Therapists and nurses working in the long term care (LTC) environment often note poor posture and inadequate seating with their residents. This comes with the territory, unfortunately, as many LTC residents have disease processes and injuries that have weakened their muscles, decreased functional endurance and impacted the ability to maintain adequate balance during daily tasks. Regardless of whether positioning deficits are noted with a wheelchair, bed, recliner or other seating mechanism, it is up to daily caregivers and clinical staff to ensure safety, comfort and promote highest level of function.
OTs and PTs are uniquely qualified to address seating and positioning problems, but it takes a village, i.e. care plan team, to ensure follow-through and brain storm solutions with challenging resident situations. Often, therapists and caregivers find themselves limited by reimbursement and available funds, so creative clinical problem solving is a must! Recently, FP sent out a reference tool for common seating & positioning problems with possible interventions. This was provided to rehab managers to enhance decision making and problem solving. It is crucial to understanding that poor posture and positioning can be the cause of numerous problems for the resident including:
- Falls, increased use of restraint devices
- Swallowing deficits (dysphagia)
- Impaired respiration/breathing
- Reduced circulation
- Loss of skin integrity, skin tears, pressure ulcers
- Muscle atrophy and contractures
- Reduced endurance and fatigue
- Decreased social interaction and poor daily task performance
It is paramount in providing elite care that therapists and daily caregiving staff understand the importance of good seating and positioning to enhance quality of life and promote independent function.