How to assess for a stairlift

Published on 7 May 2024 at 18:19

Difficulties when mobilising on the stairs can cause unnecessary pain, breathlessness and fatigue, and increase risk of falls. It can also contribute to dehydration if someone is restricting their fluid intake to avoid using stairs to get to the toilet.

How to assess?

It is important to see what the persons general mobility and transfers are like first, what walking aids they use, and see them use the stairs if safe to do so. Note any existing handrails and what condition they’re in, the surface or carpet condition, any turns, obstacles, lighting, and space at top and bottom. Talk to the client and find out exactly what they find difficult on the stairs, how often they would like to use them, and what rooms are where.

Transfers

To use a stairlift safely, the client needs to be able to safely get on and off. Find out whether they will be using the stairlift independently or with assistance. They may need room to turn with a walking aid. Is the client tall enough? (I worked with 1 lady who already had a stairlift installed, but who had to literally jump on and off it as she was so short. All the stairlift companies I approached told me the only way they could make it short enough would be to install a childs seat, but these were all bucket shaped, designed for a child to be lifted into). Some clients may benefit from a grab rail on the wall to help with transfers.

Space

The clients dimensions should be discussed with stairlift companies- if the upper leg length is long, will there be enough space on narrow staircases and when turning corners? Ensure that the clients knees won’t be scraping on the wall opposite. Stairlifts also have a weight limit, which needs to be considered for plus size clients.

Cognition

The client needs to understand the purpose of using a stairlift and how to use it safely. Will they be alone in the property and using it without help? If they are supervised, are they willing to use it? Consider the safety implications of someone not using it safely, for example trying to get off halfway, entrapment risk or trying to mobilise around it. Also think of the safety of other people in the property including adults and children with cognitive impairment or learning disabilities.

Moving/handling equipment

Stairlifts can be used alongside some moving and handling equipment, but this requires careful consideration and risk assessment. Space needs to be available to use this with, and it is safer at the top of the stairs if the seat can be moved on a track away from the stairs (I have heard of an accident using a turntable directly at the top, where the client lost control and fell between the stairlift seat and the stairs). I have never known of a Sara Stedy or a stand aid to be used, as there isn’t generally room for the legs to be placed around the seat. I have seen a ceiling track hoist used, but at the top of the stairs the track came well away from the stairs.

Sitting balance

The client needs to have good sitting balance, including awareness to stay focused and awake throughout the journey. Harnesses can be considered in cases where the person needs postural support, but they are not to be used for restraint.

Contractures

Contractures and deformities need to be considered, including a ‘worst case scenario’ of how a client presents during times of stress, tiredness or high muscle tone. Are they able to sit in a neutral position in a stairlift during these times?

Ability to use controls

Will the client be using the stairlift independently, or will they always be accompanied? Controls can be put on either side of the chair, or controlled by remote control for caregivers.

Spasms/seizures

Is the client likely to injure themselves if they kick or hit out, either through contact with the stairlift or the wall opposite? Will they lose sitting balance? How often do they have spasms or seizures, does this follow a predictable pattern?

Through Floor Lifts

If a stairlift isn’t appropriate, it can be worth considering a through floor lift. To assess for this, you will need to determine the minimum space required, when static and for manouvres. Will the person be travelling in a wheelchair- if so, how much space does this take up? Does a carer need to travel in the space too- how much space do they need? Does any medical equipment also need to be transported? Is there enough space around the chair to avoid injury if the client moves their limbs outside of the chair? Are they likely to physically deteriorate- for example are they in a standard wheelchair now, but likely to need a tilt in space chair in the future? Planning ahead is key.

Also think about how much room the through floor lift will take up in the existing spaces- will there remain enough room for all required activities? This will benefit from a joint visit with a technical officer or company rep to determine what is structurally possible in the space.