Tilly was recently appointed as the equipment lead for her regional joint equipment loans store, funded by social care and NHS. Her role includes reviewing the current equipment stock to ensure it reflects the needs of service users and prescribers. One of her first tasks is re-organising the store’s slings and reducing costs to the commissioners on special slings.

During her first visit, the store’s manager showed Tilly two large transport cages of special slings that they couldn’t or struggled to reissue. Tilly was asked if there was a way of changing the slings to something more versatile to reduce waste and meet the community’s needs.

As a practising OT for over ten years and with an interest in moving and handling equipment, Tilly discusses with the store’s manager how modern sling designs have evolved from the classic universal tapered leg sling. She advises the store on more comfortable and versatile, modern deluxe-shaped slings. The unique leg design of the Prism Medical CA701 Deluxe Hammock supports the service user’s leg more evenly across the thigh, making it a more comfortable hoisting experience for the user. It is an excellent option whether the user is plus-size or small and frail. Also, the integral slide sheet material and padding in the leg supports make this sling easier to fit in many circumstances, including for a seated user.

Tilly also advised that the leg supports overlap/interlink and can support service users with lower limb amputations, highlighting the sling’s flexibility and the potential impact it could have on reducing the amount of special-order slings, thus reducing waste and saving money for the commissioners.

Transactive Advanced 272 ceiling track hoist with sling

In addition, Tilly was tasked to find a range of in-chair slings that would suit a variety of service users. She reviewed the CA702 in-chair hammock sling and the CA703 split leg variety, allowing air and moisture to pass through them more readily using a modern spacer fibre. These are ideal for individuals with high postural needs, where fitting and removing a sling in situ is hard or impossible.

Tilly discussed these slings with the store and OT service managers, highlighting their versatility and the potential to cut costs on special order slings, thus reducing waste. The OT service manager identified the need to train her teams on the new provisions. Tilly arranged product training with an OT-based moving and handling company at the local Prism Medical logistics hub.

In conclusion, Tilly’s expertise in modern sling designs and her ability to identify the community’s needs has allowed her to cut costs and reduce waste by introducing new sling designs. Her efforts have helped improve the hoisting experience for service users while providing a cost-effective solution for the commissioners.

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.

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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.

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Faizal is 62 and had a stroke five years ago. Consequently, he has been left with a left-sided weakness leaving him unable to stand. Faizal lives with his 60-year-old wife, Nadia; they have been married for 30 years and have two children, both of whom are away at university. Faizal is hoisted for all transfers, a transition which he and Nadia have found difficult, particularly allowing paid carers into the family home to support Faizal with personal care.

Nadia works from home and, through the day, supports her husband by preparing all his meals and maintaining the family home. Nadia uses care calls as an opportunity to go out and attend to shopping.

Over the last six months, Faizal has been experiencing issues with his continence. Before this, Faizal was well-regulated and hoisted onto a T40 commode/shower chair to open his bowels and pass urine; however, more frequently, Faizal can’t wait. This has become a concern for Faizal, Nadia and the district nursing service, who are increasingly concerned about pressure damage. Nadia’s primary concern is that overnight, she struggles to move Faizal, which means he is lying in his soiled pad all evening.

Faizal and Nadia were visited the following week by an OT from social services, and they discussed the potential for Nadia to be able to support her husband overnight. It is agreed that hoisting is unrealistic as Faizal states he isn’t always aware when he has opened his bowels or passed urine. The OT discusses a strategy of making it possible for Nadia to turn her husband, clean him and change his pad on her own overnight.

Nadia discusses with the carers the possibility of hoisting Faizal onto the commode overnight on her own. The carers advise her that it is illegal to hoist single-handedly, and they will have to report this to social services if they think this is what she is doing. Nadia discusses this with the district nurse when she visits, who advises that the carers’ advice doesn’t sound quite right and refers her to the local social services team for an urgent Occupational Therapy (OT) assessment to see how Nadia can support her husband overnight.

Faizal and Nadia agree to try a satin sheet bed management system and a gantry hoist. The OT shows the couple how the combination of the two (in conjunction with a positional wedge) can enable Nadia to turn Faizal, allowing Nadia to attend to her husband’s personal care. Faizal and Nadia trialled this for two weeks, and although initially, it was quite an adjustment for them both, the trial was successful. Nadia described the process as “easy”, and Faizal stated the turn is smoother than when the carers do it! Following this initial success, Faizal and Nadia allow the OT to look into installing a permanent Ceiling Track Hoist. They also discuss Nadia’s potential to hoist Faizal into a chair in the future.

This case study is based on a real-life situation that OTs come up against regularly. In this case, the carers in the area are not trained in single-handed care; however, this does not stop the OT from empowering the client and his wife. Using systems such as gantry hoists, bed management systems and wedges can reduce the strain on carers in handling operations. This could reduce the number of carers required at each call.

Case study courtesy of our friends at Athena Handling Ltd.

Copyright Athena Handling Ltd 2023

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Grace is 80 years old and lives with her daughter, son-in-law and two teenage grandchildren. Grace has several physical conditions, including arthritis, which has led to 2 hips and one knee being replaced over ten years ago. Consequently, Grace’s mobility has deteriorated, and she now needs hoisting for all transfers. Grace and her family have been preparing for this, and Grace has a bedroom on the ground floor of the house, with part of the garage converted into a shower area and toilet. Grace moving to residential care is not an option Grace or her family want.

Grace’s Daughter Olivia works from home and wants to support her mum. Still, following discussions, they believe that proper care will be required to ensure Olivia can work and maintain a good balance between being a carer for her Mum and her daughter.

Grace and Olivia discuss their concerns with a social worker who recommends an Occupational Therapy (OT) assessment. On meeting the OT, Grace discusses her wish to continue to use a toilet and not wear pads for as long as possible. Grace also stated she would like to be able to sit in a chair also. Olivia says that her Mum leans to the left over time and can sometimes start to slip forward.

The OT suggests a package of interventions to meet Grace’s needs, supports her wish to allow her daughter to help her and enables the provision of formal care. The OT discusses the concept of single-handed care, which can support Olivia in demonstrating techniques and equipment to help, and care agencies in the locality are also trained to provide this level of care.

The OT arranges for a Ceiling Track Hoist (CTH) to replace the current mobile hoist, and a bed management system is provided. The OT looks at Grace’s wish to continue to use the toilet and sit out in a chair. When assessing Grace’s postural needs, the OT establishes that a well-fitted shower chair that can fit over the toilet and support Grace at the hips and the lower thoracic area would help her maintain a good upright position. The OT chooses a T40 shower chair which he builds in his local stores to Grace’s measurements. The T40 height is adjusted so it moves easily over the toilet, allowing Grace to use the toilet as usual and making it easy for one handler.

The OT picks a Dartex seat that is more comfortable than standard material coverings and side support that help hold the hips and the lower thoracic area comfortably, preventing Grace from leaning – making toileting and showering a more pleasant experience. The OT also provides a lap strap to stop Grace from sliding forward over time and holding the hips in an optimal position.

The OT also sources a Brooklyn Recliner chair from his regional stores. The OT chose this chair as it can be moved between rooms allowing Grace to spend time with family in family areas. It has a good degree of pressure care support and postural support, ensuring Grace’s comfort and consideration of longer-term needs.

These provisions, along with OT support and guidance to the family, enable Grace’s wishes and empower Olivia and local care providers to support Grace’s care and wellbeing within a caring family environment.

Case study courtesy of our friends at Athena Handling Ltd.

Copyright Athena Handling Ltd 2023

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