Nov 082018
 

Charles Adams of the Shropshire panel needs help with the following please:

 

I am at a standstill with a case and wonder if the Remap community could help.

This lady is in her late 40s and suffers from Crohn’s disease and this has resulted in the surgical removal of large amounts of tissue from her buttocks.

She can stand and walk to a limited degree, but to avoid pain she must lie on her right side (pain prevents her from lying on her left side) and this is without variety, is uncomfortable and limits her social interaction.

Together with her OT, we have discussed some type of kneeling support/chair, but the available types require support from the buttocks and this would not be tolerable.

The lady has an ileostomy bag that would limit her ability to be supported on her front and also has a condition that prevents underarm support.

Any and all ideas are sought to help this lady.

All best,

Charles Adams

charadam@btconnect.com

  8 Responses to “Kneeling support/ chair”

  1. Elements of a sling could be incorporated like below however I don’t think this particular product would give much relief:

    https://www.fairfieldcare.co.uk/p987/Toileting-Sling-with-Padded-Roll—Medium/product_info.html

    Alternatively, If she finds it comfortable on the right side, maybe something she can lean on using the strong side combined with the garden kneeler. I’m imagining a slanted ergonomically padded product, making use of the knees, her good side and her elbow possibly. Almost like leaning on a sofa with more support in certain areas.

  2. Would something as simple as a garden kneelers that has handles at the sides (intended for tasks such as weeding) be effective even if just used for short periods? They are widely available and cheap.

  3. I assume the OT has considered special cushions: https://www.completecareshop.co.uk/articles/chairs-and-seating-for-the-elderly-and-disabled/guide-to-pressure-cushions
    and this one with alternating pressure, which I have not seen before: https://www.completecareshop.co.uk/chairs-and-seating/chair-booster-cushions/standard-alternating-pressure-cushion
    Perhaps these, with a tipped back sitting position which would increase the percentage of weight taken by the back, would help.
    This seems quite informative: https://seatingmatters.com/reducing-pressure-ulcers/

  4. Perhaps a total even load spread might be the answer using two part ‘foam’ as used for seats in formulae one racing cars – this might spread the load across the whole body and it one particular pressure point is the ‘pain spot’ this point of contact could be relieved so that it is not touching. the body. or perhaps PORON, http://www.poroncomfort.com/index.aspx might provide some comfort.

  5. Maybe something like these wearable chairs??

    https://newatlas.com/wearable-chairless-chair-2018/53521/

  6. The Tempur memory foam is very good. What about bed sore’s preventative stuff ?

  7. What about support from above? A hammock chair of some sort? It might be possible to remove material from regions where it is uncomfortable for her to bear weight.

  8. Trouble is, for any seated position, I can’t see how you could avoid some sort of support for the buttocks Charles. If you were to (for example) move the seat pad of a kneeling stool forward so it supports under the thighs, the full weight of your upper body is unsupported and you’d be in discomfort within minutes. Adding a back rest would make very little difference as your upper body weight is bearing straight down.

    Has something been tried that would distribute the pressure better across her thighs and back, such as a beanbag? I don’t mean one on the floor – I mean something like a sun-lounger seat, with a bean bag on that and the back reclined and leg rest up, such that the weight is distributed all down the back and most of the way down the legs.

    There are also seats that convert to support you in an upright position, but angled slightly backwards. I just don’t know how comfortable they are though and how long you could reasonably stand like that.

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