Ben is 54 years old and has Multiple Sclerosis (MS). He lives with his wife, Jennifer and their two children (18 and 20). Ben still works as a design technician and ostensibly works from home; however, he maintains face-to-face consultations and drives an adapted vehicle to meet clients. Ben has a powered wheelchair to mobilise outdoors and uses this indoors when he tires and, occasionally, a self-propelled wheelchair.
Ben has been transferring using a transfer board; however, he has been struggling lately, and his wife, who also works from home, struggles to support him. Ben and Jennifer’s children are in university, and they want them to focus on their studies rather than Ben’s care. This ties in with Ben’s condition, which, following a recent review, is now referred to as secondary progressive MS by Ben’s neurologist.
Ben refers himself to his local social services department for advice from Occupational Therapy. He is subsequently contacted and visited by an Occupational Therapist (OT). The OT observes Ben on the periphery of being able to manage transfers in his home using a transfer board independently and even with support. Ben reports he is increasingly falling when transferring; however, he is adamant that he wishes to use a transfer board as long as possible. Jennifer states she has arthritis in her hands and is finding it increasingly challenging to support Ben, particularly when he is tired.
The OT recommends hoisting; Ben is initially resistant to this seeing this as a loss of independence and taking up floor space. They discuss a Ceiling Track Hoist (CTH) as a longer-term alternative to a mobile hoist and only hoisting in the bedroom. Ben already has a height-adjustable bed to support transfer board transfers. The OT advises that this compliments the use of the CTH and discusses slings and the available options.
Following the initial concerns, the OT reviews sling options that will enable Jennifer to support the sling’s application. The OT assesses Ben and Jennifer and recommends the CA701 Deluxe Hammock-style sling. The slide sheet material on the leg supports and dog leg design makes this easier to fit and remove than conventional universal slings with a tapered leg. It is also more comfortable. The OT also discusses in-chair slings, such as the CA703 split leg sling. This will allow Ben to stay seated in the sling throughout the day. Ben acknowledges the usefulness of the CA703; however, after a fortnight’s trial, the CA701 appeared to work well. A mobile hoist was less useful, as it was difficult for Jennifer to move it.
The OT reviews the feedback and further observes transfers with Ben and Jennifer. He is satisfied that he can make a case for a CTH. This will reduce strain on Jennifer by removing the weight of the mobile hoist, the friction caused by Ben’s weight and the weight of the hoist against the floor. This will also make the transfer more comfortable for Ben, as he describes a sea sickness sensation being buffeted in the mobile hoist.
Via a discretionary Disabled Facilities Grant (DFG), Ben has a CTH installed. The OT demonstrates to Ben and Jennifer and goes through a review process. The result is that Ben is using the CTH more and more to transfer, and Jennifer is finding it very easy to support Ben. Ben is now aware of slings that could help him in the future following further deterioration; however, the OT also discusses supportive seating available via the local loans store. He advises that the seating would support Ben’s posture, allowing him to rest, feed, work at home, and deter pressure damage.
The OT places Ben’s case on an automatic 6-month review which will be flagged by the local authorities system and allocated to an OT to review.
Our friends at Athena Handling Ltd provided this case study. They are a moving and handling company that provides risk assessments and training based on over 20 years of Occupational Therapy practice.
