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Seating Strategies to Prevent Falls

The Configura comfort chair ticks each of these boxes, which makes it an excellent choice for somebody at risk of falls.

This article is written in honour of my grandfather who had a fall last week, broke his hip, had an emergency hip replacement surgery and is now recovering in a rehab hospital. He was previously living in an independent unit, mobilising around his village daily, able to get himself around his flat to grab himself food to eat, loved going out for coffee with his family (a true Aussie) and had plans to redesign his garden. He is now unable to get out of bed without the assistance of 2 people. He was previously living in an independent unit, mobilising around his village daily, able to get himself around his flat to grab himself food to eat, loved going out for coffee with his family (a true Aussie) and had plans to redesign his garden. He is now unable to get out of bed without the assistance of 2 people.

This is an unfortunate reality of so many older Australian’s who within a split second, fall to the ground and critically change their lives. Unfortunately, falls are the leading cause of hospitalisation and resulted in over 120 000 hospital admissions in Australia for the over 65 population in 2016/17.

When it comes to falls prevention interventions the approach is multifactorial . Assistive technology is a game-changer in the field of falls-related intervention. Whether it is a mobility aid that allows a person to be independent with their walking or a pendant alarm which allows a person to call out for help in the event of a fall. The products available are endless and are changing the lives of people at risk of and with a history of falls.

An important question to ask and a key part of an Occupational Therapy assessment is – where & how did the fall occur. In the same study completed in 2017, it was found that falls from household objects (bed and chairs), accounted for 15% of the total number of falls that resulted in hospital admission. This is a large number of falls that are avoidable through the provision of the correct seating. The features of an ideal chair for someone at risk of or post-fall should include:

The dimensions of the chair correct for a person

Size

The dimensions of height and depth are incredibly important when it comes to seating and the main reason for this is to facilitate independent and safe transfers. If a person sits on a chair that is too high or too short, it poses a long list of hazards and potential risks of falls. By getting these 2 dimensions right we are reducing the risk of falls. The configura comfort chair is adaptable to height and depth to ensure the correct fit for a person. If someone who is particularly tall and requires more height onto the standard 18” this is an available feature using the height adjustment kit. So too a person who has broken their hip following a fall and requires furniture that accommodates hip precautions (hip higher than knees when sitting to avoid dislocation or further fracture), the configura chair can be modified to suit this need.

Transfers

This is commonly the original reason we might investigate the option of a recliner or lift chair for a person. Unfortunately, what often prompts us to implement this intervention is a person having had a fall trying to get out of their low-level furniture. The ability to use anterior tilt to position into a standing can make all the difference to a person’s quality of life in allowing them the ability to stand, with freedom and without the risk of falling off the chair in the process. Width is also an important factor of a safe transfer, especially for people who rely heavily on armrests to push up and stand from. The configura comfort armrests can be adjusted to minimise the width between the armrests and so too allows increased access to the armrests to assist in an independent transfer. And for our clients who require a level of assistance and need a transfer aid and carer to help stand, the configura comfort chair is compatible to safely allow the legs of the transfer aid beneath the chair due to its horseshoe-shaped subframe, so too reducing the risk of transfer related incidence.

The height a person can comfortably transfer from
Postural support for someone with reduced sitting balance

Posture

For many people sitting in a chair, often for long periods of time, a level of postural support is needed in order to stay upright and in neutral position at the pelvis and trunk. A person who has reduced sitting balance and requires postural support may be at risk of leaning heavily to one side or slipping forward. This often results in a person slipping out of a chair due to the lack of core stability and postural supports. The features of the configura chair like tilt in space positioning, adjustable backrest recline, a range of lateral supports and profiled headrest will keep a person in an ideal posture whilst also reducing their risk of falling out of the chair.

Pressure

Another factor that leads to slipping out of a chair, is the use of pressure cushions on top of an armchair or sofa. The pressure relief would have been prescribed as an essential item however by correcting one area of concern it often results in creating a further issue if the cushion slips forward, taking the client with it. Subsequently, the configura chair has been designed to incorporate pressure-relieving fabric and an integrated pressure cushion.

In built pressure relief
Element of Rise/Lift
Tilt in space and recline to avoid slipping out

Whilst these features would be ideal to implement before a person having a fall, they are also key in the treatment and rehabilitation of a person post-fall. The configura comfort chair not only provides a level of comfort and ensures pressure relief for less mobile people, but over time, when used correctly the chair can assist a person to return to a level of strength and mobility following their fall related injury.

I implore OTs to consider the importance of seating when it comes to falls prevention so we can reduce those 15% of falls occurring off household objects and maintain the quality of life of our clients for as long as possible.

~ To my grandad (you could do with one of these chairs) I wish you a very speedy recovery ~


References

Sweeney, R., Meade, R. & Wold, C. (2019). Injury Matters. Western Australian Falls Report 2019. Perth, Western Australia: Injury Matters.

Pointer, S. (2019). Trends in hospitalised injury due to falls in older people, 2007–08 to 2016–17. Injury research and statistics series no. 126. Cat. no. INJCAT 206. Canberra: AIHW.

Australian Commission on Safety and Quality in Healthcare. Best Practice Guidelines for Australia Residential Aged Care Facilities (2009). https://www.safetyandquality.gov.au

Clemson, L., Stark, S., Pighills, A,C., Torgerson, D,J., Sherrington, C. & Lamb, S,E .(2019). Environmental interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2019, Issue 2.