Hoyer Lifts and ALS Patients: Safeguarding Safety and Dignity Amid Progressive Disability

Amyotrophic Lateral Sclerosis (ALS), commonly known as "Lou Gehrig’s Disease," is a progressive neurodegenerative disorder. In ALS patients, motor neurons gradually lose function, leading to muscle weakness, atrophy, and eventually a complete loss of the ability to move independently, swallow, or even breathe. Throughout this irreversible process, safe, painless, and dignified position transfers have become one of the core challenges in caregiving.

Hoyer Lifts, with their features of stability, labor-saving operation, and single-person usability, are widely used in the daily care of patients with moderate to advanced ALS. However, the unique physical conditions of ALS patients—such as abnormal muscle tone, joint contractures, fragile respiratory function, and sensitive skin—require highly individualized adjustments to the use of Hoyer Lifts.

This article will detail the key role of Hoyer Lifts in ALS care, principles for adaptation, and humanistic considerations.

I. Why Do ALS Patients Particularly Need Hoyer Lifts?

The transfer needs of ALS patients evolve rapidly with the progression of the disease:

Early stage: Patients can still walk with the help of mobility aids or minimal assistance;

Moderate stage (usually 6–18 months after diagnosis): Lower limb weakness worsens, making it impossible to stand, and a wheelchair becomes necessary;

Moderate to advanced stage: Upper limb strength gradually declines, leaving patients unable to support their bodies and fully dependent on others for transfers;

Advanced stage: Neck muscles are affected, leading to difficulty in head control; respiratory muscles weaken, making patients extremely sensitive to any changes in body position.

At this point, traditional manual lifting not only easily causes pain or fractures (osteoporosis is common in ALS patients) but also triggers respiratory distress or anxiety attacks due to severe shaking. In contrast, Hoyer Lifts, through even support and slow lifting/lowering, minimize physical stress to the greatest extent and serve as the gold standard for safe transfers.

✅ Core Value: Providing a controlled, stable movement in a world where muscles are gradually "freezing."

II. Special Considerations for Using Hoyer Lifts with ALS Patients

1. Sling Selection: Comfort Takes Priority Over Efficiency

Avoid standard full-body slings: The pressure points under the armpits and at the base of the thighs may compress already atrophied muscles, causing severe pain;

Recommend "underarm-free" or "soft-padded" slings:

Examples include Arjo’s "Comfort Sling" or Drive’s "SoftFlex Sling";

Opt for wide shoulder straps and thickened hip pads to distribute pressure;

Ensure flat stitching and no hard labels.

For toilet transfers: When using open-style slings, someone must hold the patient’s head and torso steadily throughout the process to prevent forward leaning.

2. Head and Neck Support Is Critical

Patients in the advanced stage of ALS often lose head control. When suspended, their heads may tilt backward, easily causing cervical discomfort or airway obstruction.

Solutions:

Add an adjustable headrest inside the sling;

During transfers, the caregiver gently supports the back of the patient’s neck with one hand;

Choose a wheelchair with a high backrest as the target seat to ensure head support after the patient is seated.

3. Lifting/Lowering Speed Must Be Extremely Slow

Rapid lifting or lowering may trigger orthostatic hypotension or respiratory rhythm disorders;

For electric models, it is recommended to set the speed to the lowest gear;

Before each lift/lower, inform the patient softly: "We’re going to lift/lower slowly now—take a deep breath," to help them mentally prepare.

4. Skin Protection Is a Priority

ALS patients have extremely thin skin due to reduced activity and malnutrition, making them prone to pressure sores;

Add a layer of pure cotton padding inside the sling;

After each transfer, check pressure-prone areas such as the armpits, sacrococcygeal region, and ankles.

III. Equipment Selection Recommendations: Evolution from Moderate to End-Stage

Disease Stage Recommended Type Key Features

Moderate stage (partial cooperation possible) Manual hydraulic model Low cost, simple structure, suitable for 2–3 transfers per day

Moderate to advanced stage (complete disability) Fully electric model Remote control operation, can be completed by one person, reduces shaking

Advanced stage (loss of head control + fragile respiratory function) Electric model + dedicated sling + head support accessories Emphasizes stability, comfort, and emergency response capabilities