Tips to Prevent & Treat Bed Sores And Pain in a Home Recliner & Lift Chair
For people with limited mobility, sleeping or spending their day in a hospital bed is not always possible. Comfort and care is often found at home in a home recliner or lift chair. This is quite common when suffering from conditions such as ALS, Parkinsons, Congestive Heart Failure (CHF), TSCI, debilitaitng injury and more. For others, sleeping in a recliner is a more practical choice due to advanced age or obesity. Whatever the condition, limited mobility or the inability to reposition oneself, increases the possibility and incidence of bed sores and potentially devastating bedsores. Below are several tips on how to prevent and help heal bed sores and pain in a home recliner or lift chair.
- Proper Positioning
- Prevent Skin Shear & Friction
- Redistribute Pressure
Proper positioning to prevent pressure sores
It is dificult for those who are less mobile to achieve and maintain a proper seating position in a home recliner or lift chair. Even with the assistance, the patient may not be positioned properly. Due to the seat depth patients may not be able to get their pelvis far enough back and sitt directly on the tailbone or sacrum “sacral sitting”. Rather than sitting upright, this improper seating position can cause additional pressure on the tailbone. This causes pain and can lead to skin breakdown.
Sitting upright with the weight balanced is very important. Improper balance can cause IT pain, that is pain in the Ischial Tuberosity or Sit Down Bones. Without the ability to reposition, prolonged pressure can lead to pain and skin breakdown. Since the skin is thin over the boney prominences of the coccyx, sacrum, IT, it does not take long for pain or a pressure sore to develop.
- One way to prevent sacral sitting is to place the hips against the back of the recliner or wheelchair back.
NOTE: This may be a more difficult in a recliner due to the patient's height and the seat depth. Ideally with the patient's back against the back of the chair, there should be a gap between the inside of the knee and the recliner seat. A proper back cushion may help reduce the seat depth and improve patient positioning.
When seated, weight is placed on the IT Ischial Tuberosity aka Sit Down Bones. If seated improperly, pressure is not evenly distributed and therefore can be the source of pain. It is essential that the patient is in a neutral seating position and not leaning.
For proper positioning, it is always best to seek the assistance of a seating specialist.
Prevent Skin Shear & Friction
When repositioning, shifting back in a recliner or transferring one must move across the surface of the wheelchair / recliner seat or mattress. This is made far more difficult without the ability to lift one's weight off the support surface during repositioning and can create injury to the skin. Skin shear occurs when the skin and underlying bones move in opposite directions. This happens because of the forces needed to move the body against a surface that grabs the skin (friction). These opposing forces can tear the skin.
TIPS TO PREVENT SKIN SHEAR INJURY
- A non-shear, low-friction cover material such as Vyvex can help prevent skin shear and friction injuries. This highly specialized material feels like human skin, is anti-bacterial, anti-microbial, stain resistant and fluid proof.
- Prevent repositioning when bearing weight in a seated position
Pressure Redistribution to Prevent Bed Sores.
Prevent prolonged pressure between the body and the seating surface. Unfortunately, there are many who are unable to reposition themselves without assistance. Prolonged pressure especially where the bone is closest to the skin can impede vital blood flow to the skin. This can rapidly lead to tissue injury aka bed sores.
There are many factors that determine what type of cushioning is appropriate to help redistribute pressure including, if sores are currently present, location, the stage, mobility, patient weight and more. Below are several types of cushions that can be used in a recliner:
TIPS FOR PRESSURE REDISTRIBUTION
• Foam One Piece Seat & Back Cushion - (Memory foam is NOT recommended) - The most basic cushion, mild risk of skin breakdown, patient is able to reposition themselves.
• Fluidized Gel Recliner Overlay - For patients whose skin is clear, mild to moderate risk of skin breakdown and the patient is able to reposition themselves.
• Gel-Flex Bariatric Recliner Overlay - For patients over 250 lbs up to 1000 lbs. whose skin is clear, mild to moderate risk of skin breakdown and the patient is able to reposition themselves
• Gel/Form/Air Combination- Prevention and healing with alternating pressure in the seat only. For patients whose skin is affected with an early stage to late stage bed sore on their bottom with moderate to severe risk of skin breakdown and the patient is unable to reposition themselves. Recliner Air - Air/Gel/Foam. The back is a fluidized gel for pressure redistribution and the heal wedge is foam to help prevent heel ulcers
• Alternating Pressure Recliner Cushion- Full body head to heel prevention and healing. For patients whose skin is affected with an early stage to late stage bed sore with moderate to severe risk of skin breakdown and the patient is unable to reposition themselves. Alternating Pressure Recliner Overlay.
There are many factors that can lead to the development of a pressure ulcer. The tips above are some of the more common yet addressable issues that can help maintain healthy skin.
None of the above is meant as medical advise or to be used to diagnose or treat a pressure wound. Always seek the assistance of a medical professional or seating specialist.