Chairs for the elderly--design considerations

Seating in aged care: Physical fit, independence and comfort

Objectives:

This research was intended to provide a greater understanding of the context and needs of aged care seating, specifically:

Methods:

Methods included a chair dimension audit, interviews with residents, experts and carers and observations of aged care residents getting into chairs, sitting in them and getting out.

Results:

Results showed that residents, experts and carers all prefer chairs which are above the recommended height for older people so that they will be able to get out of them more easily. Armrests were essential for ease of entry and egress. However, many residents struggled with chairs which were also too deep in the seat pan so that they could not easily touch the floor or sit comfortably and were forced to slump. Most residents used cushions and pillows to relieve discomfort where possible.

Conclusion:

The implications of these issues for chair design and selection are discussed. Variable height chairs, a range of chairs of different heights in each space and footrests could all address the height problem. Chair designers need to address the seat depth problem by reducing depth in most aged care specific chairs, even when they are higher. Armrests must be provided but could be made easier to grip. Addressing these issues would increase access to comfortable yet easy-to-use chairs for a wider range of the aged care population.

Evidence-Based Strategies for Preserving Mobility for Elderly and Aging Manual Wheelchair Users

Elderly and aging manual wheelchair (MWC) users have increased risk for accelerated loss of function and mobility that greatly limits independence and affects quality of life. This review paper addresses important issues for preserving function and mobility for elderly and aging individuals who use a MWC by presenting the current available evidence and recommendations. These include recommendations for maximizing function, by decreasing pain, improving the ability to self-propel, and prolonging mobility and endurance through ergonomics, individualized wheelchair selection and configuration, and adaptations for increasing the capacity to handle the daily mobility demands through training, strengthening, and exercise. Each recommendation is supported by current research in each relevant area.

Weight Limits for Foldaway Wheelchairs

Designers have neglected the issue of portability in wheelchair design.

Chair design affects how older adults rise from a chair

OBJECTIVE

To determine how modifications of key chair design aspects, such as seat height, posterior seat tilt, backrest recline, seat compressibility, and armrest placement, affect how older adults rise from a chair and the seating comfort they experience.

DESIGN

Cross-sectional comparison.

SETTING

Congregate housing facility and university laboratory.

SUBJECTS

Two groups of volunteers, Old (n = 29, mean age 84) and Young (n = 21, mean age 23).

MEASUREMENTS

Analysis of time to rise, body motion (determined by use of digitized videotaping), and self-reported difficulty when subjects rose from a variety of controlled chair settings thought to represent important chair design specifications encountered by older adults. Subjects also reported their comfort while being seated in these settings.

RESULTS

Lowered seat height, increased posterior seat tilt and backrest recline, and perhaps increased seat compressiblity cause increased time to rise, increased body motion, and increased self-reported ratings of rise difficulty in both Young and Old groups. Under the most challenging conditions, the effect appears to be stronger in the Old than in the Young: a few Old were unable to rise, and the Old took disproportionately longer to rise and used disproportionately greater neck motion (P generally < 0.001) compared with the Young. Arm rest placement did not alter rise performance or ratings significantly. The conditions in which rise difficulty increases or decreases do not correspond exactly to conditions in which comfort increases or decreases. Some aspects that increase rise difficulty, such as tilt/recline and seat compressiblity, may also increase comfort.

CONCLUSIONS

Aspects of chair design such as lowered seat height, increased posterior seat tilt, increased back recline, and increased compressibility interfere with chair egress in older adults. While decreasing ease of egress, however, these same factors may increase seating comfort. Furniture designers and manufacturers must find a balance between degree of sitting comfort, ease of egress and the degree to which the seating device facilitates functional independence, particularly to meet the needs of disable older adults.

Determination of gross weight limit for foldaway powered wheelchairs through isometric and psychophysical strength simulations

This study concerns the maximum weight of a powered wheelchair for transfer to and from the trunk of a car by individuals with limited exercise endurance. The loading and unloading of a folded wheelchair from the trunk of a medium size American car was simulated. Both static and dynamic simulations were carried out. The isometric (static) and psychophysical (dynamic) strengths of eight adult males while simulating the loading/unloading activities were measured. The results indicated that: (1) the maximum weight of a powered foldaway wheelchair that individuals can load in the car and unload from the car is much lower than the weight of most commercially available powered wheelchairs, and (2) static simulation of the folded wheelchair loading and unloading activity provides wheelchair weight ceiling that is easily exceeded during the dynamic simulation of the activity. The upper limit on the weight of a foldaway powered wheelchair is provided and implications of this limit on future foldaway powered wheelchair designs are briefly discussed. In addition, the user gender and age effects on the foldaway powered wheelchair weight ceiling are also discussed.

Wheelchair seat comfort for the institutionalized elderly

Studies have reported many wheelchair problems faced by the institutionalized elderly. Because knowledge is limited regarding seat comfort in general and for the nursing home population in particular, we elected to investigate seat comfort in order to gain insight needed to solve seat discomfort problems. This study's primary objective was to identify quantifiable indicators of seat comfort. Seat comfort was investigated in relation to peak sitting pressure, asymmetry of sitting pressure distribution, and seat cushion type. Fifty nursing home residents who were able to reliably rate the comfort of their wheelchairs were surveyed. The survey consisted of several questions regarding wheelchair seat comfort, wheelchair use, and functional and cognitive abilities. Measurements included peak sitting pressures and parameters of sitting posture. This study failed to identify robust indicators of seat comfort. It failed to confirm the hypothesis that higher peak sitting pressures correspond to greater discomfort. No relationship was found between the asymmetry of sitting pressure and reports of seat discomfort. Although we were unsuccessful in achieving statistically significant results, we did identify seat comfort indicators that are not only statistically significant but are also of practical clinical usefulness. Further research with additional subjects is required to identify cushions that are both comfortable and pressure relieving.

A survey of wheelchair seating problems of the institutionalized elderly

This study attempted to define and quantify the need for appropriate seating for elderly nursing home residents. A questionnaire was administered to 200 randomly selected nonambulatory elderly residents living in six Memphis area nursing homes. The study results supported previous findings that many nursing home residents have seating and mobility problems. Of the 139 wheelchair users analyzed, 112 (80%) experienced at least one problem related to discomfort, hindered mobility, or poor posture. Thirty-four percent of the residents had at least one problem considered to be severe. In most cases our respondents' seating and mobility problems could have been solved by the tailored application of presently available technologies.

Specifications for a mass producible static lounge chair for the elderly

An adjustable seating rig was used to create the three-dimensional shape of a static lounge chair. Elderly subjects from long-term care and rehabilitation hospital wards tested the chair. Questionnaires and video tapes were used to evaluate their comfort, posture, safety and ease of ingress/egress. The test shape was modified on the basis of results and retested to a total of four shapes. Contours and specifications of the final chair are presented.