The OT’s Perspective: Stairlifts vs Through floor lifts

Four things to consider before recommending a Through Floor Lift

As an OT, one of the most important things I can do for the people under my care is to ensure they’re able to get around their home safely, especially when transferring from one floor to another.

And in many circumstances, a stairlift is the correct option to perform this function. But as you know, installing a stairlift is not always possible, which is why through floor lifts are popular in some circles.

But before you go ahead and make that recommendation to your customers, it’s worth thinking it through carefully – it’s something that must be seriously considered.

With that in mind, I’ve put together the four key things you must consider before deciding whether to recommend a through floor lift – I hope it helps!

#1 Is provision of a through floor lift reducing risk as far as is reasonably practicable?

There are numerous times when moving from a house to a flat or bungalow negates the need for an adaptation, thus reducing risk significantly. Likewise, building a ground floor bedroom and wet room extension removes the risk also, but is this reasonable in every situation? Of course not.

Should you provide for a person who has a progressive neurological condition, knowing that they may require care or support to use the lift safely?

Clinical factors to consider regarding stairlifts are sitting tolerance, stability, transferability, cognitive ability and risk of seizures on the stairlift, however, these considerations apply to through-floor-lifts as well.

Environmental factors to consider with stairlifts are space on the stairs at the top, bottom and going past. Additional factors include other family members, radiators, cupboards, hoarding, pets, small children; a through floor lift removes these concerns.

It is often a consideration that anyone who is wheelchair dependent should be considered for a through floor lift.

Obviously depending on environmental and resource availability, this must be the optimal solution for those whose home environments are on more than one floor level.

Stairlifts pose great problems for some wheelchair users and some thoughts are the dislike of the transfer, especially at the top. I have been asked for stairlifts in the past with ceiling track hoists to aid transfer to and fro, top and bottom, but that’s not an option I would provide in 99.9% of circumstances.

#2 Is installing a through floor lift reasonable and practicable?

The design and layout of the property and staircase can also influence the outcome, for example, split levels and steps into bedrooms. For relatively able-bodied persons, a stairlift would suffice if the stairs are wide enough.

Consideration must be made for other ambulant stair users and the level of use. The stairs are an area of least interest within the home - you don’t often sit in the hallway looking at the stairs.

For wheelchair users, a through lift becomes a greater necessity.

As a general rule of thumb, on smaller properties, a stairlift may be the only option; on a larger property, through lifts are a more sensible choice.

One key concern that must be considered when thinking about a through floor lift is the fact that each unit has a mirror in it as standard.

The use of mirrors in a care environment can cause anguish or agitation for many living with dementia, with many dementia sufferers unable to recognise the person in the reflection as themselves. Paying attention to small details such as this can make a huge positive impact on the well-being of a customer.

#3 Is installing a through floor lift necessary and appropriate?

It all comes down to a comprehensive assessment of the situation at the initial period, but consideration must also be given to how the client's needs may change.

Manufacturers are often called into properties where the stairlift is no longer practical due to balance or transferring problems.

The through floor lift can be a simple, long-term solution, where the user's condition may be likely to deteriorate and should be considered first to avoid extra costs.

Ben Hutchins of Pollock Lifts explained that the impact the through floor lift may have on other people living in the property and even neighbours also need to be considered. Ben further explained Pollock Lifts continually adds innovations to their lifts to adjust to the needs of the users.

If through floor lifts can be amended and adapted to become appropriate, is there a risk that we are dismissing this option too soon?

#4 What if we do not provide anything?

As an Occupational Therapist, I have battled with the issue of what would happen should I not provide a stairlift or come up with another safe option?

There is a fine balance between weighing up the manufacturer’s input, my clients, the retailer or supplier, the families, the fund holder and my clinical opinion.

It is also important to look long-term at a customer’s needs, the time taken for funds to be approved, and have the necessary skills & experience of the client’s medical condition(s) and the possible choices available to make the decision that feels right, even if that’s saying no!

I have visited clients who have fallen down the stairs, who are breathless on the stairs and on one occasion I remember calling an ambulance because my client could not catch her breath or recover from ascending the stairs despite having inhalers for her breathing difficulties.

If the provision of a through floor lift is not possible, a stairlift may be recommended as it reduces risk more so than non-provision. Alternatively, adding an extension to the property or relocating to a new property could be a safer alternative and should be considered too.

Occupational Therapy Adaptations Conference (OTAC) run seminars around stairlifts and through floor lifts and in December 2017 at Edinburgh OTAC, we will be having an ‘ask the expert’ session around this topic.


Stuart Barrow of Promoting Independence is a member of the British Association of Occupational Therapists panel and a recognised contributor in the field of home adaptations. His experience is sought by manufacturers and service providers looking for an expert opinion. He also runs the Occupational Therapy Adaptations Conference