I do whatever it takes. For bed size quilts I use one of my floor hoops. At the senior center we have a long floor frame. It took me years to learn to do more than one stitch at a time. Now I can load up to 4 stitches depending on the fabric. I also use both hands when working on a frame. For small stuff like wallhangings etc. I use a PCP snap frame that you just hold in your hand. I was at my best when I used a size 12 needle. Since I developed an autoimmune disease 9 years ago my hands are not what they used to be. I now usally have to use at least a #9 needle.