Diagnosed with chronic heart failure
Person
Shirley1, an 87-year-old lady weighing 8st 7lb stones with diagnosis of chronic heart failure, but no other specific medical conditions. She has some short-term memory deficits, but no dementia diagnosis.
She is generally quite lethargic and intermittently short of breath on exertion.
She is hoisted due to lethargy and pain on weight baring at right knee and left hip. Shirley has had hip and knee replacements several years ago. She has had pressure damage before without open sores, but currently skin is healthy and intact.
Shirley has 2 daughters, 5 grandchildren and has always been the matriarch of the family.
[1] Name used for illustration purposes
Environment
Shirley lives in nursing home due to symptoms/treatment of heart failure and care needs.
Occupation
Shirley can complete elements of her personal care independently. For example, if positioned correctly she can wash her upper body at the sink or in the shower/bath and can feed herself. She engages in social activities such as arts and crafts, current affairs and reminiscence/history groups that run regularly within the home. This independence and engagement rely on good positioning and posture within a seated position.
Family visit regularly and are keen to be able to move Shirley around the home and its immediate grounds themselves.
Outcome – Clinical Reasoning
Harlem porter chair with leg support block
This Harlem allows the family to move Shirley around the home and exterior flat surfaces with ease whilst ensuring that she can be safe and comfortable without compromising health.
The contoured leg support block increases the positional and postural flexibility meaning that flexion/extension at hip and knees can be altered and supported according to task, environment and specific levels of pain or discomfort at any given time.
Back Cushion - Waterfall back
The waterfall back cushion provides excellent comfort for Shirley in her current condition. However, another consideration when selecting the Harlem was that it has the option to easily change the back cushion for another design to meet different postural and pressure management requirements as Shirley’s condition deteriorates. This makes it a cost-effective long-term solution to meeting Shirley’s needs.
Seat Cushion - Liquiform
As Shirley is sitting for long periods with specific comfort issues, she is at a high risk of developing pressure areas. This cushion uses the latest medical grade silicone gel technology allowing pressure to be evenly distributed. The gel conforms to the shape of the body and equalises to body temperature by allowing air to flow easily which will also maximise Shirley’s comfort.
Fabric
The Harlem was supplied with a Dartex VP multi-way stretch fabric to aid pressure management and to help with heat dispersion as Shirley may sit in the chair for fairly long periods.
