July 29, 2019 at 7:22 pm #4430
A question about comfort chairs for dementia and fully dependent residents has arisen at an aged care facility. Can comfort chairs which are good for pressure relief be seen by auditors as a restraint ?.The tilt in space feature can improve comfort and prevent sliding out of the chair but is it restricting mobility ?. Would welcome any comments thanks
July 30, 2019 at 8:33 am #4431
Answering a side question within your post above. I worked for a residential facility as their Physio for a wee while and found the tilt in space was helpful to prevent sliding and that in turn useful for skin protection. In a audit of range of motion for our comfort chair users I found that many of the (dementia included) users were also having the leg rest raised too. Lazy boy type style. The staff were so used to raising the footrest with those comfort chairs that in one smooth move the resident was tipped back and legs up “secured” for whatever activity was taking place. The chairs own functions were in this case trapping the client.
The issue there was (and one feeds back on the other here) many residents had short hamstrings. When a person is asked to extend the knee with the hip in flexion (sitting with legs out in front) the hamstring requires length. Especially if a person is off their feet. If no length in the hamstring then the only choice is actually for both knees and hips to flex more and even wind sweep then the client slides down into the bottom of the chair where they get stuck. Range of motion continues to get worse as the days go on. There is no getting out of the bottom of a comfort chair if you have slid down and don’t have the range of motion to get out. So that is a form of restraint I think, because had the chair been fitted with hamstring relief rather than leg extension the chances of moving independently would be much improved and on going range of motion could be retained.
July 30, 2019 at 11:01 am #4432
Hi Ann, I recently purchased the restraint standards so I could answer this question intelligently! The standards say that it is the INTENTION that is vital and if the intention is NOT to restrain then no there should be no issue. IF the product does restrain the person (i.e they can’t move in a way they could otherwise – I believe that for someone who can’t walk then this isn’t an issue) – then the facility needs to have documentation around this. So they can still use the product but there documentation and clinical pathway will allow for the use to be documented and monitored in a clinically appropriate way. Does this make sense?!
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