Seating Patients with Complex Needs

 Complex Conditions 

In a daily case load, each patient we encounter is different, with individual needs which change and evolve throughout the duration of their medical condition.  When seating patients with complex conditions such as Huntington’s Disease, Motor Neuron/ALS or Parkinson’s Disease, these needs are often more challenging and severe.

Patients with complex conditions suffer from various uncontrollable symptoms meaning they can be more challenging to seat; these symptoms include but are not limited to:

  • Low mobility
  • Postural instability
  • Involuntary movements
  • Loss of voluntary movement
  • Low/high muscle tone
  • Rigidity
  • Muscle degeneration
  • Weakness
  • Fatigue
  • Confusion / Altered mental state
  • Agitation

WATCH: Martina Tierney OT outlines some of the key things to consider when seating patients with complex needs

Example case studies of patients who might prove challenging to seat

Parkinsons Disease - Those suffering from Parkinsons disease can suffer from arm and leg tremors, rigidity of the muscles, as well as pain in the back, neck shoulders and chest, which need to be considered in seating and selecting the correct chair.

Multiple Sclerosis / MS – Patients suffering from MS endure extreme fatigue, pain, loss of muscular strength as well as spasticity of the muscles which can lead to uncontrolled movements.  These need to be factored into selection of the right seating solution.

ALS/Motor Neuron Disease – Patients with ALS/Motor Neuron Disease often present spasticity of the muscles which can lead to uncontrolled muscle movements, weakness and muscle degeneration which can eventually lead to paralysis of the limbs.  Their rapidly changing needs need to be accommodated in one solution and can be catered for in a multi adjustable chair.

Huntington’s Disease - It has been said that having Huntington’s Disease Feels Like having ALS, Parkinson’s and Alzheimer’s Disease, all at the same time.  One of the most significant side effects of Huntington’s Disease is involuntary movements of the trunk and arms and feet which can result in falls and in the patient coming to extra harm.  Comfort and safety are key considerations in selecting an appropriate chair for Huntington's Disease patients.

 Dementia / Alzheimher's Disease - In our recent randomized control trial with Ulster University, patients with Dementia and Alzheimers proved to be one of the most difficult patient groups to seat.  This client group present a number of complex needs including agitation in the chair, constant moving in the chair which might leave them at risk of falls and sliding from the chair causing injury.

In our experience these conditions are some of the most challenging patient conditions to seat as they have a variety of symptoms from their neurological condition which need to be accommodated in one seating solution.  Quite often these patients are cared for at home by family members or full time carers so it is important that their seating solution is affordable, reliable, functional, easily adjustable and adaptable to their needs as their condition changes.

Tips for Families and Caregivers –

  • Make sure the patient is comfortable - This goes without saying, if the patient is not comfortable in the chair, the other functions are rendered virtually worthless.
  • Know your requirements – Opt for multi - adjustable seating –Know which features are required to accommodate the needs of the patient, and ensure they come as standard on your chair.  All of our chairs as standard have back angle recline and a footplate.  Do they need postural support?  Accessories such as lateral supports can aid postural deformities and can be added at a later date.  You can check out our range of chairs here which are multi adjustable to suit changing needs.
  • Consider the level of pressure care - Ensure that the chair provides adequate pressure management properties.  These patients are sitting for long periods of the day and can be subject to risk of pressure ulcers which can be debilitating.  Our chairs are made with memory foam in the back, seat and calf pad as standard.  Furthermore our groundbreaking clinical research proves a reduction in pressure ulcers by 88% from using our chairs making us the only range on the market to be backed up by clinical evidence.  Tilt in space and back angle recline are important properties to aid in pressure management and loading the body.
    • Material - As a lot of these patient groups are at risk of involuntary movements or altered mental states, they can also move a lot in their chair/be at risk of sliding and falling, and therefore be exposed to further risk from shear and friction which can ultimately lead to pressure ulcers.  All the weight bearing areas on our chairs are covered with Dartex material which is multi stretch, breathable and durable to reduce moisture, increase circulation and reduce the effects of friction and shear.
  • Patient dignity -   Can the person sit at the table to dine or join others in the family room?  To encourage dignity and independence of patients these are very important factors to consider when choosing your seating.  The Seating Matters chairs are very mobile throughout a home or care facility, and can have powered adjustments for tilt in space and repositioning, allowing users to be more independent.

To check out our range of chairs please click here or request a seating assessment with the Seating Specialist in your area.

Spotlight on The Atlanta chair:

The Atlanta chair is robust and durable chair which provides a safe and comfortable seat for those with vigorous involuntary movements, reducing instability whilst also reducing the risk of falling from the chair.  This specialist seating has been very successful for Huntington’s Disease and Dementia patients in particular, and for patients at high risk of falling from their chair.

  • The seat angle adjustment and back angle adjustment on the Atlanta means the pelvis can be lowered low down into the chair reducing the effect of the involuntary movements typical with Huntington’s Disease.
  • The integrated fully padded leg rest is angle adjustable to maintain a secure and comfortable position in the chair and can be used with the seat or taken away if not required.  The high arms and low seat angle position helps to keep patients very safe and secure within the chair.
  • The arms are fully memory foam padded to reduce any risk of injury as a result of involuntary movements.
  • The high arms maintain lateral support and stability keeping the patient comfortable and minimising pressure risk.
  • The Atlanta has proven to be a very successful chair for Huntington’s patients, Dementia patients, Parkinson’s patients and those with lower limb odema.

Find out more about the Atlanta HERE and watch this great overview video below.

 

Seating Matter

 

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