You often see pictures of people sitting in the care home environment very happily – in the day room or out in the garden. As long as people are able to manage their own posture and can sit out in comfort, all is well. However, many elderly people, particularly those with kyphosis sit in inappropriate chairs which do not support them. Their head slumps forward or to the side – chin to chest. Gravity can trap people in these destructive postures and can have some very damaging, sometime life-threatening results.
Imagine being stuck in bed for weeks …months …years. Four walls around you which never change, carers (who might be the kindest, loveliest people in the world) but who have to do everything for you each day, every day. When, in fact, with the right seating you could be up, and if not completely about, you could re-join your community in daily occupations.
When a person is seated correctly the chest can open up to facilitate breathing, the head is supported in a comfortable position, eye contact can be made, so communication is improved and it’s just easier to speak when you are not hunched over looking at the floor. Eating, drinking and digestion are facilitated, and, of course, there’s the simple pleasure of being able to sit comfortably in a supported position.
The pictures below highlight which chair/seating position is the most comfortable and beneficial to aid posture. The HydroTilt is slightly tilted and Grandma is sound asleep in a safe, supported positon.
In recent years there have been a number of research projects published. A trial of specialist seating in care homes in Ireland showed:
- A reduction in pressure ulcers
- A reduction in the number of falls
- Less use of restraints
- A reduction in time to treat injuries
- A reduction in the cost of treating injuries
In another trial by two senior clinicians at Salford University, participants commented on the CareFlex Seating:
‘I’d forgotten what it felt like to sit somewhere comfortable …for the past three years I’ve literally been in bed or in a wheelchair.’
‘It’s got to be down to the chair …it’s a strange feeling …because I’ve not experienced that in such a long time (8—9 years).’
“It was like my whole body had had a transformation really because the comfort is good.”
“I have sat in this chair …and done things that I woudn’t normally do …for longer periods of time that I would anywhere else.”
“I’m just very comfortable and I can sit and cloud watch and I can sit for quite a while watching clouds!”
An important point to remember, of course, is that chairs are not magic. A person must be properly assessed to select the right chair to meet their needs. The chair must be correctly set up for the individual. That is imperative – a chair set up for someone else could cause more harm than good! And then, of course, ongoing, carers need to understand how and why the chairs are effective so they can use them correctly and can monitor their patients throughout the day to check they have not manoeuvred themselves back into a destructive position, or they are just not comfortable. Seating is just one part of the 24 hour posture and pressure management system. You need to get the rest right too!
Prevention is better
CareFlex Clinical Specialist, Becca Dunstall, reports that 30% of patients in the community and around 20% of patients in nursing homes in the UK are at risk of pressure injury, resulting from improper seating.
“If we’re thinking about a grade one pressure injury, were there may be some redness but the skin is still intact, treatment costs about £1000. For a grade four, which can see full tissue loss, even down to the bone, it could cost up to £14,000 to treat that one injury.
So if we’re thinking about a 100-bed nursing home where up to 20 of those residents are at risk, we’re talking over a quarter of a million pounds just to treat 20 pressure injuries in one home!”
Roll that figure out nationally and the figure is staggering.
Specialist seating can play a very important part in alleviating the problem.