Using a Hoyer Lift for Diaper Changes? — Safeguarding Dignity and Safety in Basic Care

Changing diapers for fully disabled adults is a daily, yet challenging task that many caregivers must face. Factors such as the patient’s excessive weight, stiff body, fragile skin, or resistance to lying flat due to cognitive impairment can turn this seemingly simple procedure into a difficult ordeal. Forced dragging not only risks straining the caregiver’s lower back but also easily causes the patient’s skin to tear, worsens pressure sores, and even inflicts psychological trauma.

In such cases, a Hoyer Lift can serve not only for bed-to-wheelchair transfers but also as a key tool to complete diaper changes safely, efficiently, and with dignity. This article will detail how to correctly and gently integrate a Hoyer Lift into the adult diaper care process.

I. Why Is a Hoyer Lift Needed for Diaper Changes?

Many people mistakenly believe that Hoyer Lifts are only used for "major transfers" (e.g., from bed to wheelchair). However, for the following groups of patients, briefly suspending the body during diaper changes is actually the safest option:

Those completely unable to roll over or lift their hips (e.g., patients with high-level spinal cord injuries, advanced ALS);

Those who are overweight (>80 kg) and whose hips cannot be lifted by a single caregiver;

Those with extremely fragile skin (e.g., long-term hormone users, diabetics), where even slight friction may cause damage;

Those with severe joint contractures or spasms, making it impossible to spread their legs when lying flat;

Those with sacrococcygeal pressure sores, who need to avoid any dragging or shearing forces.

In these situations, gently lifting the patient a few centimeters off the bed is far safer and more humane than forcibly pulling at the diaper.

II. Specialized Slings: Key Accessories for Diaper Changes

Not all slings are suitable for diaper changes. The following two types are recommended:

1. Toileting Sling

Features an open hip design, facilitating quick diaper changes or perineal cleaning;

Shoulder straps and leg straps provide sufficient support to keep the body stable when suspended;

Most are made of quick-drying, waterproof materials, making them easy to clean and disinfect.

⚠️ Note: Toileting slings are for short-term use only (<15 minutes) and cannot be used for prolonged sitting or transfers.

2. Hygiene Sling with Snap Crotch

The crotch is designed with snaps or zippers, eliminating the need to remove the entire sling during changes;

Suitable for patients requiring frequent care, reducing the hassle of repeated putting on and taking off of the sling.

III. 5-Step Safe Diaper Change Method

Step 1: Prepare the Environment

Adjust the care bed to a suitable height (approximately level with the caregiver’s hips);

Prepare clean diapers, wet wipes, protective pads, and garbage bags;

Ensure privacy by drawing curtains or closing the door.

Step 2: Put on the Toileting Sling

Assist the patient to lie on their side and slide the folded toileting sling under their back;

Fasten the shoulder straps and leg straps, ensuring the opening is aligned with the perineal area;

Check that all buckles are secure.

Step 3: Lift Slowly

Activate the Hoyer Lift and gently lift the patient until their hips are 5–10 cm off the bed;

There is no need to lift too high, as this avoids unnecessary anxiety from suspension;

The caregiver should place one hand lightly on the patient’s back to provide a sense of security.

Step 4: Efficient Diaper Change

Quickly remove the soiled diaper and clean the perineal area and hips with wet wipes;

Apply protective cream if needed;

Unfold the new diaper and place it correctly from front to back.

Step 5: Lower Gently and Tidy Up

Slowly lower the patient onto the bed and confirm their body is fully supported by the mattress;

Undo the sling and assist the patient in adjusting their lying position;

Fold the sling to air dry and return the equipment to its storage place.