In this post we’ll look at how to carry out a seating assessment on a new patient.
To carry out an effective seating assessment, it’s important to consider not just their comfort in the chair, but the ease with which they can move and carry out activities, and the resulting impact this may have on their psychological wellbeing.
Key elements you should be looking for a chair are:
- Support and comfort
- Alleviation of any pressure issues
- Safety
You may want to consider more functional factors as well. For example, how easy the chair is to set up, how easily adjustments can be made for pressure, and how easy it is to clean. If the patient is likely to be moved often, the ease with which this can be achieved is worth considering as well.
Testing Posture and Motion
The first thing to look at when carrying out a seating assessment is your patient’s comfort and range of motion in their current chair.
Move up the body, observing the flexion and extension of all key joints. Check to see whether the position of the chair impedes movement, for example, whether feet are too high off the floor, or seating position is too low. Could foot or arm rests be adjusted to allow more comfort in joints?
Look for any adduction (limbs moving towards the body) or abduction (limbs moving away from the body) in the hips and legs that may be a source of discomfort. Could seat width or support cushions be added to encourage a more natural seating position?
Check to see of the pelvis is tilted forwards or backwards in their current chair. Should you be looking to use the Tilt in Space feature or a footrest, or adding supporting cushions to the lumbar region to encourage a more natural seated position?
In the spine, look for evidence of kyphosis (forward curvature), lordosis (inward curvature) or scoliosis (curvature to one side). Check if the shoulders are level and supported. Is a different configuration of back support cushions needed to help maintain a comfortable position?
Observe the range of movement in the head and neck, to see if any help is needed with support. Check the neck from both sides and behind as well, to see if there is any flexion in the cervical spine area or any rotation in the neck. Would a head rest be beneficial?
Setting Seating Goals
Once you have thoroughly assessed a patient’s comfort and motion in their current chair, you can now identify their seating goals and priorities for a new chair. Consider comfort, reduction of pressure injuries and safety as you make your recommendation.
It’s important to remember you may not be able to solve all a patient’s issues with one chair. Your role is to identify the main priorities and find a chair that will solve these. Be aware also that your goals may be different to your patient’s.
A good template to follow is the following:
- Identify any problems with existing seat
- State what needs to be done to help the patient achieve greater comfort in their new chair
- List these goals in order of importance (Limit the list to between 3 and 5 main goals)
- Add anything else you hope to achieve from the new chair
Choose your chair
Now you have a good sense of your patient’s seating needs you are in a position to recommend your patient a new chair.
Next month we’ll look at how to use your seating assessment to help choose the right chair for your patient.
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