Person
Geoff1 is a 58 year old gentleman, who suffered a left total anterior circulatory infarct (TACI) resulting in right sided inattention and neglect.
Geoff leans to his right due to lack of midline trunk position awareness.
He is PEG (Percutaneous Endoscopic Gastrostomy) fed, but able to swallow small amounts of thickened fluid.
Geoff is hoisted for all transfers and unable to proactively alter his own position.
[1] Name used for illustration purposes
Environment
Geoff lives with his wife in a large bungalow. A level access shower has been installed and there is an on-going assessment process regarding appropriate shower seating and transportation for him.
Occupation
Geoff depends on a number of carers to meet his functional needs including washing, dressing, administration of PEG feed and toileting regimes.
Outcome – Clinical Reasoning
Boston Porter Chair
The tilt in space mechanism allows for Geoff’s pressure to be redistributed with ease by carers and his wife whilst reducing shear and friction. It supports moving and handling by being able to fix the angle of recline to that of Geoff in the sling therefore ensuring little to no repositioning.
Being able to independently adjust the back and leg-rest angles provides any number of postural changes which means that specific alterations can be made to support different activities, both to benefit Geoff and the care team.
The porter controls allow carers to use the chair as a form of mobility aid, minimising the number of transfers.
The Boston has the option to choose from a range of interchangeable back and seat pressure management cushions should Geoff’s conditions change.
Back Cushion - Large profile headrest with support lateral
This back cushion provides Geoff with a combination of a firm back and lumbar support whilst in addition providing firm lateral supports to maintain midline trunk alignment. This makes it ideal for Geoff whose dense stroke has left him unable to support his own sitting balance or coordinate head/neck movements.
Seat Cushion – Dynaform
Geoff is at very high risk of developing pressure sores. The Dynaform cushion is a dynamic alternating air cushion, which constantly changes the air levels within its air cells to recreate the effect of normal body movements, which provides constant pressure redistribution to prevent pressure build up. For Geoff this means that pressure will be constantly being moved despite his inability to alter his position himself.
Along with the mechanism features and a good skin care regime this offers Geoff the best opportunity to maintain his skin integrity.
Fabric
To support Geoff’s pressure management and skin integrity a Dartex VP multi-stretch health fabrics were selected to aid movement by reducing any shear and friction as well as providing protection against accidents that might occur.
