Using a Hoyer lift for toileting requires a specific type of sling, careful clothing management, and a clear sequence of steps to keep the person safe and dignified throughout the transfer. The process is more involved than a standard chair transfer because you need to handle garments, position over a toilet or commode, and allow for hygiene access, all while the person is suspended. With the right equipment and technique, it becomes a smooth routine.
Choosing the Right Lift Type
Not every patient lift works the same way for toileting. The choice depends on how much weight the person can support on their own legs.
A sit-to-stand lift works when the person can bear at least partial weight on their legs and has some trunk control. It lifts them from a seated position to standing, which makes pulling clothing down straightforward. This is often the simpler option for toileting when the person qualifies.
A full-body floor lift (the classic Hoyer lift) is necessary when the person cannot bear weight at all or has severe weakness. It uses a sling to lift the entire body, which adds complexity for toileting but is the only safe option for fully dependent individuals. Standard models typically support 400 to 600 pounds, while bariatric versions handle up to 850 pounds. Always check the specific weight capacity of your lift before use.
Picking a Toileting Sling
The sling makes or breaks toileting with a Hoyer lift. A standard full-body sling wraps under the legs and behind the back, which blocks access to clothing and hygiene. For toileting, you need one of two designs.
A full-body sling with a commode opening has a cutout in the seat area. This lets you lower the person onto a toilet or commode while the sling stays in place, providing access for hygiene tasks without removing it entirely. These slings come in mesh, solid fabric, and water-resistant materials.
A U-shaped seated sling supports the thighs and back but leaves the bottom open. It’s ideal for toileting, peri care, and bathing. U-shaped slings come with or without head support depending on how much upper body control the person has. If they can hold their head and trunk steady, a version without head support allows more freedom of movement. If not, choose one with head support.
Whichever sling you use, make sure it’s the correct size. A sling that’s too large lets the person slide; one that’s too small digs in and restricts circulation. Most manufacturers provide sizing charts based on weight and body measurements.
Managing Clothing Before and During the Lift
Clothing management is the trickiest part of toileting with a Hoyer lift, and getting the sequence right prevents frustration. Here’s the order that works:
- Before positioning the sling: Undo belts, buttons, zippers, or any fasteners on pants or skirts. Push clothing down as far as possible while the person is still seated or lying down.
- After fitting the sling: Once the person is lifted, pull clothing further down over the buttocks. Gravity helps here.
- After lowering onto the toilet or commode: Remove the leg sections of the sling, then lower clothing the rest of the way past the knees. Remove any continence pad at this point.
This staged approach avoids trying to do everything at once while the person is suspended, which would be uncomfortable and unsafe. Loose-fitting pants with elastic waistbands make the whole process significantly easier than jeans or belted trousers.
Step-by-Step Transfer to the Toilet
Position the commode or raised toilet seat in an area with enough floor space for the lift’s base legs to spread wide. If you’re using a commode chair, lock its wheels. If transferring onto a standard toilet, make sure the lift’s base can straddle the toilet or fit close enough to center the person over the seat.
Roll the person onto their side (or lean them forward if seated) and slide the sling behind their back, then roll or lean them the other direction to pull it through. Position the leg straps under each thigh. Handle clothing as described above, pushing garments down before completing the sling setup.
Attach the sling straps to the lift’s spreader bar. Most slings have multiple attachment points that adjust how upright the person sits. For toileting, you generally want a more upright, seated position, so use the attachment points that achieve that angle.
The Safety Check
Before lifting even an inch off the surface, run through these checks every single time:
- Examine all hooks and fasteners to confirm they won’t unhook during the lift.
- Double-check the position and stability of all straps.
- Confirm that clips, latches, and the spreader bar are securely fastened.
- Spread the lift’s base legs to their fully open position for maximum stability.
- Make sure the emergency release feature works.
Lift the person slowly, just a few inches at first, and pause. Check that the sling is seated properly and the person feels secure. Then raise them high enough to clear the surface they were on. Swing them gently over the toilet or commode by moving the entire lift, not by pushing the person’s body. Lower them slowly onto the seat.
Once seated, you can unhook the leg straps to improve access for hygiene. Leave the back portion of the sling in place behind them so you don’t have to reposition it from scratch for the return transfer.
During Toileting and Hygiene
Keep the lift nearby but rolled slightly out of the way so the person has space. If using a commode opening sling, the cutout provides access for wiping and cleaning without removing the sling. If using a U-shaped sling, the open bottom design serves the same purpose.
Give the person as much privacy as the situation allows. If they have enough upper body stability to sit safely on the commode for a few minutes, stepping to the other side of a privacy screen (while staying within earshot) can make a real difference to their dignity.
When they’re finished, help with hygiene as needed, replace any continence products, and begin pulling clothing back up before reattaching the sling straps for the return lift. Reverse the transfer process: hook the straps, run the safety check again, lift, move the lift back to the bed or chair, and lower.
Keeping the Sling Clean
Toileting slings need more frequent cleaning than slings used only for chair transfers. Reusable slings should be laundered according to the manufacturer’s instructions, which include a maximum washing and drying temperature specific to the fabric. Avoid strong bleach or harsh disinfectants, as these can weaken the fabric fibers over time and compromise the sling’s integrity. Between full washes, wiping the sling down with a ready-to-use disinfectant wipe is standard practice.
Disposable slings exist for situations where infection control is a high priority. These are single-use and don’t come with laundering instructions. If you’re caring for someone with skin infections or open wounds, disposable options reduce cross-contamination risk.
Inspect the sling before every use. Look for fraying seams, worn stitching, or any tears near the attachment points. A sling that shows visible wear should be replaced immediately, not after one more use.
Common Mistakes to Avoid
Rushing the clothing step is the most frequent problem. Trying to pull pants down while the person is already suspended is awkward, uncomfortable, and risks shifting them in the sling. Handle as much clothing as possible before lifting.
Using a standard sling without a commode opening forces you to remove the entire sling for toileting, then reposition it afterward. This doubles the physical handling and increases fall risk. Investing in a proper toileting sling saves time and is far safer.
Forgetting to widen the base legs leaves the lift less stable, especially on tile bathroom floors. Always spread the legs to their full open position. If the base won’t fit around the toilet, a bedside commode in a more open area is a better choice than forcing the lift into a tight space.
Never leave someone suspended in the lift while you step away to grab supplies. Have everything you need (wipes, gloves, clean clothing, continence products) within arm’s reach before you start the transfer.