A patient lift (often called a Hoyer lift) transfers a person from a bed to a wheelchair, commode, or other surface when they can’t move safely on their own. The process involves placing a fabric sling under the person, connecting it to the lift’s overhead bar, and raising them just high enough to reposition. It sounds intimidating the first few times, but the steps are straightforward once you understand the sequence.
Types of Patient Lifts
Patient lifts fall into two broad categories: full-body lifts and sit-to-stand lifts. Both come in manual and electric versions.
- Manual hydraulic lifts use a hand pump to raise and lower the boom arm. They’re less expensive, but the pumping requires physical effort, so the caregiver needs reasonable upper-body strength.
- Electric (power) lifts replace the hand pump with a battery-powered motor. You press a button to raise or lower, which removes most of the physical strain.
- Sit-to-stand lifts help a person move from sitting to standing and back again. These are designed for people who still have some mobility but lack the strength to change positions independently.
Standard lifts typically handle up to about 340 pounds. Bariatric models go much higher, with some rated for 700 pounds or more. Always check the safe working load printed on your specific lift before using it.
Choosing the Right Sling
The sling is just as important as the lift itself. Using the wrong size or type creates discomfort and safety risks. Slings are sized by the person’s weight and body girth, and they come in several styles depending on the type of transfer you’re doing.
A full-body or “highback” sling supports the person from behind their shoulders down to their thighs, making it suitable for someone with little or no ability to sit upright. A universal sling works for most standard bed-to-chair transfers. For toileting, hygiene slings have an open bottom. Vest-style slings are used with sit-to-stand lifts for people who can bear some weight through their legs.
Materials vary too. Mesh or net polyester slings dry faster and work well for bathing transfers. Padded polyester slings are more comfortable for longer use. Disposable slings exist for short-term or single-patient infection control situations. Whatever sling you choose, confirm that its weight rating matches or exceeds the person’s weight.
Preparing the Lift Before Each Use
Before every transfer, do a quick visual and hands-on check. Look for cracked welds, hydraulic leaks, and any damage to cables or the wire harness. On a manual lift, test the hydraulic pump and release valve to make sure they engage and hold smoothly. On an electric lift, verify the battery is charged and the controls respond.
Inspect the sling for fraying, torn stitching, or worn loops. The connection points where the sling attaches to the spreader bar (the overhead crossbar) take the most stress, so pay close attention there. If anything looks questionable, replace the sling before using it. A torn loop during a transfer can cause a serious fall.
Placing the Sling Under the Person
Getting the sling positioned correctly is the part most new caregivers find tricky. For someone lying in bed, the standard method is a log roll. Stand on one side of the bed, roll the person gently toward you onto their side, and fan-fold or roll the sling lengthwise behind their back. Then roll the person back over the folded sling and onto their other side so you can pull the sling flat. When they roll back to center, the sling should be spread evenly beneath them.
The top edge of a full-body sling sits behind the person’s head or shoulders, depending on the sling style. The bottom edge runs under their thighs, with the leg straps (if present) crossing between the legs. Make sure the sling is centered and not bunched to one side. An off-center sling causes the person to hang crookedly once lifted, which is uncomfortable and harder to control.
Connecting the Sling to the Lift
With the sling in place, spread the base legs of the lift to their widest position. This is essential for stability. Lock them open. Then use the steering handle to roll the lift into position over the person, with the spreader bar directly above them.
For chain-and-hook style connections, attach the S-hooks from the sling’s loops to the spreader bar. Insert hooks facing outward, away from the person’s body, so there’s no risk of the hook pressing into skin. Count the chain links on each side to make sure they’re even. Unequal chain lengths will tilt the person during the lift. If you’re adjusting the back angle, hook the back straps into links one, two, or three as needed, but always keep both sides equal.
For clip-style connections (common on newer electric lifts), the clips snap directly onto the spreader bar loops. The principle is the same: symmetry on both sides, attachments facing away from the body.
Lifting and Transferring
Once everything is connected and double-checked, raise the person slowly. On a manual lift, pump the handle in steady strokes. On an electric lift, hold the “up” button. Lift only until the person’s body clears the surface beneath them by a few inches. There’s no reason to raise anyone higher than necessary.
As the person rises, a self-leveling spreader bar will naturally bring them into a seated position. Watch their expression and body language. If they report pain or you see the sling shifting, lower them back down immediately and reposition.
To move the lift, steer it by the handle while keeping one hand free to steady the person if needed. Move slowly and watch for obstacles on the floor. Carpet edges, cords, and throw rugs can catch the base wheels. When you reach the destination (a wheelchair, for example), position the lift so the person is directly over the seat, then lower them gradually using the release valve (manual) or “down” button (electric). Once they’re seated, unhook the sling from the spreader bar and roll the lift away. You can leave the sling in place beneath the person if you’ll be transferring them again soon.
How Many People Are Needed
A mechanical lift is designed to replace manual lifting, but that doesn’t always mean one caregiver can do it alone. For a straightforward bed-to-wheelchair transfer with a cooperative person, one trained caregiver can typically manage. For someone who is very heavy, anxious, or unable to assist at all, two people make the process safer and more comfortable. One operates the lift while the other guides the person’s body and legs into position. OSHA recommends basing staffing decisions on the person’s physical condition and the equipment available, so use your judgment rather than defaulting to a fixed rule.
What to Do if the Lift Loses Power
Electric lifts have a manual emergency lowering mechanism for situations where the battery dies or the motor fails mid-transfer. This is usually a valve or release knob located on the lift arm or actuator. Activating it allows the boom to descend slowly under the weight of the person, bringing them down in a controlled way rather than leaving them suspended. Familiarize yourself with where this release is on your specific model before you ever need it. If the person is in the air and you can’t figure out the emergency release, call for help rather than trying to force any mechanism.
Common Mistakes to Avoid
Most lift-related injuries come from a handful of repeated errors. Forgetting to widen and lock the base legs is one of the most dangerous, because a narrow base can tip when the boom is loaded. Raising the person too high increases swing and makes steering harder. Rushing through sling placement leads to uneven attachment points, which tilts the person sideways. And skipping the pre-use inspection misses problems like a leaking hydraulic valve that could cause the lift to drop unexpectedly.
One less obvious mistake is using a sling that’s too large. An oversized sling bunches up and doesn’t support the body properly, which can let the person slide through. A sling that’s too small digs into the skin and restricts blood flow. Take the time to size the sling correctly using the manufacturer’s guidelines for weight and girth.