Sitting is when the body position is transferred to the supporting area mainly the ischial tuberosities of the pelvis and the surrounding tissue.
Our aim is to provide the client with the best possible seating to relieve pressure, provide comfort and promote independence.
There are a variety of chairs available to suit the numerous sitting positions and various customer sizes. It is essential therefore to gain an understanding of the clients needs to assist in prescribing the best possible piece of equipment. (The correct seating position is not always the most comfortable for the client. As this may discourage them from using the chair, we must on occasion compromise seating position with comfort.)
Features to take into account when assessing clients for chairs:
· Nature of illness
· Muscle tone
· Deformities e.g. curvature of spine
Kyphosis C shaped back
Pelvic obliquity Sideways C shape spine
Scoliosis Sideways S shaped spine
· Length of time spent sitting
· Skin integrity
· What the client wants to achieve with the chair e.g. eating, medication
· Environmental issues e.g. will the chair fit in the home
Risks of poor seating
· Increased dependency
· Pressure sores
· Reduced functions of internal organs
· Reduced mobility
· Increased pain and discomfort
· Muscular fatigue
4 main types of Rise and Recline chairs
1) Single motor – the footrest rises to ‘TV’ position then the backrest will recline.
Benefits – Easy controls, least expensive
Disadvantages – Restricted positions, needs to be away from wall.
2) Dual motor – independent control over the legrest and backrest.
Benefits – Total control over chair positions for maximum comfort
Disadvantages – More complicated controls, more expensive, space issue as backrest reclines further.
3) Tilt-in-space – the back ratio to the seat will always remain the same – usually at 110°. This maintains the knee to hip position and posture and pelvic position. This discourages the body from sliding forward.
Benefits – fixed back reduces tension on the body, clothes not ‘rucked’
Disadvantages – Restricted positions, need to be away from wall.
4) Wall hugger – wall proximity chair.
Benefits – Can use closer to wall ideal in smaller properties.
Disadvantages – restricted positions, need space in front of chair.
· Waterfall back – the cushions can be manipulated to provide client with best support. E.g. when curvature of the spine, head projecting forward. Check position of client’s head in recline position.
· Cushion back (T back) – client tends to sit naturally in the centre of back rest.
· Button back – traditional design, but sometimes buttons may cause discomfort.
Measuring for a chair
When possible seat the client in the closest fit chair and use this as a base for assessment.
Seat to floor
Check the client is in usual footwear for seating in the chair. Ensure clients feet flat on the ground and hips and knees are at right angles . (i.e. lap is flat) Measure from the back of the knee to the floor. If too high there are pressure implications and safety issues. If too low there are pressure issues in pelvis area and lack of support for legs when raised.
There should be a gap of approximately 1.5” (2 fingers) between the edge of the seat and back of the knees. Measure from the back of the hips along the thigh to the back of the knee. If too deep there is risk of pressure on spine and irritation behind the knee. If too shallow the thigh will not be adequately supported and therefore increase the risk of pressure sores.
Measure the width of the person and approx 3” each side (use clenched fist as a guide) N.B some clients like a more snug fit to feel safe and comfortable. Check the clients arms rest on armrests without overstretching. If too narrow this causes discomfort and skin integrity issues.
Need the back and head to be fully supported, If the back rest is too low this can cause discomfort and pressure on neck area.
Arms should be fully supported on the armrests. If too low this will cause downward pressure on the shoulders, if too high this will cause tension along the shoulders. NB not all clients will use the armrests.
When assessing the client for a chair ensure the client is sitting centrally and as far back as possible in the chair to benefit from the back support. The client should be relaxed and comfortable in the chair before the assessment can begin. By reclining the chair gravity will naturally draw the client into a good seating position. The majority of our clients are less mobile and sit for long periods of time, therefore we need to take their pressure needs into account.
Chairs normally have high density foam in the seat and legrest. This can be upgraded should the client need pressure care built into the chair. (See the individual manufacturer’s specifications)
a) Visco foam (memory)
c) Gel and Visco foam
d) Watercells and visco foam
e) Seat cutout (can insert high spec cushion e.g. air)
We do not advocate the use of a loose cushion on a rise and recline chair because of trip hazard issues when the chair rises/down.
Chairs can be manufactured in a variety of fabrics. Vinyl and Panvelle are waterproof. Vinyl and leather tend to creak and can also be slippy when the chair rises.
Do not allow children play with the chair or leave children/pets unsupervised near to the rise and recline chair. Advise visitors with children/pets of the danger of entrapment.
Clients may benefit from the chair if suffer:
Arthritis Muscular Dystrophy
Osteoarthritis Ambulant and Semi-ambulant
Rheumatism Cardiovascular conditions
Frailty Multiple Sclerosis
Many other mobility issues.
We always recommend a client assessment to determine the most suitable chair for our clients needs.
We have a wide range of rise and recline chairs available from off the shelf” to bespoke chairs. Should the rise and recline chair not be suitable, we have a range of higher specification chairs available.
All new chairs sold will carry a minimum 12 month warranty which is held with Snowdrop Care and Mobility. Details available on request.
Choice of materials
Pressure relieving foam/gel/water cells available
Battery back up (some chairs have this as standard)