Assessing and seating bariatric patients, particularly those with additional health conditions, presents unique challenges. It’s not as simple as just getting a wider chair.

Seating Matters offers specialised bariatric chairs designed by occupational therapists, including the Bariatric Sorrento and the new Bariatric Orlando. The Sorrento supports bariatric patients who require hoisting, while the Orlando, a bariatric riser recliner with a tilt in space feature, is ideal for those who can transfer independently.

These chairs are available to trial, hire or purchase, in both hospitals, care facilities, and home environments.

The first step is to Book a Free Seating Assessment & Bariatric Chair Trial for your client. 

Challenges & Considerations for Seating Bariatric Patients

Due to the challenges associated with seating bariatric patients, seating assessments may need to be conducted over a few days rather than a few hours. Two people will be required to  take accurate measurements.

To thoroughly evaluate posture and potential challenges, we recommend keeping your bariatric chair on trial after the initial assessment.

Specific seating challenges may include:

  • Fear/Embarrassment: Bariatric patients may worry about falling, sliding, moving from lying to sitting, or equipment not being strong enough. It is essential to build up a rapport and reassure the client before commencing an assessment.
  • Reduced Range of Motion: The mass of their body parts may limit a patient’s ability to stand and/or transfer into a bariatric chair.
  • Difficulty Repositioning: This can lead to pressure injuries.
  • Bulbous Gluteal Region: Excess buttock tissue may prevent proper contact with the seat back, forcing the client into a posterior pelvic tilt. This can cause back pain and sliding out of the chair.
  • Increased Risk of Pressure Injuries: Pressure ulcers and skin damage represent a preventable yet serious health threat to bariatric patients. These can result from an altered centre of gravity, greater skin weight, slower wound healing, and reduced vascularity and perfusion in adipose tissue.
  • Potential breathing difficulties: These are particularly prevalent when lying down, making clients more dependent on their chair.
Bariatric chair - the Orlando by Seating Matters
Facts About Obesity in Australia

32% of Australian adults (aged 18 and over) are living with obesity. 13% are living with severe obesity (BMI of 35 or more).1

Overweight (including obesity) is the second leading risk factor (after tobacco use) contributing to ill health and death in Australia.2

Seating Matters chairs have been clinically proven to reduce the incidence of falls and sliding by 100%.3

Clinical studies demonstrate a 75% decrease in pressure injuries after swapping to a Seating Matters chair.3

Bariatric Body Shapes

Bariatric weight distributions can be categorised into four main body types.

Anasarca (Severe Generalised Oedema): This involves oedema throughout the body, requiring a chair that can accommodate widespread swelling.

Bulbous Gluteal Region: Excessive buttock tissue creates a protruding shelf, which can contribute to back pain and sliding out of the chair as the patient is forced into a posterior pelvic tilt. An adjustable back rest is essential to address this issue.

Apple Shape: Excessive weight is distributed in the belly area, leading to an anterior pelvic tilt, anterior instability, and restricted hip flexion. A bariatric chair for this body type will require a back angle recline and tilt in space feature, along with an adjustable leg rest to accommodate knee flexion and protect against pressure ulcers.

Pear Shape: Most adipose tissue is located below the waist and above the knees, either medially (inside the leg) or laterally (outside of the leg). Excessive lateral tissue requires a larger seat width and larger footrests for proper support. Ensure there is enough space (the width of your hand) between the lateral aspects of the client’s thigh and the armrest to reduce the risk of pressure injuries.

Bariatric chairs by Seating Matters - the Bariatric Sorrento

Features Required in Bariatric Chairs

The below features will not just support pressure management, but drive independence and quality of life for the bariatric patient.

  • Removable arm rests: Facilitate easy access, transfers, and the application of slings for movement.
  • Adjustable backrest: Accommodates various body shapes, particularly the bulbous gluteal region.
  • Back angle recline: Essential for individuals with limited hip flexion, often due to increased abdominal tissue.
  • Forward tilt: Assists with stand transfers and helps maintain independence.
  • Negative angle leg rest setting: Accommodates legs and aids in stand transfers.
  • Powered adjustment: Eases movement and handling, as bariatric patients may have difficulty repositioning.
  • Vapour permeable/breathable material: Reduces microclimate and moisture on the skin’s surface, essential for bariatric patients who tend to sweat more.

Bariatric chairs by Seating Matters - the Bariatric Orlando

Seating Recommendations: Bariatric Chairs

Seating Matters offer two chairs that are specifically designed and tested for bariatric patients: the Bariatric Sorrento and the new Bariatric Orlando.

The Orlando is a bariatric riser recliner with a tilt in space feature to support individuals who can transfer independently, while the Sorrento is suitable for bariatric patients who require hoisting.

Both chairs have been specifically designed by occupational therapists to enhance the mobility of bariatric patients, help with transfers, and encourage early mobilisation.  

They have been designed to accommodate the gluteal shaft and unique body proportions of a bariatric patient. These benefits can drive independence, reducing the risk of pressure injuries, optimising pressure distribution, and ultimately improving a patient’s psychological wellbeing.

Bariatric Orlando

Recently launched, the Orlando is a bariatric riser recliner that has been enhanced with innovative features to optimise patient comfort. It offers comprehensive pressure care, adjustable posture supports, and a stand assist riser function.

The Bariatric Orlando is equipped with three motors, enabling independent leg elevation to enhance comfort, repositioning and pressure distribution. It features tilt in space to facilitate independent transfers, and an adjustable back angle recline. 

The Orlando design accommodates various body shapes, including a bulbous gluteal region, and minimises the risk of sliding. It has adjustable seat depth and backrest configuration, with optional lateral supports to help maintain posture. 

Bariatric Sorrento

The Bariatric Sorrento is a tilt in space bariatric chair on wheels, designed to support patients of up to 294kgs.

It is fully motorised and mobile, with adjustable features (seat depth, seat width and footplate height) to accommodate a user’s unique body shape. An adjustable backrest further helps to provide comfort for clients with a bulbous gluteal region.

Equipped with electric controls, the Bariatric Sorrento offers tilt, recline, and leg rest adjustments, minimising the need for patient handling. It can tilt forward to facilitate standing transfers and promote patient independence.

Bariatric Chairs: Case Studies & Further Information

Case Study: Finding a Bariatric Chair for Alan

In this case study, we meet 41-year-old Alan - a 294kg bariatric patient, who required significant assistance from caregivers, was unable to sit unaided, had frequent respiratory infections, and did not have a chair to accommodate his weight or needs.

We explore the functional and postural changes that resulted from Alan's trial of a Bariatric Sorrento chair, and hear directly from both Alan and his carers.

Read More

A Practical Guide to Seating Bariatric Patients

Seating a bariatric person is complex and can present many challenges. It's certainly not as simple as providing a wider chair! In this article, occupational therapist Martina Tierney explores some of the key mistakes made and risks taken in bariatric seating.

From not getting correct measurements to not accommodating the gluteal shelf, here are the things to look out for and avoid. Plus a potential solution for bariatric patients with limited mobility.

Read More

Case Study: A Bariatric Chair for Stroke Recovery

This is the story of Len, a bariatric gentleman of 181kg, who was admitted to hospital after suffering a stroke. Because of Len's condition, he was spending most of his time in bed and had trouble sitting upright.

The Bariatric Sorrento was a game changer for Len. It enabled him to sit upright for most of the day and adjust his positioning, leading to a dramatic improvement in his condition and state of mind.

Read More

References

1. Australian Institute of Health & Welfare (2022)
https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity/contents/overweight-and-obesity

2. Australian Institute of Health & Welfare (2018)
https://www.aihw.gov.au/reports/burden-of-disease/abds-2018-interactive-data-risk-factors/contents/overweight-including-obesity

 3. ‘The Effectiveness of Specialist Seating in a Hospital Enviroment’ (Seating Matters & Saint Camillus Hospital, 2018)

Download Your Copy Of 'The Clinician's Seating Handbook'

This practical guide by world-renowned OT, Martina Tierney will assist you in the prescription and use of therapeutic seating for patients with various conditions. It’s the best place to start.

Download your free copy now.