TASK to Select a Dining and Recliner Chair for an Elderly and Physically Challenged Person

The chair selection team can be either an interior designer, family member, caregiver, and the disabled person, collectively called ‘Team S’ for this blog. A medical therapist is the most suitable person to evaluate and advise on the seating needs of the person in question.
In the first place, Team S must understand the person’s physical limitations, abilities, body shape, size, and the activities to be completed while in the chair. Discuss problems, client skills, and goals to get this understanding. Some joints may have contractures and so have no or little flexibility. Sitting up straight with the correct balanced posture and comfort is the goal. Posture is either dynamic (moving) or static.

The shape, orientation, and flexibility of a person’s spine, hips, limbs, knees, shoulders, and neck make up the framework to sitting correctly.

The three main spinal challenges are: kyphosis, lordosis, and scoliosis. These challenges may be improved when sitting in a chair or may need to be accommodated with additional cushioning and supports.

From left to right a back view of a healthy spine with a green vertical line showing the straight centre line spine. Kyphosis spine, side view, has a large rounded back at shoulder height. A lordosis, side view, has rounded shoulders and an arched back below and protruding buttock. A scoliosis spine has curvatures away from the centre vertical line as in the healthy spine. — Diseases of the spine
https://stock.adobe.com/search?k=lordosis

The image is a table with two columns, firstly the basic goals for seating from Prosthetics and Orthotics International Journal. The second is a comment or explanation of the goal. Goal alleviates abnormal muscle tone. Comment muscle tone may alter with age or, for example, after a stroke and correct positioning will improve the tone. Goal prevent, delay, or accommodate deformity. Comment Position body parts in correct position. Goal increase comfort. Comment if the user is not comfortable in a chair, they will not use it. Many will sit in a chair for hours. A stable position adds comfort and reduces fatigue. Goal -manage pressure. Comment pressure or rubbing on the skin or bony body areas for long periods of time will result in bedsores. It is critical for the seated person to lift up, rise, and move in the chair to maintain blood circulation. Goal facilitates physiological function. Comment optimal internal body processes continue. For example, lungs to breath, digestive tract for food absorption and elimination. Incorrect posture hinders these functions and can cause other challenges. Goal promote caregiving or independent activities of daily living. Comment, sitting correctly allows people to complete tasks independently with the least amount of fatigue. It also assists caregivers with feeding the person. Goal enhance quality of life, improve self-image. Comment a chair can make the elderly and physically disabled person’s life easier, reduce frustration, and increase independence and personal motivation. — Prosthetics and Orthotics International, 1991,15, 217-224. E. Trefler and S.J. Taylor. Prescription and positioning: evaluating the physically disabled individual for wheelchair seating. Adjusted for blog- dining chair and television viewing chair.

Side view of a seated person on a chair with good posture. A straight back and feet on the floor.

How to sit in a chair with a stable posture

Position hips and buttock at the back of the chair. Weight to be evenly distributed for pelvic stability.
Place upper legs side by side, at 90º to hips.
Position knees side by side, at 90º to upper legs.
The feet must be positioned on the floor with a natural ankle angle. If required, a footstool or block can be used to rest the feet on.
Position back approximately 90º to hips. Use supports to achieve a comfortable relaxed position. For example, a lumbar support on the lower back.
The neck and head to be in a functional position. Use supports to achieve a comfortable, relaxed position.
Place the arms on the chair armrests or lap. This must not cause the shoulders to rise unnaturally.

A group of four images showing unbalanced postures, from left to right. It is a side view of a person seated with their buttock at the front of the chair and leaning back onto. the back rest. This way of seating does not provide pelvic stability. The next side view image shows a person with an arched back or anterior tilt unable to be comfortable in a flat backed chair. The third image is a front view of a person whose hips are not aligned and sit mostly on one side of their buttocks. Fourthly, a front view of a person who pushes their knees to one side in a swayed position. — Sitting posture challenges
https://www.careflex.co.uk/info-centre/blogs/part-nineteen-seating-prescription-chair-measurements/
https://vimeo.com/310303015

Guidelines
• The width of the chair to be suitable to the size of the person, with sufficient space to rest hands alongside upper legs or on armrest/s. In a chair without arms, allow for space for the person to use their hands to push on the chair seat to lift themselves up. The seat should not be too wide as the sitter may lean over to one side and be unbalanced.
• The measurement from the front to the back of the seat must accommodate the buttocks and upper limbs and the knees should extend two fingers beyond the front edge of the seat.
• The height of the back of the chair must facilitate the support required by the user: mid back, upper back, shoulder, ear, head height.
• Firm and comfortable upholstery and a cleanable chair finish is important.
• Keeping consistency in the seat height of chairs is beneficial for those who transfer from wheelchairs to other chairs independently or using transfer boards.
• Beware; chairs that tilt are not good for people with swallowing difficulties and concerns of their catheter not working.
• Each individual has unique needs and the use of supports can assist to ensure their comfort.

Examples of support cushions