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Case studies on CONFIGURA® specialist seating

 

Martin's story

Condition:

 

Difficulty:

 

Functional benefit:

    adjustable_lateral_support_system.jpg
  •  Lung cancer
 
  • Standing transfer
  • Pressure sore
  • Retaining appropriate postuire
 
  • Riser function
  • Integrated pressure relief
  • Postural support
 

Evidence:

80-year-old Martin is being treated for lung cancer. The palliative care team provide Martin and his family with support at home.  Martin is experiencing significant fatigue and weakness, he tires very quickly when sat out in his current armchair and he is unable to retain an appropriate upright seated position. This has also resulted in difficulty pushing himself to stand. Due to poor mobility and rapid weight loss, Martin is now being treated for a pressure sore on his sacrum.

Reasoning:

Due to reduced strength, Martin is unable to retain an upright seated position in his existing chair as it does not provide adequate postural support. Martin therefore tends to lean significantly to one side, which causes him great discomfort. A pressure cushion was provided to assist with the management of his pressures sores, however this raised the height and reduced his stability, causing Martin to slip off the chair on more than one occasion. His poor posture and weakness have caused him great difficulty with his standing transfers and he is now dependent on the assistance of his wife.

Conclusion:

Martin required specialist seating which could incorporate appropriate pressure relief and postural support.

  • The modular design of the Configura® Rise & Recline allowed the chair to be set up according to Martin’s seat depth, popliteal height and width.
  • An airflow cushion was integrated into the seat base to replace the existing cushion.
  • An adjustable lateral support backrest was fitted to replace the waterfall backrest.
  • Once Martin was sat in the chair, the lateral supports were adjusted to accommodate his needs, this along with the tilt-in-space function provides the additional support he requires to obtain and retain an appropriate, upright position.
  • The integrated, interchangeable pressure cushion enabled Martin to have the appropriate pressure management he required without compromising his sitting balance, and the riser function enabled him to manage his standing transfers independently once again.
  • Martin reported that the chair felt very comfortable.
 
                 configura_chair_duratek_fabric_with_tilt_riser_setting_889x1024.jpg

Sonia's story

         
Condition:   Difficulty:   Functional benefit:  
  • Spinal fracture
  • Osteoarthritis
 
  • Standing transfer
  • Discomfort
 
  • Riser function
  • integrated pressure relief
  • Postural support
 

Evidence:

Sonia is 91 years old and has been diagnosed with osteoarthritis, which unfortunately led to a fracture in T7 to T11 (the middle of the thoracic spinal column). This is now healing but does cause some pain and discomfort. The osteoarthritis also causes Sonia to experience pain and a restricted range of movement in most of her joints, which affects her mobility and general functional levels. In addition, Sonia has bilateral oedema in her lower limbs.

Reasoning:

Sonia currently sits out in a high-back armchair and struggles to push herself to stand due to pain in her wrists and spine. Sonia is therefore dependent on the assistance of two carers to stand, which impacts greatly on her independence. The firm backrest also causes Sonia some discomfort when sat out for a period of time.

Conclusion:

  • The modular design of the Configura® Rise & Recline allowed the chair to be set up according to Sonia’s seat depth, popliteal height and width.
  • Sonia was able to use the riser function of the chair to carry out safe and independent transfers, eliminating the need for assistance from the carers.
  • The soft waterfall backrest was adjusted to support Sonia as required, taking pressure off of the fractured part of the spine, providing increased comfort.

 

Heather's story

        bariatric_tilt_in_space_chair_in_recline.jpg
Condition:   Difficulty:   Functional benefit:  
  • Lymphedema
  • Stage 1 pressure sore on sacrum
  • Obesity
 
  • Standing transfer
  • Risk of further pressure damage
 
  • Riser function
  • integrated pressure cushion
 

Evidence:

45 year old Heather experienced difficulty with bed and chair transfers due to restricted range of movement and Lymphedema in her lower limbs. Heather weighed 33 stone which impacted on her transfers and mobility and had a stage 1 pressure area on her sacrum.

Reasoning:

Heather’s elderly mother or paid carers were required to assist with all chair transfers and with lifting her legs into bed, however this was becoming more difficult and unsafe.

Conclusion:

A Configura® Bariatric Tilt-in-Space chair was set up to accommodate Heather’s specific measurements and needs; a castellated seat and a Multi-adjustable Pillow Backrest provided appropriate support and pressure relief. Now using the Configura®, Heather is no longer dependent on her mother or carer as she is able to manage her transfers safely and independently. Using the leg raise function has resulted in reduced Lymphedema, enabling Heather to lift her legs into bed independently. Heather is now able to mobilise more frequently and is participating in more meaningful activities.
This increase in mobility and activity resulted in a weight loss of two stone in two and a half months as well as the healing of the pressure areas. This has produced a saving of approximately £3000 per year in care costs and significantly reduced the risk of injury to all involved.

 
 

Maria's story

          configura_chair_duratek_fabric_with_tilt_riser_setting_889x1024.jpg
Condition:   Difficulty:   Functional benefit:  
  • Polio
 
  • Standing transfer
  • Shoulder pain
 
  • Riser function
 

Evidence:

Maria was diagnosed with polio as a child, which has resulted in a curvature of the spine and paralysis of her right leg. She has also had to undergo surgery on her hip, knee and ankle due to complications resulting from the polio. Maria, who is 63 years old, has been dependent on crutches for all mobility for several years and this has caused pain and discomfort in her shoulder joints.

Reasoning:

Due to the paralysis in her right leg, Maria was dependent on her upper-body strength to manage all standing transfers. The strain on Maria’s shoulder joints began to cause her a great deal of pain and she was no longer able to push her weight through her arms. As a result, she became dependent on her daughter to assist her to stand. Unfortunately, this resulted in the daughter experiencing a shoulder injury, which is when Maria contacted her occupational therapist to review alternative options.

Conclusion:

  • The modular design of the Configura® Rise & Recline allowed the chair to be set up according to Maria’s seat depth, popliteal height and width. 
  • The riser function enabled Maria to stand independently, minimising the amount of pressure she needed to place on her arms or shoulders. 
  • During a follow-up, Maria informed her OT that this made a huge difference to her quality of life, stating that the chair has ‘transformed my life’. She advised that not only is she now independent with her transfers, she is experiencing a lot less shoulder pain, which has enabled her to sleep much better at night. 
  • Maria reported that the chair was very comfortable and she was very grateful for the provision.
 

Graham's story

        rr_vparmrestback_540.jpg
Condition:   Difficulty:   Functional benefit:  
  • Kyphosis
  • Poor skin interity
  • Osteoarthritis
 
  • Standing transfer
  • Risk of further pressure damange on the spine
 
  • Riser function
  • Adapted waterfall backrest
  • Oressure relieving fabric throughout contact areas
 

Evidence:

Graham is an 85 year old with severe arthritis, a significant kyphosis and poor skin integrity, he has very restricted range of movement and mobility. Graham’s privately purchased armchair was very wide and deep, there was no integrated pressure relief and so a pressure cushion was perched on top. 

Reasoning:

The combination of these factors caused him great difficulty with his transfers, very poor posture when seated and also resulted in a pressure sore on his sacrum and the apex of his spine where his kyphosis was most pronounced, both of which caused him great pain and discomfort. Graham required regular input by the district nurses.

Conclusion:

A Configura Rise and Recline was set up according to Graham’s seat depth, popliteal height and width, his pressure cushion was inserted into the seat of the chair, making it more secure. The chair had high pressure relieving fabric covering all surfaces his body came into contact with. Graham demonstrated safe and independent transfers using the riser function of the chair and used the tilt mechanism to obtain and maintain a safe, supported seated position. Graham commented on the difference in comfort and size of the chair.

"This is the most comfortable chair I have sat in, I cannot feel the sore on my back" – Graham 

 

Deidre's story

        configua_chair_duratek_fabric_in_tilt_position.jpg
 Condition:   Difficulty:   Functional benefit:  
  • Lymphedema in lower lymbs
 
  • Standing transfer
 
  • Riser function
  • Leg-raise function
 

Evidence:

Deidre is 80 years old and experiences great difficulty with her mobility and lifting her legs into bed, due to very oedematous lower limbs. Deidre had a riser recliner with leg-rest elevation to reduce the Oedema and a riser function to assist with transfers. However, Deidre found this very uncomfortable, as the chair was very large and did not offer any postural support. As a result, Deidre did not use this often.

Reasoning:

Unfortunately, the Oedema in her lower limbs worsened, and Deidre had increased difficulty with lifting her legs into bed and began to avoid attempting this, due to the effort and difficulty involved. Deidre therefore spent more time in her chair, which increased the Oedema in her lower limbs. Deidre’s difficulty with her transfers increased, and her mobility deteriorated. She required an appropriate intervention to reduce the risk of further deterioration in her functional levels.

Conclusion:

  • The modular design of the Configura® Rise & Recline allowed the chair to be set up according to Deidre’s seat depth, popliteal height and width, and the waterfall backrest was adjusted to provide appropriate support. This enabled Deidre to obtain a comfortable position.
  • Deidre was able to use the riser function of the chair to carry out safe and independent transfers. 
  • The elevated leg rest provided comfortable support for Deidre to raise her legs and therefore reduce the Oedema.
  • The reduced Oedema resulted in improved mobility, and Deidre was once again able to lift her legs into bed independently.

Son’s testimonial

"We are very pleased with it. The chair has helped a lot, as the Oedema is going down nicely, thanks to the chair. My mother can get in and out of the chair more easily, and it has given back her independence. Her posture is better, her legs are much better, and I really thank everyone involved."

 
 

Beth's story

        configura_care.jpg
Condition:   Difficulty:   Functional benefit:  
  • Ischaemic heart disease
  • Diabetes
  • Right sided weakness
 
  • Poor posture
  • Inability to access other rooms
 
  • Postural support
  • Portable function
 
 

Evidence:

69-year-old Beth has been diagnosed with ischemic heart disease and Diabetes. Beth also has right sided weakness as a result of a stroke.

 

Reasoning:

The weakness has impacted greatly on Beth’s sitting balance and her armchair no longer provided the support she required. As a result, she tended to lean to her right which caused great discomfort and placed her at risk of falls.
Due to inappropriate seating being available, Beth remained in bed for extended periods of time and became socially isolated as she was unable to safely access the communal facilities within the residential care home.

Conclusion:

The modular design of the Configura® Care chair allowed the chair to be set up according to Beth’s seat depth and width.
The lateral supports and true tilt in space function enabled Beth to obtain correct pelvic positioning which resulted in a well-supported, appropriate, upright posture.
The portable function enabled Beth to access the communal lounge safely whilst in the Configura Care chair, reducing the amount of transfers carried out each day and enabling safe access to communal activities and the dining area.

 CAS-CFC-002EN Rev 1
 

Harry's story

 
            configura_care.jpg
Condition:   Difficulty:   Functional benefit:  
 
  • Duchenne, Becker and Limb girdle muscular dystrophy 
  • Curvature of the spine
  • Type II Diabetes
  • Undiagnosed blackouts causing him to slip out of chair, resulting in high risk of choking
 
  • Back pain
  • Poor posture impacting on breathing 
  • Frequent transfers
 
  • True tilt in space 
  • Leg-raise function 
  • Portability
 
 

Evidence:

Harry is a 60-year-old gentleman who has been diagnosed with three types of muscular dystrophy. The significant muscle wastage has limited his functional levels greatly and has affected his ability to breathe independently. Harry is dependent on a ventilator 24 hours a day and is fully dependent on others to meet all of his daily needs. 

      

Reasoning:

Harry’s riser recliner, did not offer adequate support, his posture was compromised and he was at risk of slipping out of the chair due to blackouts. Harry had difficulty obtaining and retaining appropriate posture in his chair, this was of particular concern as Harry slept in the chair as he needs to obtain an upright position to enable safe use of the ventilator. Due to the curvature in the spine, Harry was often uncomfortable and experiencing back pain.

The chair was static and so it was necessary to frequently hoist Harry onto his scooter to enable access to all facilities including the garden and bathroom where further hoist transfers were carried out on to the closomat or into the bath. On each hoist transfer, pressure is placed on Harry’s chest, this was uncomfortable and also resulted in a need to suction Harry after each transfer which was concerning and distressing for all involved. As a result, Harry often declined activities that involved additional transfers such as accessing his garden which he took great pleasure from.

Harry required comfortable, supportive specialist seating that would enable him to retain appropriate, upright posture and increase his comfort. It was also necessary for this chair to be portable to reduce the amount of transfers required and increase socialisation and well-being around his home and garden.

A Configura Care chair was recommended and trialled.

Conclusion:

The most significant, unexpected outcome was that once in the chair, Harry’s Saturation levels increased by 3% which is a huge improvement. This demonstrated that his improved posture enabled Harry to breathe more easily and therefore decreased the dependence on his breathing apparatus. In addition, the following benefits were observed:

  • The modular design of the Configura® Care chair allowed the chair to be set up according to Harry’s seat depth and width.

    • The true tilt in space function and the waterfall backrest enabled Harry to obtain correct pelvic positioning which resulted in a more appropriate, upright posture and reduced the risk of slipping out considerably. This negated the need for a harness or lap straps which reduced the risk of choking should they have interfered with the ventilator.
    • The portable function enabled Harry to access his garden and bathroom whilst in his Configura Care chair, significantly reducing the amount of transfers carried out each day.
    • This reduced the need for frequent suctioning, which was a huge benefit to Harry and his carers due to the difficulties and discomfort associated.
  • The improved posture and comfortable padding throughout provided a much higher level of comfort for Harry, particularly around the curvature of his spine.

Wife’s testimonial

"This chair is 100% better, it has cut down on the amount of transfers which reduces the impact on his lungs, the chair has made a remarkable difference to my husband”.

OTs comment:

“Reducing transfers was key to reducing risks which can be potentially life-threatening due to tracheostomy & breathing difficulties. Physical exertion and stress greatly compromises patient’s quality of life as the transfers were greatly affecting his breathing, causing high levels of fluid and phlegm build-up which required removal taking approx. 20-30mins each time transferred via suction pipe.”

N.B Oxygen saturation is a term referring to the fraction of oxygen-saturated haemoglobin relative to total haemoglobin (unsaturated + saturated) in the blood. The human body requires and regulates a very precise and specific balance of oxygen in the blood. Normal blood oxygen levels in humans are considered 95-100 percent. Oxygen treatment may be prescribed for people with low oxygen levels in their blood. Low oxygen levels can damage the heart or brain          

 CAS-CFC-003EN Rev 1

Heather's story

            bariatric_tilt_in_space_chair_in_recline.jpg
Condition:   Difficulty:   Functional benefit:  
  • Lymphodema
  • Stage 1 pressure sore on sacrum
  • Obesity
 
  • Standing transfers
  • Risk of further pressure injury
 
  • Riser function
  • Integrated pressure care
  • Leg-raise function
 

Evidence:

45 year old Heather experienced difficulty with bed and chair transfers due to restricted range of movement and Lymphedema in her lower limbs. Heather weighed 33 stone which impacted on her transfers and mobility and had a stage 1 pressure area on her sacrum.

Reasoning:

Heather’s elderly mother or paid carers were required to assist with all chair transfers and with lifting her legs into bed due to the difficulties Heather experienced as a result of her very heavy, edematous legs. This was becoming more and more difficult and unsafe due to the increase in the Oedema.

A Configura Bariatric chair was recommended and trialled.

Conclusion:

A Configura® Bariatric Tilt-in-Space chair was set up to accommodate Heather’s specific measurements and needs; a castellated seat and a Multi-adjustable Pillow Backrest provided appropriate support and pressure relief. Now using the Configura®, Heather is no longer dependent on her mother or carer as she is able to manage her transfers safely and independently. Using the leg raise function has resulted in reduced Lymphedema, enabling Heather to lift her legs into bed independently. Heather is now able to mobilise more frequently and is participating in more meaningful activities.

This increase in mobility and activity resulted in a weight loss of two stone in two and a half months as well as the healing of the pressure areas. This has produced a saving of approximately £3000 per year in care costs and significantly reduced the risk of injury to all involved.

Testimonial ~ “My OT recently sourced me a new chair and I feel this has changed my life, it helps me with getting up to walk and also I can put my legs up to rest them. This helps me to get into my bed on my own at night which I couldn’t do before. The chair has given me my life and independence back” – Heather

 CAS-CFB-001EN Rev 1
             

Sarah's story

           
Condition:   Difficulty:   Functional benefit:    
  • Dementia
  • Depression
 
  • Discomfort
  • Poor posture
  • Risk of further pressure injury
 
  • Waterfall backrest
  • Tilt-in-space function
  • Integrated pressure care
  • Portability
   
Evidence:            

A specialist seating assessment was requested as Sarah demonstrates challenging behaviours in her current chair. She tends to be very active, calls out in distress and slides her hips forward. The movement of her hips has resulted in her slipping out of the chair on a few occasions.

Sarah has been diagnosed with Dementia, however, she is still aware of risk, so it is felt that these behaviours are possibly a way of her communicating her discomfort.

On observation, when sat in her current chair, Sarah appeared to be dependent on the armrests for support. Sarah’s posture was poor, and she looked uncomfortable.

Reasoning:

The recommended chair was adjusted to accommodate Sarah’s dimensions. This enhances her comfort and posture, and will also contribute to appropriate pressure care management in the long term.

The integrated pressure cushion has high pressure relief, managing Sarah’s pressure needs whilst reducing the risk of slipping off when a cushion is placed on top of the seat. The tilt in space function provides additional support to enable Sarah to retain a more appropriate, well supported position. 

Conclusion:

Sarah immediately relaxed into the chair and did not display any distress which she reportedly often does when hoisted into her own chair. On observation, Sarah looked well supported and comfortable and was no longer dependent on the armrests to support her posture as the chair accommodated her postural needs.

Having had the chair in situ for a 24-hour period, the manager of the care home reported that Sarah was able to retain her position in the chair, that she no longer tried to slide out of the chair and that she was able to tolerate sitting out for longer periods of time.

The portable function enables the carers to transport Sarah between her bedroom and lounge easily which will reduce the amount of transfers required.

Testimonial ~ "The chair for this lady is brilliant. She is more settled and is tolerating sitting in her chair for most of the day which is a big achievement"       

CAS-CFC-001EN Rev 1