Atlanta Case Study – Margaret’s Story

By Seating Matters, Case Study, Pressure Injuries, CVA, Stroke

This case study is a real patient scenario.

The images have been created from real photographs taken with permission. This is a real person in a real situation but illustrations have been used in order to protect their identity.

Images & Content © Seating Matters 2020

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.

 

This was a conflicting situation as Margaret was a very sociable person and enjoyed sitting up and spending time in different environments thorughout the home. However, due to the challenges associated with sitting, she often missed out on those activities which she enjoyed.

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

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.

BEFORE

Margaret sitting in a Atlanta™

AFTER

Images & Content © Seating Matters 2020

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.

 

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.

 

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.

 

Because of the breathable properties of the Dartex covering on this head support, Margaret was able to use the pillow without sweating and becoming hot, as she had done previously using towels and bed 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.

Margaret had not required medication for pain and discomfort whilst sitting in her new chair.

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.

 

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.

Images & Content © Seating Matters 2020

 

Margaret’s Story and other patient case studies are found in The Clinicians Seating Handbook.

This practical guide to seating is written by Martina Tierney, OT, and used in academia, in clinical practice and with caregivers around the world to guide their practices around specialist seating.

The handbook contains:

  • Providing practical tips on performing seating assessments.
  • Your go-to guide for supporting various spinal presentations.
  • An extended guide to seating bariatric and paediatric patients.
  • Information on the new staging guidelines for pressure injuries.
  • Expanded, detailed patient case studies.

 

If you would like to receive a free copy of The Clinicians Seating Handbook posted to your address, please fill in your details here:

 

 

*Note – the purpose of this blog is to give an overview of the product with some tips to consider on its use. This is not intended to be a substitute for professional or medical advice, diagnosis, prescription or treatment and does not constitute medical or other professional advice. For advice with your personal health or that of someone in your care, consult your doctor or appropriate medical professional.

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