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Cushions – what do you need to know By Repose Furniture & The OT Service

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You and your client have decided on a suitable style of chair, job done right? No. The type of cushion you specify for the chair is one of the most important decisions about the chair you will make. So, what do you need to know?

Why is the cushion important?

When in a seated position the majority of your client’s bodyweight is supported through their buttocks and thighs. If your client can change their position in the chair and is deemed to be at a low risk of pressure injury then this amount of pressure is unlikely to cause any issues. However, if this is not the case then you will be considering a pressure redistributing cushion as part of the seating solution.

Pressure risk

Pressure cushions are provided with the primary purpose of assisting to manage the risk of pressure injury that comes with prolonged sitting. It is critical that you fully understand your clients risk level when it comes to pressure. Take a holistic approach to this, looking at the main factors that increase risk of pressure injury such as age (being over 70 increases risk), reduced mobility, paralysis, obesity, incontinence, poor diet, any medical condition affecting blood supply (such as diabetes, peripheral artery disease, kidney failure or heart failure) or affecting movement (such as MS or Parkinson’s)[1]

Other considerations when choosing the cushion

Other important factors that you need to consider before finalising your cushion choice are:

 

  • Mobility: can your client move themselves in the chair to redistribute their body weight? How are they going to get out of the chair? Is this by themselves or with someone assisting? Will the cushion make moving around or getting out of the chair easier or more difficult?

 

  • Posture: are they able to maintain a good sitting posture themselves? If not, what postural support is going to be provided? Will the cushion complement this postural support plan and be an integral part of it?

 

  • Integral cushion: As part of your seating assessment you would have already taken specific measurements of your client to enable you to specify their seat dimensions. If you then place a cushion on top of the seat, sitting them higher up on the chair, it automatically becomes the wrong size for them. Not to mention the risk of the cushion moving whilst the person is sitting on it or whilst transferring in and out of the chair. To ensure none of this happens, always insist on an integral cushion as a part of your seating specification which avoids the sizing change whilst managing pressure needs.

Types of cushions?

Once you’ve reviewed these various factors for your client you can finalise the type of cushion they require for their individual needs. The option you choose will depend on your clients risk level and what you are aiming to achieve with the cushion but can include:

- pocket sprung and reflex foam combination

- reflex foam

- memory foam

- liquid gel with reflex foam combination

- manual or air alternating air cushions

It is important to consider the impact of weight on air cushions in particular in relation to pelvic stability and core or dynamic sitting balance.

Also make sure that whichever material you use for the cushion that it is then covered in a fabric that is multi-stretch, breathable, incontinence proof and can be cleaned appropriately.  Dartex fabrics have different properties so it is important to ask the right questions and ensure the product specialist is fully aware of the client’s skin integrity needs which enables them to recommend the appropriate fabric.

And finally, always remember that the cushion is one part of the seating system. The cushion should never be the only strategy in a pressure care plan, nor should the impact that a certain type of cushion has on posture, mobility and moving in and out of the chair be overlooked

 A must read for Healthcare Professionals is the Repose Posture Seating Guide downloadable from the website.

For more information on the full range of bespoke seating solutions available from Repose or to receive a copy of the posture guide  call 0844 7766001, email info@reposefurniture.co.uk or visit www.reposefurniture.co.uk



[1] NHS. Pressure Ulcers: Who’s most at risk of getting pressure ulcers. www.nhs.uk/conditions/pressure-sores/ f

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