Let’s get it clear: Seat to eat

Let’s get it clear: Seat to eat

We wear different footwear for different activities– football boots for playing football, ski boots for snowboarding, trainers for running, wise leather shoes for official indoor events, slippers in the bedroom, flippers for diving, and so on.

We have different postures to achieve different outcomes in life. Different activities need us to line up our feet, our legs, our hips, our upper body, and our head in different respective positions. In this article, we take a look at what might be considered an excellent posture for eating, and how our seating set-up can assist or impede us.

Along the very same line of thinking, for those people who, in particular, have physical obstacles developing from little size (including children), old age, diseases, or disorders, we should think about different seating plans for different activities. These different activities can range from unwinding to view the tv, through getting access to regular everyday activities, to dealing with a keyboard, to eating a meal, to access to toilet facilities, to transferring to bed for an excellent nights sleep.

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The need for adjustability

In many care homes, homeowners are given the table in their transfer manual wheelchairs. In this type of wheelchair, the foot assistances are typically positioned forward of the castors, pushing the feet forward, and the occupant back into a spinal kyphotic position, with the head away from the table. Not ideal!

In addition, the more the back curvature, the more the person needs to press their heads back into cervical extension to get their heads level to put their food into their mouths. For those who have been taught CPR, we are told to push the individuals head back to open the air passages.

The beginning point is getting food to the mouth. Ideally, we like to have our head over our plate or bowl so that any food that drops arrives back on the plate and not down our front. To attain this, our feet are best put vertically listed below our knees or further back.

If you put yourself into the ideal position for any among these activities, you may well discover that your head, shoulders, hands, hips, and feet end up in very various positions relative to each other for each activity. To help those people with impaired motion, it is necessary that the equipment with which they are provided permits, and ideally assists, their getting into the very best posture for that a person activity, and after that change it for the next activity.

This is the position that the head winds up at with the cervical extension when the head and neck position are compensating for the curvature of the spine. A folding transit wheelchair is not ideal for a senior person to utilize at the dining table. More on this later on.

Figure 2. The Breezi chair with height adjustable seat plate and foot supports

Seating for consuming.

For many of us, we have various chairs for our workplace, for dining, for watching tv, and so on, however it is typically not readily affordable/practical to provide a mobility-impaired person a various chair for each activity. Thus we ought to consider what can be done to make the equipment that is offered as adjustable as possible to accommodate the needs of the various activities that individual wants to perform. In this article, well be looking at what modifications may be required, and how they can be used, with specific attention to seating for eating

A variety of wheelchairs attend to tilting the seat back to help relaxation. From what we have actually detailed above, being able likewise to tilt the seat forward too could facilitate getting the head over the plate and by negating the posterior pelvis tilt connected with spine lordosis, could result in a straighter back (for this position, an anterior trunk support could be advantageous). Few wheelchairs provide this center.

For optimal swallowing and food digestion, we want the trunk to be as straight and upright as possible. This position also assists with breathing and other physiological functions incorporated within the trunk. To accomplish this, ideally, the specific requirements appropriately placed supports to facilitate this posture: a company back support to withstand the advancement of spine lordosis, a pelvic positioning belt positioned throughout the thighs to stop the pelvis slipping forward, lateral trunk supports to assist maintain a midline position, and, as required, an anterior trunk assistance.

Figure 1. Millie is able to move her grandfather towards and far from the dining room table with little effort.

Out of a wheelchair

To cope with this, here are seating systems derived from the initial Scandinavian Tripp Trapp chair, where the seat panel can be moved up and down between different slots in the chair legs. The Breezi was the first of these, where the foot print was extended for higher stability, various widths provided, and different devices made readily available to cover the requirements of children with moderate disabilities and behavioural difficulties (Fig. 2).

The next best alternative is to transfer the person to a properly shaped normal dining chair which will provide sufficient posterior and lateral support, while permitting the feet to move back and the head forward. A terrific service is the MillieMova– a simple gadget that can be connected to a standard dining space chair that, when you put your foot on a lever at the back it, momentarily engages a set of wheels that allows the chair to be pressed into the table (Fig. 1).

The positioning of any arm supports on the chair can end up being important if they prevent the chair from being moved far enough forward under the table (Fig. 3)– options include adjustable or detachable height arm supports, or shortened lengths so that they are more simply elbow than full lower arm supports.

Adjustability

For children, it is essential that their seating is at the appropriate height for the table they are sitting at. Often this can vary from sitting at the regular table with grownups, to sitting at lower height tables, particularly in schools, etc. The next obstacle is that as a kid grows the range needed for the seats position relative to the table top changes.

More intricate requirements

https://youtu.be/3ozdphoB4nk.

Too far back and this likewise impairs the swallow reflexes, which might be impaired currently, anyway. These feeding challenges are often entered the care of speech therapists. These experts have actually found Stealths i2i head assistance system to be an excellent solution for helping the private to get their head into the finest position for eating and swallowing. (There is an excellent film demonstrating this, which is available on YouTube.).

BS 8625:2019, Selection, positioning and fixation of flexible postural assistance devices in seating– Specification.

Related.

Referrals.

Click to read more from the Lets get it clear series from Dr Barend ter Haar.

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More items can be discovered at www.beshealthcare.net. If you have an interest in getting further information on the topic, please contact barend@beshealthcare.net.

Different activities require us to line up our feet, our legs, our hips, our torso, and our head in various respective positions. For numerous of us, we have various chairs for our workplace, for dining, for enjoying tv, and so on, however it is frequently not easily affordable/practical to supply a mobility-impaired individual a various chair for each activity. Therefore we need to consider what can be done to make the equipment that is offered as adjustable as possible to accommodate the needs of the different activities that individual wants to perform. To cope with this, here are seating systems derived from the initial Scandinavian Tripp Trapp chair, where the seat panel can be moved up and down between different slots in the chair legs. The Breezi was the first of these, where the foot print was extended for higher stability, various widths offered, and different devices made available to cover the requirements of children with behavioural challenges and moderate disabilities (Fig. 2).

Dr Barend ter Haar has been involved in seating and movement for over 30 years, including lecturing globally and developing international seating standards.

Where a person, due to physical obstacles developing from the likes of muscle weak point or bad motor control, is not able to feed themselves and require to be fed, it is vital to guarantee that the head is positioned into the optimal position– e.g. if pressed too far back this opens the trachea and threats food getting in respiratory tracts rather than the digestive system, and thence choking.