The Clinician's Seating Handbook

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Margaret's Story copy

  • Atlanta

Margaret, an 81 year old female with a history of pneumonia, had recently suffered a stroke (CVA). She had a high risk of pressure injuries and had developed a red area on her left heel.

Background

  • 81-year-old lady.
  • Cerebrovascular accident (CVA) (left sided weakness).
  • History of pneumonia.
  • High risk of pressure injuries.
  • Developed a red area on her left heel for which she wore a pressure management boot.

Problems with old chair

  • Margaret used her original chair for approximately 6 hours per day.
  • She was choosing to stay in bed over sitting in her chair as she reported the chair to be unbearably uncomfortable.
  • She would request paracetamol at night due to her pain and discomfort.

Caregiver Issues

The caregivers found it very hard to position Margaret in the chair. Despite various attempts, they could not get her in a comfortable position and would often be aware of how much pain she felt within the chair. The caregivers would often feel frustrated that they could not alleviate her pain. They would use pillows and rolls for positioning and comfort and would regularly correct her posture as a result.

Postural Issues

  • Margaret was sitting in a right-sided pelvic obliquity and rotating to the right.
  • Her feet were not loaded on the footplate and her legs were in a non-elevated position, encouraging oedema in both lower legs.
  • Limited hip flexion on her affected left side which made her assume a near lying position in the chair and contributed to the deviations in her pelvis.

Intervention

After a thorough assessment it was deemed suitable that Margaret would trial the Seating Matters Atlanta™ chair. This chair was designed specifically for her needs with the provision of a leg rest to be used to reduce swelling on both lower limbs.

The Seating Matters Atlanta™ was designed to reduce swelling in the lower limbs.

Qualitative Client Feedback

Immediately Margaret expressed her satisfaction at how comfortable the chair was and that it made a huge difference to her life. She was excited to show the staff and other residents her new chair and delighted in telling them she was now comfortable.

Atlanta

  • Falls Prevention
  • Integrated Tilt & Recline
  • Leg Elevation

For patients at risk of falls, and those with vigorous, involuntary movements, the Atlanta has been clinically designed to provide a robust, durable and safe environment, reducing the risk of injury and falls.

Postural Changes

  • The leg rest was used to reduce and manage oedema in both lower legs.
  • Her ischial tuberosities and pelvis were secured in a more comfortable and sustainable position.
  • She was able to maintain a midline position of her trunk.
  • A concave head support was used when needed to support her head in a midline position, which eliminated the need for additional pillows.

Functional Changes

A tray table was also provided with Margaret’s chair. This encouraged bilateral hand function as she was able to use both hands or rest her left on the table, preventing preventing weakness in her left side.

Social Interaction

One of the most pivotal advantages of her new chair was that for the first time since her admission, Margaret was able to attend a religious service that was being held in the nursing home. This was owing to the fact that the Atlanta™ chair could be wheeled from room to room easily. Also, Margaret was now able to sit comfortably for extended periods. In previous years she could not tolerate sitting long enough to attend this service, which was undoubtedly very important to her.

Impact on Skin

  • Margaret was now maximising her body contact with the support surface and distributing her weight throughout the seat, back and leg rest, all of which were made with integral pressure management materials.
  • This significantly reduced any localised or concentrated pressure areas and reduced the risk of skin breakdown and pressure damage.
  • The level of pressure management included in the leg rest, combined with an elevated position, ensured that the risk of breakdown on her heels was minimised.

Next Steps

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