Abstract:
An arrangement for transferring a supine patient longitudinally or laterally between beds or surfaces adapted to accept the patient in a supine position. The arrangement is adapted to function with a conventional or hospital-type bed. It includes apparatus for transferring a collapsible bathtub or a bedsore prevention pad onto said bed and transferring a patient onto and off these devices.

Description:
BACKGROUND OF THE INVENTION 
     The present application is a continuation-in-part of the parent application Ser. No. 731,533 filed May 7, 1985. 
    
    
     The process of transferring an invalid person from a hospital bed to a wheelchair, to a commode, or to a bathtub in a hospital, nursing home, or home, or assisting such a person in such a transfer, often involves more than one person, is labor intensive and can be costly. The task frequently requires considerable strength and is occasionally a source of injury to the invalid person or attendant. Further, the task of periodically moving or turning a patient to prevent decubitus ulcers (bedsores) is arduous and fatiguing. These problems often are the major factors that cause a person to be hospitalized or moved to a nursing home, rather than being cared for at home. They also increase the cost of caring for persons in hospitals and nursing homes. 
     Principal objects of this present invention are to provide a novel arrangement of parts or attachments which can be added and attached to existing or new beds or designed into new beds which will significantly assist in: 
     (A) the transfer of a person or patient from one bed to a reclining wheelchair or other surface; 
     (B) the transfer of a person or patient to and from a &#34;tub&#34; arrangement for bathing of said patient; 
     (C) the transfer of a person or patient to and from a pad surface designed to automatically vary the pressure or reduce the pressure on a person&#39;s skin to prevent decubitus ulcers; 
     (D) the removal and replacement of soiled bed sheets. 
     Objects A and D have have been the subject of previous inventions. The present invention comprises improvements which address objects B, C and D. 
     Additional objects and advantages of the present invention will become more evident from the following description of specific embodiments when read in conjunction with the accompanying drawings. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a perspective view of the essential elements of this invention; 
     FIG. 1a is an enlarged perspective view of a portion in FIG. 1; 
     FIG. 2 is a perspective view of one form of &#34;bathtub portion&#34; of this invention, when inflated and ready for use, less patient; 
     FIG. 3 is a perspective view of one form of the &#34;bathtub portion&#34; of this invention, when deflated; 
     FIG. 4 is a perspective view of the unit as in FIG. 3 when rolled (or unrolled) from storage on bed; 
     FIG. 5 is a perspective view of the unit as in FIG. 3 when rolled (or unrolled) from storage off bed; 
     FIG. 6 is a perspective view of the unit as in FIG. 3 when deployed from (or to) storage (not rolled); 
     FIG. 7 is a partial plan view of the bed as shown in FIG. 1; 
     FIG. 7a is a view of a hand crank for an auxiliary roller; 
     FIG. 7b is a partial side elevation view showing a belt drive for the auxiliary roller; 
     FIG. 7c is a partial plan view showing the belt drive of FIG. 7b; 
     FIG. 7d is a schematic diagram of the electrical controls for the roller drivers in FIG. 1; 
     FIG. 8 is an elevation view of an item in FIG. 7; 
     FIGS. 9 through 14 are schematic sequenced views showing the operation of this invention using the bathtub apparatus stored at the foot end of the bed; 
     FIGS. 15 through 20 are schematic sequenced views showing the operation of this invention using the bathtub apparatus stored at head end of bed; 
     FIGS. 21 through 23 are schematic sequenced views showing operations of this invention using the bathtub stored on the auxiliary surface; 
     FIG. 24 is a perspective view of a bedsore preventor part of this invention; 
     FIGS. 25 through 27 are elevation views of the bedsore prevention pad in operating sequence; 
     FIG. 28 is an elevation view of the bedsore prevention pad with a cover sheet; 
     FIG. 29 is a perspective view of one form of the bedsore preventor portion of this invention when rolled on main bed sheet roll; 
     FIG. 30 is a perspective view of one form of the bedsore preventor portion of this invention when rolled on auxiliary roller; 
     FIG. 31 is a perspective view showing an arrangement for attaching an additional sheet to the movable transfer sheet on a bed; 
     FIG. 32is a a schematic view of a configuration similar to FIGS. 2-4 for lateral transfer of a person from a wheelchair to the bed; 
     FIG. 32b is a schematic view using the configuration of FIG. 32a, in which the patient is being transferred onto a collapsed tub; 
     FIG. 32c is a schematic view using the configuration of FIG. 32a, in which the patient rests in the tub after it has been inflated and partially filled with water. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     For the purpose of describing the operation of the present invention, the patient is considered to be transported in a longitudinal (head to foot) direction from the bed to the other surface, and to return in the opposite direction (foot to head). This is done for the convenience of the discussion only, and it will be clear that the invention may be designed to move the patient in a lateral or side-to-side motion with the transfer apparatus located on the left and right sides of the bed rather than at the head and foot ends as illustrated and described. It is not intended that the invention be limited to end-to-end, or longitudinal, transfer. 
     Two transfer operations are required to prepare a patient for a bath in accordance with this present invention. The first is to transfer the patient from the bed 2 to a reclining wheelchair or other suitable surface. This transfer procedure, which is the subject of other inventions, is summarized schematically in FIGS. 9, 10, and 11. The second transfer procedure, which is the subject of the present invention, is to transfer the patient and a collapsed bathtub together onto the bed so that the patient is placed on the surface of the bathtub as shown schematically in FIGS. 12 and 13 and variously through FIG. 23. 
     FIG. 1 is a perspective view of the equipment in a preferred embodiment of the present invention. 
     FIGS. 1 and 9 show the bed 2, which consists of a conventional bed 4 as found in a home or an institution such as a hospital or nursing home. An elevating device 5, either manual or power driven, as found on hospital-type beds, is used to raise or lower the bed 2 to the proper height, to perform the required operations. Alternatively, the bed may be blocked up to the proper height and left there for the duration of the patient&#39; use. 
     Also attached to the conventional bed 4 is an arrangement for transporting a person from a position on the bed to and beyond the edge of the bed. This arrangement contains a foot-end roller 6 whose length is approximately equal to the width of the bed, and which is mounted to the bed frame at the foot end of the bed. A similar head-end roller 7 is positioned at the head end of the bed. A specially designed bed sheet 10, approximately equal in width to the width of the bed and equal in length to several multiples of the length of the bed, is fastened to and partially rolled up on the foot or near end roller 6 while the other end is fastened to the head or far end roller 7 at the head end of the bed. 
     Although not a requirement of this invention, it is desirable to keep the length of the modified bed 2 as short as possible. For this reason, the rollers 6 and 7 are located under the main bed frame members 11. To ease the transport of the sheet 10 over the mattress 12, a foot-end-corner idler roller 8 and head-end-corner idler roller 9 are mounted to the bed frame 11. These idler rollers 8 and 9 can be of relatively small diameter and covered with a soft material over a stiff core to enable comfortable patient transfer over them. The top surface of these rollers is approximately level with the top surface of the bed 2. 
     Mechanical power sources such as, but not limited to, electric motors or hand cranks (not shown) are provided for driving the two rollers to wind up the sheet 10 on one roller while allowing it to unwind from the other so as to move the sheet over the surface of the mattress 12 and thereby transport a reclining person 1 from a position on the bed 2 to and beyond the end of the bed. 
     The wheelchair 3, shown in FIGS. 1, 9, 10 and 11 at the foot end of the bed 2, is in a reclining position. A mechanism, not shown, allows the wheelchair 3 to assume this reclining position. Alternatively, any surface suitably equipped as described below may be used in place of the wheelchair. The bed 2 is adjusted by mechanism 5 to the same height as the wheelchair 3. 
     The wheelchair 3 is equipped with rollers 14 and 15, one on each end. Fastened around these rollers 14 and 15 is a sheet of material 13 which extends over the top surface of the wheelchair 3 and back under the chair as an endless belt. Provision (not shown) is made to apply proper tension to this sheet 13 and to propel it around rollers 14 and 15 by mechanical means such as a motor or hand crank. Alternatively, the wheelchair 3 (or other suitable surface) may have rollers with a sheet fastened between them as in the manner of the bed 2 described above. The transfer operation of the wheelchair apparatus is similar to that of the bed apparatus, with the ability to transport a patient onto or off the surface. 
     FIGS. 10 and 11 show the transfer of a person 1 from bed 2 to wheelchair 3, which is locked in position at the foot of bed 2, as shown. Motion of sheet 10 as it is wound up on roller 6 moves the patient 1 over bed 2 onto wheelchair 3, where motion of sheet 13 continues the transfer process. If the velocity and direction of sheet 13 on wheelchair 3 is approximately the same as that of sheet 10 on bed 2, a supine patient on the bed will be transported smoothly onto the surface of the wheelchair 3, or from the wheelchair onto the bed 2. 
     FIG. 1 shows guidance members 17 which are used to guide sheet 10 onto and off rollers 9 and 8. The hems 16 of the sheet 10 are made thicker than the body of the sheet, and members 17 contain suitably shaped grooves with narrow outer portions 38a through which the center section of the sheet 10 slides and with larger inner portions 38b through which the thickened hem 16 slides and is restrained and guided. The guidance members 17 are placed as shown in FIG. 1 at the corners of the bed 2 so that the sheet 10 will be guided smoothly and will track properly over rollers 8 and 9 onto rollers 6 and 7. Similarly, hems 18 on sheet 13 on wheelchair 3 are guided by guidance members 19 fastened to the wheelchair 3. 
     The tub assembly 20 consists of an impervious sheet 21 of material to which is fastened a series of walls 22, shown here as four interconnected, inflatable cylindrical shapes. These walls may be of any shape that will fold up simply when rolled or folded and they can be supported by any suitable means such as internal air pressure or exterior or interior supports, removable or not, as required. Bathtubs of this general type are commercially available for use on beds. 
     The sheet 21, which may extend beyond the tub walls 22, is fastened to the bed sheet 10 by means of a closure 23 (also shown in FIG. 6) such as zippers, VELCRO, snaps or buttons. The other end of the sheet 21, in FIG. 1, is fastened to a separate auxiliary roller 24, but, as to be shown, it is not a requirement of this invention. This roller 24 is supported by brackets 27a and 27b, attached to the bed frame 11 and driven by means shown in FIG. 7. 
     The tub walls 22 and impervious sheet 21 form a water-tight container or bathtub. The technique for loading and unloading the patient from this and similar apparatus is described later and is illustrated in FIGS. 9 through 23. 
     The bathing procedure which is standard and is not shown is as follows: The tub walls 22 are inflated by air pressure from a pump or compressor or otherwise raised to form a tub. This operation may be powered by any conventional means, including manual. To bathe the patient, a hand-held shower connected by a hose to a standard water tap may be used. Alternatively, a cart with water storage, suitable pumps and connections may be used as the supply. To avoid over-filling, a push button valve may be incorporated in the shower head to allow water to flow only as required. The patient may be wet down, soaped, and then rinsed as in a conventional bath. To drain the tub, a hose may be fitted to the lower wall and connected to a floor or other drain, to a pail, or to the afformentioned cart. A wet vacuum may then be used to dry the tub. The walls may be lowered by allowing the air to drain out or by using a vaccuum source. The sheet 10 and collapsed bath tub 20 may then be rolled up on their respective rollers 6 and 24 as shown in FIG. 5. 
     FIGS. 2, 3 and 4 show another version of this invention wherein roller 24 is eliminated and the impervious sheet 21 is fastened at both ends to sheet 10 by closures 23. FIG. 2 shows the tub walls 22 when inflated, FIG. 3 the tub walls 22 when deflated, and FIG. 4 the tub assembly 20 when being rolled up for storage on near end roller 6. 
     FIG. 32a shows schematically a similar configuration of the tub for lateral transfer of a person from a wheelchair 49 to bed 50. The collapsed tub 20 attached to sheet 51 is partially unrolled from roller 52, ready to accept the patient. FIG. 32b shows the patient being transferred onto collapsed tub 20 as sheet 51 is being wound up on roller 53. FIG. 32c indicates the patient resting in tub 20 after it has been inflated and partially filled with water 32. 
     FIG. 6 depicts a separation of sheets 10 and 21 during storage with the tub assembly 20 going into a box 26 or other passive storage device. 
     In the embodiments shown in FIG. 1, 5 and 6, the tub assembly 20 may be unfastened by opening closure 23 and then the sheet 10 may be used as desired. In the embodiment in FIGS. 2, 3 and 4, the tub assembly 20 may remain attached to sheet 10. Its location must be taken into account when using the sheet as a transport device in transferring a patient onto the bed 2. 
     FIG. 7 is a plan view and FIG. 8 an elevation view showing the drives of the various storage rolls for the sheets 10 and 21 (which is part of tub 20) used in the embodiment of FIG. 1. Idler roller 8, foot roller 6 and auxiliary roller 24 are supported in brackets 27a and 27b mounted to bed frame 11. Foot roller 6 is driven by motor 28 driving through gear box/clutch 29. Roller 24 is driven by motor 30 driving gear box/clutch 31. 
     When the tub assembly 20 is being deployed to the left in FIGS. 7 and 8, a motor 56 through gear box/clutch 57, drives roller 7 in FIG. 1 and pulls sheet 10 to the left. The closure 23 (shown in FIG. 5) between sheets 10 and 21 pulls the tub assembly 20 to the left. During this process, the gear box/clutch 29 is disengaged and sheet 10 unrolls freely from roller 6. The gear box/clutch 31 also is disengaged to allow the tub assembly 20 to unroll from roller 24. 
     When the tub assembly 20 is being removed or moved to the right, the gear box/clutch on roller 7 is disengaged and motor 28 driving gear box/clutch 29 rolls up sheet 10 on roller 6 and motor 30 drives gear box/clutch 31 to roll up sheet 21 with folded bathtub walls 22 on roller 24. 
     FIG. 7d is a schematic diagram of the control system whereby an operator can control the relative speed to prevent excessive slack from developing in either sheet 10 or sheet 21 as the sheets are taken up on rollers 6 and 24. Such variable speed motor control systems are well known to those skilled in the art and are widely used. Control box 50, which controls the motion of sheet 10, includes a spring-return, momemtary contact forward-reverse switch 51 and a variable speed control 52. Electrical cables connect to motor 56 and clutch 57 and to motor 28 and clutch 29. The motor speed control and switching circuitry is packaged in control box 50. Control box 55 is similar to control box 50, except that it connects to motor 30 and clutch 31. Momentary contact switch 54 has no reverse position. Control 55 provides variable speed control for motor 30. Alternatively, control 55 can be designed to provide variable torque control, or control 55 can be omitted and the operator can use switch 54 intermittently for torque conrol on motor 30 to take up slack in sheet 21 as required. A further alternative is to measure the tension in sheet 21 by a sensing device and used to control motor 30 automatically to take up the slack. 
     In another procedure, not illustrated, sheet 21 is unfastened from sheet 10 and is rolled up independently from sheet 10, by motor 30, or by means of a hand crank 39 in place of motor 30 as shown in FIG. 7a. Thereafter, sheet 10 is moved between rollers 6 and 7 as desired. 
     FIG. 7b and 7c show a further embodiment which replaces motor 30 and gear box 31 with a belt drive arrangement whereby pulley 40 on roller 6, as shown (or alternatively, on roller 8), drives pulley 42 by means of belt 41. Pulley 42 in turn drives one-way drag clutch 43, which applies a drag torque to cause roller 43 to wind up sheet 21 when sheet 10 is being wound up on roller 6. The speed ratio of the drive is chosen to prevent slack from developing on sheet 21. When sheet 10 is being unwound from roller 6, pulley 42 is rotating in the opposite direction with respect to roller 24, and in this direction the one-way clutch 43 turns freely without applying torque to roller 24 which is free to unroll sheet 21 as required. Alternatively, clutch 43 may be an electrically engageable clutch instead of a one-way clutch. In this case, clutch 43 will be engaged electrically when the tub 20 is to be rolled up on roller 24. 
     If closure 23a is implemented with VELCRO, it can be designed to automatically peel off and disconnect as sheets 21 and 10 are wound up on their respective rollers 24 and 6. With most other fasteners, the sheet motion must be stopped to open closure 23 manually. 
     FIGS. 9 through 13 show schematically a possible sequence of operations to use the equipment arrangement shown on FIG. 1. In FIG. 9, the person 1 is shown supine on bed 2 with wheelchair 3 fixed in position end-to-end at the foot of the bed 2 and both are at the same elevation. If roll 6 rotates clockwise, sheet 10 will wind up on roll 6 and move across the surface of the mattress 12 to the right, carrying the supine person 1 with it. If belt 13 on wheelchair 3 is also actuated to move in the same direction and velocity as sheet 10, then the person 1 will be transferred smoothly from bed 2 to wheelchair 3 as in FIGS. 2 and 3. When the person is on the wheelchair 3, or other suitably equipped transfer device, the tub assembly 20 is fastened to sheet 10 by the closure 23. If roll 7 is now rotated counter-clockwise as in FIG. 12, then sheet 10 will move to the left, unrolling from roll 6, pulling the tub assembly 20 and unrolling it from roll 24. At the proper time, sheet 13 on wheelchair 3 is moved to the left to transport the supine person 1 to the left and place the person into the proper bathing area in the tub assembly 20 as it is being pulled onto bed 2. The result is shown in FIG. 13 with the person 1 located on the bed 2 in the tub assembly 20. If the tub rolls 22 are erected as in FIG. 14, the person may now be bathed. After use, the tub assembly 20 must be drained, the walls 22 lowered, and the operations reversed from FIG. 14 through 9 with all directions reversed, closure 23 being disengaged and rollers 6 and 24 rolling up their respective sheets 10 and 21 in FIG. 12. 
     This sequence is also relevant to the apparatus shown in FIG. 6 except that in this case, the tub is initially drawn out of storage box 26 and returned to it after use, instead of being stored on roller 24. 
     If the apparatus is arranged as in FIGS. 2, 3 and 4 with the tub assembly 20 fastened on both ends to, or part of, sheet 10, there are two possible sequences. If the tub assembly is stored on roller 7, at the head end of the bed 2, then after the patient has been transferred to wheelchair 3, the sheet 10 must continue to move to the right until the tub assembly 20 is wrapped around roller 6 with its leading edge at closure 23 ready to receive a supine person. The sequence can then continue as in FIGS. 12, and 13 except that the tub assembly 20 will be drawn off roller 6 alonq with sheet 10 and roller 24 will not exist. After bathing, when the tub 20 is returning to storage on roller 7, the patient must be held on wheelchair 3, as in FIG. 11, while the tub 20 rewinds to the left toward its proper place on roller 7. In the other sequence, where the tub 20 is stored on roller 6 at the foot of bed 2, then the patient 1, after being transported to wheelchair 3, must be held there while the sheet 21 is moved to the left until the tub 20 is in a position to be transferred onto bed 2 so as to receive the supine person. The sequence will then continue as above, except that for storage, the sheet 10 will move to the right to restore the tub 20 on roll 6, and at least one bed sheet length will also be stored around the tub assembly before the patient is returned to the bed 2 onto sheet 10. 
     The same equipment shown in FIG. 1 may be rearranged to that shown in the sequence of FIGS. 15 through 20. In this case, the auxiliary roller 24 with the tub assembly 20 is positioned at the head end of bed 2 near roll 7 and, as shown in FIG. 15, the closure 23 between sheets 10 and 21 must first be secured. Then, as in FIG. 16, the person 1 is transferred to the wheelchair 3 or other suitably equipped surface. In FIG. 17, as the person is held on wheelchair 3, the sheet 10 and tub assembly 20, including sheet 21, are rolled about roller 6. FIGS. 18, 19 and 20 are the same as FIGS. 12, 13 and 14 except that the tub assembly is drawn off roller 6 instead of roller 24, and the speed of auxiliary roller 24 is controlled, as described earlier, so that the velocity of the sheet 21 and bathtub 20 matches that of sheet 10. To return the patient from the bathtub 20 to bed 2, the sequence from FIGS. 20 through 15 is reversed, except that in FIG. 17, the tub assembly is unrolled from roller 6, and, in FIGS. 16 and 17, the velocity of the tub assembly must match that of sheet 10. 
     For a configuration in which the tub assembly 20 is loose, as in FIG. 6, and is located at the head of the bed 2, then a second closure similar to closure 23 will be required at each end, so that each end of bathtub sheet 21 can be fastened to sheet 10. Some manual handling may be required to return the tub assembly 20 to storage 26. 
     In another embodiment of the present invention, the surface of wheelchair 3a, shown in FIG. 21, is used as the bathing area. This may require additional support structure on wheelchair 3a for strength and stability. The tub 20a, for the wheelchair 3a, may have to be smaller than tub 20 for bed 2 because of the limited space on wheelchair 3a. As seen in FIG. 21, roller 24a is fastened to the lower part of wheelchair 3a. Impervious sheet 21a of tub assembly 20a is fastened by closure 23a to endless belt 13a. Roller 6 is driven clockwise to transport the supine person to the right and beyond the edge of the bed 2. The top surface of sheet 13a will, at the proper moment, also be driven to the right, unwinding tub assembly 20a from roll 24a. The patient will then arrive at the edge of the bed 2 at the right moment to be transported on top of the tub assembly 20a and be transferred to the position shown in FIG. 22. If the walls 22a of the tub assembly 20a are raised, as in FIG. 23, the patient may be bathed. After bathing, the bath water 32 must be drained, the tub walls 22a must be lowered and the top surface of sheet 13a driven to the left to return the patient to bed 2. The surface velocities of wheelchair sheet 13a and bed sheet 10 must be approximately matched by use of a manually controlled variable speed drive or by automatic control means on one of the roller drives. 
     In another configuration, the tub assembly 20a may be loose on the floor or in a box at the head end of wheelchair 3a. One end of the tub sheet 21 is fastened by closure 23a to wheelchair belt 13a. The operation is as described above, except that the bath tub is drawn up from the floor rather than unwound from roller 24a. In another implementation, the tub assembly 20a would be attached to the part of sheet 13a under the wheelchair or other suitable apparatus and would automatically be transported to the top of the wheelchair 3a by sheet 13a. 
     There are many devices that are available to reduce or periodically vary the pressure against a supine patient&#39;s body to prevent decubitus ulcers (bedsores) from forming. Some such devices employ air pressure to alternately raise and lower the pressure in two sets of interleaved inflated tubes on a special air mattress. 
     FIG. 24 shows a partial perspective view of the sheet 10 between rollers 6 and 7 as before and supported by corner guidance members 17 supporting the bed sheet hem 16. Attached to this sheet 10 by closures 36a and 36b in the form of VELCRO, zippers for example, is a bedsore prevention pad 35. This consists of manifold 33a with its air passage connected to one set of tubes 34a and manifold 33b connected to the other set of tubes 34b. Each manifold 33a and 33b is supplied by tubes and fittings with a supply of compressed air, and each can be supplied independently or vented. The controls, fittings, etc. are well known in the art and are therefore not described further herein. FIG. 25 is a section through pad 35 of FIG. 34, showing all of the tubes inflated. Similarly, FIG. 26 shows tubes 34a deflated and FIG. 27 shows tubes 34b deflated. This alternating inflation and deflation will shift the support on the supine person by lowering the pressure on various parts of the body at different times and help prevent decubitus ulcers from forming. FIG. 28 shows an optional cover sheet 45 on which a person may lie and which can be placed over pad 35 and removably attached to it by fasteners 45 in the form of VELCRO, zippers, or snaps, for example. 
     FIGS. 29 and 30 show two of the ways this pad 35 may be stored and deployed, as required. In FIG. 29, the pad 35 is fastened to sheet 10 on both ends and when not in use, is rolled with sheet 10 about roller 6. In FIG. 30, pad 35 is fastened to sheet 10 at one end only by closure 36b, and stored on auxiliary roller 37. 
     As seen from comparing FIGS. 4 and 29 and FIGS. 5 and 30, the bedsore protection pad 35 can be stored and deployed in the same manner as the bathtub 20. 
     Any other bedsore prevention device or other device such as a pad, or a stretcher cloth with the rigid members of the stretcher removed, or other sheet of material, that may be folded, rolled or otherwise fed onto a bed or other surface by a moving sheet, may be utilized in the same manner. 
     For example, sheet 21, as shown in FIGS. 4 and 5, may be used, without walls 22, as an impermeable sheet removably attached to the movable sheet 10 on a bed. It may also be a multi-layer sheet, or a bed sheet, or a pad, or a stretcher cloth, for example. Similarly, pad 35 in FIGS. 29 and 30, removably attached to sheet 10, may be a heating pad 35a or other accessory instead of a bedsore protection pad. 
     The bathing tubs and the other devices may be stored on the same or different rollers affixed to the bed 2. They may be on auxiliary rollers or stored separately and used as needed by a patient. They can also be stored on the same roller attached to different portions of a bathtub 20 or on sheet 21 and deployed as needed. 
     A further object of this invention is to provide an arrangement for easily changing a soiled bed sheet. FIG. 31 shows a perspective view of an arrangement for removably attaching a sheet of material 46 to movable sheet 10 on a bed. Attachment means, such as VELCRO, may be arranged as lateral strips 47, longitudinal strips 48 or may be located in other suitably placed locations. Alternatively, other type fasteners such as snaps, zippers, hooks and eyes or buttons can be used. 
     Sheets 10 and 46 can be of any flexible material or combinations of material. A particularly useful combination is for sheet 10 to be strong, for transfer use, and impermeable, and for sheet 46 to be a soft and comfortable bed sheet for a person to lie on. Such a sheet can be readily changed after transferring the patient to a reclined wheelchair. 
     Additional pads or other similar accessories can be added on top of or below the sheet 46, using attachments such as 47 or 48 on sheet 10 or attachments on sheet 46, similar to attachments 45 on pad 35 in FIG. 28. 
     FIG. 32a shows schematically a similar configuration of the tub for lateral transfer of a person from a wheelchair 49 to bed 50. The collapsed tub 20 attached to sheet 51 is partially unrolled from roller 52 ready to accept the person 1. FIG. 32b shows the person 1 being transferred onto collapsed tub 20 as sheet 51 is being wound up on roller 53. FIG. 32c indicates the patient resting in tub 20 after it has been inflated and partially filled with water.