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How to choose a chair

Choosing a chair: When I visited nursing homes while working as an occupational therapist, I would often see elderly residents slumped over in their chairs with poor posture, propped up by pillows and leaning to one side. I would often think if that was my mother, would I be happy to see her sitting like that?

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Typically elderly people spend a lot of their day sitting as their mobility declines with age, so comfort is vital for them. You might notice that your elderly relative may begin to complain of aches and pains in their chair, or perhaps they begin to slouch in their chair or worse still, slide down or fall out of their chair. They may insist on getting back to bed during the day due to discomfort or pain. It is then that you may decide to look at the option of buying or renting a suitable chair to meet their needs.

There are a lot of options available and various types of chairs on the market and sometimes it is not clear which chair would be best suited for your elderly relative before purchasing. It is important to be informed and to make the right decision, as it can be costly to get it wrong. This article is aimed to help you differentiate between the choices available to decide which type of chair might be best suited to your loved one.

The importance of good seating

In sitting upright we require our muscles to work against gravity to hold a correct or mid-line posture, the benefits of which are numerous. As we get older our muscles tend to become weaker and fatigue more quickly which can lead to leaning to one side, leaning forward or slouching down in our chair.

Poor posture in seating can have many negative knock-on effects on a person’s health, for example, sometimes leading to the development of recurring chest infections, lung infections and urinary tract infections. A poor seated position can also lead to sliding and falling from the chair which causes fear, pain and discomfort for the patient. This sliding action can contribute to the development of pressure ulcers (bed sores) which can become infected and in extreme cases prove fatal. Poor seating and therefore poor posture can also negatively affect a person’s appetite and ability to breathe.

Once sat upright and supported these bodily functions improve dramatically. The correct chair and positioning can significantly help improve posture and therefore positively impact overall health and well-being.

Seek professional advice

We would recommend you seek the input of a clinician such as an occupational therapist or seating specialist to guide you and provide information on the long-term requirements of your patient or family member and how their needs may change over time, so you can factor this into your decision-making process. To make an investment such as this you will want peace of mind that it will work. We believe it is essential to choose chairs with clinical research to ensure the results can be replicated in your home or facility.

Top 10 chair features to consider for elderly patients

  1. Comfort: Comfort is important as if the chair is not comfortable for the patient, all other factors are of little value. The correct chair can serve to reduce time spent in bed and therefore improves the patient’s quality of life.
  2. All features should be adjustable: Multi-adjustability of a chair allows one chair to meet the long term and changing needs of the patient. This includes having an adjustable seat width so that the chair can always be adjusted to suit the size of the patient whether they gain or lose weight over a period of time to ensure they are always properly positioned in the chair.
  3. Wheels: Chairs on wheels enable much easier movement throughout a home or care facility and make it much easier for family members or carers to move the patient from their bedroom to a day room or living room and also outside to enjoy different stimuli and views. This promotes inclusion with family members or other care home residents and encourages social interaction. All Seating Matters chairs are on wheels as standard.
  4. Pressure management as standard: If your loved one is sitting for long periods of time throughout the day, or unable to shift their weight if they get too uncomfortable, they will need pressure management in their chair. Pressure management throughout the chair increases comfort and reduces the risk of developing pressure ulcers (bed sores). Pressure ulcers can be debilitating. It’s important not underestimate the complexity and complications which can arise with a pressure ulcer.
  5. Head support: For patients whose head control is poor or declining, they will need additional head support from a structured head pillow or other head support built into the chair to ensure comfort and support for the head, neck and spine. Poor head control can impact on breathing and feeding so it is vital to support the head if independent head control is difficult for the patient.
  6. Lateral supports: Lateral supports help the person in the chair to maintain a midline posture which is harder to do when weakening muscles and gravity try to pull our bodies forward in sitting especially when our bodies are fatigued. Lateral supports can increase comfort level for the individual as well as impacting positively on their breathing, swallowing, digestive system which are all affected by posture and positioning.
  7. Footrest: 19% of our body weight goes through our feet. If the patient has reduced mobility or is immobile, they will need to be able to load their feet either on a leg rest, footplate or the ground to ensure stability and to manage pressure redistribution throughout the body.
  8. Can be user with a hoist: Can be user with a hoist: If a client is currently using a hoist this is an essential requirement. If the client may need a hoist in future, then check if the chair is hoist accessible. Understand how their condition is likely to change over time, i.e. the patient might be relatively mobile now, but their level of mobility may decline within six months or one year – will the chair continue to meet their needs once they are completely off their feet?
  9. Tilt in space: Tilt in space is an important function which allows a carer or the patient in the chair to adjust their position throughout the day, facilitating a weight shift, to reduce the risk of pressure ulcers (bed sores). If the patient is off their feet and cannot shift their weight independently when they get uncomfortable, they will need tilt in space.
  10. Bacteria: For infection control purposes, the chair chosen should be easy to wipe clean and have no areas of entrapment for dirt and bacteria. When incontinence, reduced immune systems and open wounds are factors to consider, this becomes of even greater importance. Consider the frame, the fabric used and the various areas which dirt can accumulate, are all areas easy to reach?

Choosing a chair for the elderly

  1. Wheelchairs: Wheelchairs are mainly for outdoor mobility and travelling over distances. There are many different variations of wheelchairs available from self-propelled to electric to moulded seat options. Wheelchairs usually offer the ability to load the feet but should not be sat in for long periods of time throughout the day as they often lack integral pressure management and postural support required by patients with declining mobility and function.
  2. Riser recliner/lift chairs: Riser recliner chairs are chairs which have two core functions, a riser function to enable a safe sit to stand transfer and a recline function to promote comfort. Riser recliner chairs typically do not offer pressure management, postural support or tilt in space and should not be used for patients who are immobile and who cannot shift their weight independently.
  3. Therapeutic neuro care chairs: Neuro therapeutic chairs have been designed with the help of occupational therapists to meet patient needs. They can provide optimal postural support and pressure management from the head to toe. Depending on the medical condition of the patient they may require a chair with tilt in space according to pressure care needs. The surfaces on the Seating Matters therapeutic chairs are covered with washable, durable materials such as vinyl and dartex which can be cleaned with soap and water to promote infection control. The chairs can be adjusted to accommodate changing patient needs as a condition progress meaning the one chair can last for the lifetime of the patient, or they can be adjusted in seat width, seat height and seat depth to suit various sizes of users within a multiuser environment. All clinically essential features are provided as standard including a footplate on every chair as it’s vital to load the feet in seating.

This page is based on blog.seatingmatters.com‘s article.

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