or a ceiling track.

But unlike standard slings, hygiene slings allow lift passengers to stay in the sling while using the toilet, making the whole process quicker and easier.

Victor hygiene sling with head support function.
Slings from Waverly Glen are color-coded by size and use Velcro-fastened belts for security.
SureHands hygiene sling suspended from a ceiling-track lift.

Commode models differ

Although some slings are characterized as commode slings and serve the same purpose, their design is considerably different than that of hygiene slings.

Commode slings typically have a fairly small hole cut in the bottom of the sling fabric, which usually fully encompasses the buttocks. Hygiene slings are open from the middle or upper back all the way to the back of the thighs just above the knees.

Because of their open design, hygiene slings are easier to use without making a mess. They also facilitate personal cleanup after toileting.

Design is important

When selecting a sling of any type, several factors need to be considered, especially since costs can range from less than $100 to $1000 and more:

Weight and size of the user. The load-bearing capacity of slings can vary from several hundred pounds to more than half a ton. The same is true of the lifts that support slings. Both need to be capable of accommodating the patient’s size and weight.

Special physiological conditions. Lift users who require head support should use a high-back sling with a safety belt, advises the Lift Doctor, a panel of clinical and bioengineering lift specialists at Liko (888-545-6671). Regardless of the user’s physical abilities, all slings should have a safety belt option, "in order to avoid any possibility of your patient slipping while in the sling."

Function. Hygiene slings are specifically designed for toileting and bathing use.

Sling material. Most slings are fabricated of nylon and available with either padded or unpadded leg flaps. Don Krebs, owner of Access to Recreation (800-634-4351), warns that unpadded slings can bunch up and pinch the skin. He also recommends sling material that can be washed easily.

If the sling will be used to transfer the user in and out of the shower or bathtub, mesh fabrics that dry quickly are an option. Vancare (800-694-4525) offers slings and belts made of disposable material to help with infection control. The company also sells sling fabric with a nonabsorbent coating on one side to aid spot cleaning.

Waverley Glen (800-265-0677) makes sling seat belts with hook-and-loop (Velcro) fasteners for easily securing the user.

Lift/compatibility. Some companies that sell both lifts and slings maintain that their slings are not compatible with other manufacturers’ lifts. “This is no doubt explained as a liability issue,” says Diane Huberty, 61, of Fort Wayne, Ind. Huberty, who received an ALS diagnosis in 1986, also is a neuro-certified registered nurse. “But the truth is that nearly all slings will fit nearly all lifts.”

Adaptive clothing works

Buck and Buck cut-away muu-muus and dusters are adaptive but not revealing. Illustration on right shows rear view of Buck & Buck's cut-away duster.
Silvert's open-back wheelchair pants (above) are fashionable and sling-functional.

Huberty writes a regular column (www.living-with-als.org/Diane) called “From Both Sides — Caring for an ALS Patient.” From long-time firsthand experience with hygiene slings, she has acquired knowledge that’s pertinent not only to the slings themselves, but also to clothing that’s compatible with their use.

“Nobody mentions getting your pants down!” she complains on her site of sling makers’ otherwise glowing descriptions of their products. “No one tells you that in order to use a sling lift for toileting, you have to give up wearing slacks and underwear! Well, I refuse to sit around bare-assed under a drafty skirt or lap blanket waiting for a call of nature!”

Huberty and her caregiver tried making the sling work while she wore regular slacks, but getting the pants up and down proved a struggle. “That led me to try adaptive clothing,” she recounts.

She tried slacks with zippers on both sides, but they were difficult to zip back up after re-seating in her wheelchair. Ultimately, she settled on slacks with an open back, sold by Silvert’s Adaptive Clothing & Footwear (800-387-7088). “As weird as they sound, they look like ordinary slacks when you’re seated,” she writes on her Web site. “Of course, you can’t wear underwear with them. I just put a hand towel in the wheelchair seat instead.

“When you transfer to the toilet, you don’t have to do anything with them. No removing, pulling, unzipping, unsnapping needed. Just transfer to the toilet and go! There is plenty of open space underneath. I have never gotten my slacks wet or soiled. A pit stop with the help of a caregiver who’s familiar with the process takes less than 10 minutes, even with me on a ventilator.”

Buck and Buck (800-458-0600) also sells adaptive clothing, offering open-back and overlapping-back muu muus and dusters for women, and pants for men with two overlapping back panels held together by easily detached hook-and-loop tabs.

Choose carefully

Huberty recommends doing an Internet search to find the brand and model of hygiene sling that’s best for your particular needs, and then searching further for the best price. Among the Web sites she searched were www.livewellmedical.com (877-748-3935) and sites mentioned earlier in this article. She also notes that slings don’t work without lifts, and that the latter should be selected as carefully as the former.

Several manufacturers suggest that slings should, in most cases, be taken out of service and replaced after two years of use — or sooner if necessary. Sling condition can be affected by frequency of use, disinfectants, detergents, frequency of washing, temperature of the wash/rinse cycles and weight of the user.

Bill Norman
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