Sorrento Case Study – Valerie’s Story

By Seating Matters, Case Study, Dementia, Limited Mobility

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

  • 86-year-old resident of care facility.
  • Dementia.
  • Limited mobility.
  • Previously unable to reach out and feed herself or take a drink independently.
  • Valerie would no longer carry out this task.
  • Spent much of her day with her arms crossed.

 

Problems with Old Chair

Valerie previously sat in a standard wooden frame chair that is used in many nursing homes and used this chair for approximately 8 hours per day. Some of the problems noted were;

  • The chair was too wide.
  • The back height was too high.
  • Armrests as they were too high and too far away from her body.
  • She tended to slump forward when she was sitting for long periods.
  • She would spend much of her day with her head slumped forward, which significantly limited her communication, social interaction and visual field.

Caregiver Issues

Valerie did not communicate much throughout the day
and due to the protective position of her hands and
arms, she had difficulty completing small tasks such as
drinking or eating. Valerie required assistance for these
tasks, but it proved very difficult due the position of
her head and her caregivers often felt worried that she
would choke and her motivation for feeding was quite
poor. The caregivers also noted that when assisting
Valerie to transfer from the chair she would be quite
stiff and her range of motion, particularly of her upper
limbs, was restricted.

BEFORE

Valerie sitting in a Sorrento™

AFTER

Valerie did not communicate much throughout the day and had difficulty
completing small tasks.

Images & Content © Seating Matters 2020

Postural Issues

  • Leaning to the right side was causing an imbalance in her weight distribution.
  • More weight was being taken through the right side of her pelvis, increasing the risk of a pressure injury in that area.
  • This could cause or attribute to a scoliotic deformation of the spine.
  • Valerie may have been experiencing difficulties breathing or digesting food.

Intervention

After assessing Valerie’s needs, it was deemed appropriate for her to trial a Seating Matters Sorrento™ chair.

Postural Changes

Immediately a difference to Valerie’s postural alignment was recorded. As a result of using tilt in space and changing the position of the centre of gravity, Valerie was able to:

  • Maintain an upright head position with little exertion or strain.
  • Use the armrests for support and positioning, which helped her to maintain a midline position of her trunk and head.
  • Evenly distribute her weight through both sides of her pelvis.

 

Caregiver, Family Feedback

  • Valerie had become more communicative.
  • She was more alert and responsive throughout the day, particularly when feeding.
  • She was at much less risk of choking or aspirating.

 

Functional Changes

Over time and as she felt more secure, Valerie began to use the armrests and as a result of feeling much more secure and stabilised in her correctly adjusted chair, she no longer crossed or ‘fixed’ her arms and was able to reach out to drink a cup of tea and eat independently.

Valerie is more stabilised and can now eat and drink independently.

Impact on Skin

  • The position of Valerie’s pelvis was improved and there was a more even weight distribution throughout.
  • She no longer leaned heavily to one side.
  • The risk of pain and developing a pressure injury was significantly reduced.


The tilt in space feature was used in this case, not only
to improve comfort and posture but also to distribute
pressure evenly throughout all contact areas. By tilting
the chair, as seen in the image below, weight was redistributed from underneath Valerie’s sacrum and
ischial tuberosities (ITs) and spread throughout her back and other load bearing areas.

Social Interaction

  • She was able to attend social events taking place in the nursing home such as bingo, arts and crafts and music classes as the chair could be wheeled from room to room.
  • Being able to hold her head upright and look around the room without difficulty or strain had made a difference to her motivation and she became more interactive with caregivers and other residents throughout the home.
  • It was also gratifying for those that looked after and cared for Valerie to be able to see her face when seated whereas before they would often only able to see the top of her head, she has regained her social and personal identity.

Images & Content © Seating Matters 2020

 

Rachel’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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