Using a Hoyer lift with a full body sling involves positioning the sling under the person, connecting it to the lift’s spreader bar, raising them slowly, moving them to a new surface, and lowering them back down. The process takes about five minutes once you’re comfortable with it, but getting the sling placement right is the most important step. Two caregivers make the transfer safer and easier, especially when you’re learning.
Inspect the Sling and Lift Before Every Use
Before you begin, check the sling fabric for any signs of bleaching, fraying, tears, or broken stitching. A compromised sling can fail under load, and Manitoba’s medical device guidelines are blunt: bleached, torn, or frayed slings are unsafe and could result in serious injury or death. Run your hands along the seams and look closely at the attachment loops or straps where the most stress occurs.
On the lift itself, confirm the battery is charged (for electric models) or the hydraulic pump moves smoothly. Test the brakes on the base wheels. Make sure the spreader bar hangs freely and that all hooks or clip attachments are intact and functioning. This inspection takes under a minute and should become automatic.
Positioning the Sling While Lying Down
The easiest way to place a full body sling is while the person is lying in bed. Fold the sling in half lengthwise and roll the person onto their side, facing away from you. Tuck the folded sling behind their back, positioning it so the wider seat portion will end up under their thighs (with the lower edge near the knees) and the narrower back portion sits just above the small of the back. For slings with a commode opening, the top of that cutout should align with the base of the spine.
Roll the person back over the folded sling and onto their other side, then pull the sling through flat, the same way you’d reposition a bed sheet. Roll them onto their back again. The sling should now be spread smoothly beneath them with no bunching or wrinkles, which matter both for comfort and for even weight distribution during the lift.
Next, pull the leg straps forward. Bring each strap under the corresponding thigh and up between the legs. Cross the leg loops before attaching them to the spreader bar. Crossing them provides a more secure, cradled seat and prevents the person from sliding forward during the transfer.
Connecting the Sling to the Spreader Bar
Roll the lift base under the bed as far as it will go, positioning the spreader bar (also called the cradle) directly over the person. Open the base legs to their widest position for maximum stability. The FDA notes that lift base legs are most stable in the full open position.
How you attach the sling depends on your lift model. For chain-style systems, attach the S-hooks from the seat portion to the seat hanger loops, with hooks facing outward, away from the person’s body. This prevents the hook ends from pressing into skin. Then connect the chain ends to the swivel bar hooks. You can adjust height by choosing different chain links, but always count the links on each side to make sure they match. Uneven chains create a lopsided, dangerous lift.
For the back straps, attach the S-hooks into links 1, 2, or 3 as needed to get the right recline angle. A lower-numbered link creates a more upright seated position; a higher number reclines them further back. Again, count to confirm both sides are even. Make sure every S-hook is fully seated in its chain link, not just resting on the edge. Do not hook back straps into the excess chain hanging below the seat attachment. They belong in the links between the seat connection and the swivel bar.
For clip-style systems (more common on newer electric lifts), the process is simpler: match the color-coded loops on the sling to the corresponding attachment points on the spreader bar and click each clip closed. Tug each connection to confirm it’s locked.
Lifting and Transferring
Before raising the person, tell them what’s about to happen. Use the hand control or hydraulic pump to raise them just a few inches off the bed, then stop. Check every attachment point. Look at how the sling is sitting: the person should be centered and secure, not tilting to one side. Their arms should be inside the sling or resting comfortably on their lap, not caught under a strap or dangling outside the sling edge.
Once you’re satisfied everything looks right, continue raising them until they clear the bed surface. Keep the lift as low as practical during the transfer. Higher lifts mean more swinging and less stability. One caregiver should operate the lift while the second guides the person’s body and steadies any swinging. If you’re working alone, move slowly and keep one hand on the person whenever possible.
Roll the lift carefully to the destination, whether that’s a wheelchair, commode, or another bed. Portable floor lifts have weight capacities ranging from about 350 pounds for standard models up to 1,000 pounds for bariatric versions. Never exceed your lift’s rated capacity, which is printed on the device.
Position the lift so the person is directly over the target surface. Open the base legs wide enough to straddle the wheelchair or chair base. Lower them slowly using the hand control or the hydraulic release valve, guiding them into position as they descend. Once their weight is fully on the new surface, unhook the sling from the spreader bar and remove or reposition the straps.
Should You Leave the Sling Under the Person?
It’s tempting to leave the sling in place under someone sitting in a wheelchair so it’s ready for the next transfer. Research on sling interface pressures suggests this is a bad idea for anything beyond very short periods. A study measuring pressure between slings and skin found that the highest pressures occur along the sling’s seams and edges. For seated slings, the backs of the upper and lower thighs bear the most pressure. For supine slings, the areas around the tailbone, sit bones, and hip joints are most vulnerable.
These pressures are highest during suspension (the actual lift), exceeding 200 mmHg for all seated slings tested, which is well above the threshold that restricts blood flow to skin. But even when lying on a sling flat in bed, the bunched fabric and seams create localized pressure points that increase the risk of skin breakdown over time. Remove the sling after each transfer whenever possible, especially for people who already have pressure injury risk factors like limited mobility, thin skin, or incontinence.
What to Do if the Lift Loses Power
Electric lifts can fail mid-transfer if the battery dies or the motor malfunctions. Every electric Hoyer lift has a manual emergency lowering mechanism. On the Hoyer Advance model, for example, there’s a red knob on the actuator that you pull upward to activate a slow mechanical descent. It only works when the lift is under load (at least about 66 pounds of weight pulling down).
Most models also have emergency raise and lower buttons hidden beneath the emergency stop button on the control box. These are small recessed buttons that you press with the tip of a pen. Familiarize yourself with these backup controls before you ever need them. Read your specific model’s manual and practice locating the emergency release so you can find it quickly if someone is suspended in the air and the hand control stops responding.
Common Mistakes to Avoid
- Mismatched attachment points. Uneven chain lengths or clips attached to the wrong loops create a tilted, unstable lift. Always count links or match color codes on both sides.
- S-hooks facing inward. Hooks should always point away from the person’s body. Inward-facing hooks can dig into skin or catch on clothing.
- Narrow base position. Keep the lift legs in the widest stable position throughout the transfer. A narrow base is easier to tip.
- Raising too high. Lift only as high as you need to clear the surface. Extra height adds swing and makes the transfer harder to control.
- Skipping the pause. Always stop a few inches up and recheck every strap and hook before completing the lift. This is the safest moment to catch a problem.
- Wrinkled sling fabric. Bunched or twisted fabric under the person creates pressure points and can cause skin irritation or injury, especially during longer transfers.