Harry’s story: Enhancing mobility and comfort

Description of case:

Harry is a 60-year-old gentleman who has been diagnosed with three types of muscular dystrophy. The significant muscle wastage has considerably limited his functional levels and has affected his ability to breathe independently. Harry is reliant on a ventilator 24 hours a day and is fully dependent on others to meet all of his daily needs.

Main issues:

Harry’s existing riser recliner chair did not offer adequate support, so his posture was compromised and he was at risk of slipping out of the chair due to blackouts. Harry had difficulty achieving and retaining an appropriate posture in his chair; this was of particular concern as Harry slept in the chair to try and maintain an upright position to ensure safe use of his ventilator. Due to the curvature in the spine, Harry was often uncomfortable and experiencing back pain.

The chair was static and so it was necessary to frequently hoist Harry onto his scooter to enable access to all facilities, including the garden and bathroom where further hoist transfers were carried out on to the clos-o-mat or into the bath. With each hoist transfer, pressure was placed on Harry’s chest, which was uncomfortable and also resulted in a need to suction Harry after each transfer, which was concerning and distressing for all involved. As a result, Harry often declined activities that involved additional transfers, depriving him of his garden which he took great pleasure from.

Intervention:

Harry required comfortable, supportive specialist seating that would enable him to retain appropriate, upright posture and increase his comfort. It was also necessary for this chair to be portable to reduce the amount of transfers required and increase socialisation and wellbeing. A Configura Care chair was recommended and trialled.

Outcomes:

The most significant, unexpected outcome was that once in place, the supportive, specialist seating increased Harry’s saturation levels by 3%, which is a huge improvement. This demonstrated that his improved posture enabled Harry to breathe more easily and therefore decreased the dependence on his breathing apparatus. In addition, the following benefits were observed:

• The modular design of the Configura Care chair allowed the chair to be set up to accommodate Harry’s seat depth and width. 
• The true tilt-in-space function and the waterfall backrest enabled Harry to obtain correct pelvic positioning which resulted in a more appropriate, upright posture and reduced the risk of slipping. This negated the need for a harness or lap straps which reduced the risk of choking should they have interfered with the ventilator
• The portable function gave Harry to access his garden and bathroom whilst in his Configura Care chair, significantly reducing the amount of transfers carried out each day
• This reduced the need for frequent suctioning, which was a huge benefit to Harry and his carers due to the associated difficulties and discomfort
• The improved posture and comfortable padding throughout provided a much higher level of comfort for Harry, particularly around the curvature of his spine.
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Wife’s testimonial

“This chair is 100% better, it has cut down on the amount of transfers which reduces the impact on his lungs; the chair has made a remarkable difference to my husband”.

Occupational Therapist’s comment

“Reducing transfers was key to lowering the risks which can be potentially life-threatening due to tracheostomy and breathing difficulties. Physical exertion and stress were negatively impacting Harry’s quality of life, as the transfers were affecting his breathing, causing high levels of fluid and phlegm build-up which required removal via a suction pipe, taking approximately 20-30 minutes each time”.