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Dementia and positioning: Getting it right can optimise function.

I recently saw a client with dementia in a nursing home. She was sitting in a chair which was too big for her, both width and depth. There was also no footplate and the arm rests were too high. I found out that the chair was specially designed for a gentleman and my client ‘inherited’ the chair. She had been sitting in it about 2 years. As a result, she was leaning to one side and her head was tilted to the same side. Her legs were not on a footplate, just dangling down.

As an occupational therapist I take a personal centred approach, looking at the person as a whole. I noticed that the chair did not allow her to engage in any meaningful activities. She was unable to maintain an upright position, her truck was not supported and therefore she would be unable to use her hands and fingers for activities such as feeding and engaging in music.

By completing a comprehensive seating assessment through measuring for a more suitable chair and adding in accessories such as lateral supports and a head rest allowed her to sit in a chair in a more upright position. Also completing a seating care plan was really important to ensure the nursing staff understood how the chair should be used correctly. Just after the chair was prescribed the client was found sitting with no footplate (see future blog to why this is important). A seating care plan can ensure that everyone understands how to correctly position the client to optimise function.

Within 2 weeks of sitting the prescribed chair, the client was able to move her upper limbs more freely and easily. Comments such as ‘she looks so comfy’ and ‘I haven’t seen her lift her arm independently in years’, really brought home how important positioning and seating is to maintaining and optimising function.

It could be argued that we can now focus on goals such as holding a spoon or a cup for feeding, or positioning her hand to enable her to tap a drum. This is something which has not been considered as there is a perception that someone with dementia does not have the abilities. However, if we support their position, truck and head control – who knows what activities someone can participate in no matter what the disability is.

If you feel you or a loved one may benefit from a person centred seating assessment, please do not hesitate to contact us on

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