Valerie, an 86 year old female with dementia and limited mobility, spent the majority of her day with her arms crossed to stabilize herself in her chair.
Valerie previously sat in a standard wooden frame chair, commonly used in many nursing homes, for approximately 8 hours per day. Some of the problems with her chair included the fact that it was too wide, the back lacked postural support and armrests were too high and far away from her body. The chair did not provide Valerie with the support that she needed and she tended to slump forward, which significantly limited her communication, interaction and visual field. Valerie didn’t communicate much throughout the day and encountered great difficulty when trying to complete minor tasks independently, such as eating and drinking, due to the position of her folded arms and hands.
Valerie’s caregivers assisted in her feeding, but were worried about the risk of choking due to the position of her head. They also reported that her motivation for feeding was quite poor and that during transfers Valerie would be quite stiff and her range of motion, especially in her upper limbs, was restricted. Valerie’s constant leaning to the side caused postural issues and an imbalance in her weight distribution, placing her at greater risk of pressure injuries. If not corrected, this posture could cause a scoliotic deformation of the spine and it would continue to impact breathing and digestion of food.
Being in an upright and midline position, Valerie was much less at risk of choking or aspirating and over time, as she felt more secure, she no longer crossed or ‘fixed’ her arms and was able to reach out to drink a cup of tea and eat independently.
As stated, Valerie no longer lent heavily to one side, leading to a reduction of pressure risk and improving her pelvic positioning. The tilt in space function improved Valerie’s comfort and posture, as well as distributing her weight evenly throughout both sides of her pelvis. By tilting the chair as shown in the image below, weight was redistributed from underneath Valerie’s sacrum and Ischial Tuberosities (ITs), spread throughout her back and other load bearing areas.