Understanding the Root Causes of Sliding
An elderly person sliding down in a chair, sometimes called 'sacral sitting,' increases the risk of falls, pressure sores, and poor posture. This issue stems from various factors:
Mobility and Muscular Issues
Muscle weakness, particularly in the core, legs, and back, makes maintaining an upright posture challenging. Balance and coordination problems, due to conditions or medication side effects, also hinder the ability to adjust position. Tightness in hamstrings or hip joints can pull the pelvis forward, leading to slouching and sliding.
Improper Seating and Posture
Chairs that are too deep, high, or low don't offer adequate support. If feet don't reach the floor, a person might push off, causing them to slide. Slippery chair materials like leather or vinyl can also contribute to sliding.
Cognitive and Neurological Factors
Cognitive impairments, such as those from dementia, can reduce awareness of body positioning. Medications causing drowsiness or dizziness can also affect postural control.
The Importance of Proper Seating and Chair Fit
The right chair is key to preventing sliding. It should be appropriately sized for the individual.
Seat Depth and Height
The user's feet should be flat on the floor with knees bent at about 90 degrees. If not, use a footrest. The seat depth should support the thighs but allow the back to rest against the backrest without excessive pressure behind the knees.
Armrests and Lumbar Support
Armrests aid in standing and sitting and help stabilize posture. Lumbar support, like a small pillow, helps maintain the lower back's natural curve and prevents slouching.
Comparison of Seating Solutions
| Chair Type | Best For | Pros | Cons |
|---|---|---|---|
| Standard Armchair | Minimal sliding risk | Comfortable, can use cushions | Lack of advanced features |
| Rise-Assist Chair | Difficulty standing | Lifts and tilts forward for easy standing | Often larger, more expensive |
| Tilt-in-Space Chair | Moderate-severe sliding | Tilts entire seating area back, keeping hips lower than knees and preventing sliding | Can be bulky and very expensive |
| Custom Care Chair | Complex needs | Fully adjustable to fit exact body shape | High cost, requires professional assessment |
Adaptive Equipment and Modifications
When a new chair isn't feasible or additional support is needed, adaptive equipment can help.
Non-Slip Cushions and Surfaces
Specialized non-slip cushions or mats can increase friction on the seat. Avoid ring- or donut-shaped cushions due to the risk of pressure sores.
Postural Belts and Harnesses (Used with Caution)
Used under professional guidance, postural belts can offer support without being restrictive, aiding posture and stability. Restraints should generally be avoided.
Footrests and Elevation
Footrests or adjustable footplates are helpful if feet don't reach the floor, promoting correct seating posture.
Tilt-in-Space Technology
This feature, found in some chairs, tilts the entire seating area, helping to keep the user's hips correctly angled and significantly reducing sliding.
The Role of Physical and Occupational Therapy
Therapists can assess needs and provide strategies to prevent sliding.
Posture-Strengthening Exercises
Simple seated exercises like marching, shoulder blade squeezes, pelvic tilts, chair push-ups, and ankle pumps can strengthen muscles needed for good posture.
Benefits of Professional Assessment
Therapists offer individualized plans, recommend home modifications and adaptive equipment, and provide guidance on preventing pressure sores, which can result from poor seating.
Environmental Adjustments for Enhanced Safety
Ensuring the area around the chair is safe is also important.
Reducing Friction
A non-slip rug or mat under the chair can prevent it from sliding on slick floors.
Decluttering the Space
Keep the area around the chair clear of hazards like cords or rugs that could cause trips.
How to Safely Reposition and Assist an Elder
Caregivers should use safe techniques when repositioning.
Always lift and move the person instead of dragging to prevent skin injuries. Use proper body mechanics, positioning yourself correctly and using leg muscles to assist. Ensure the person's feet are flat before repositioning or standing. Regularly check and gently remind the person to adjust their posture.
Conclusion: A Proactive Approach to Seating Safety
A comprehensive approach is best for how to keep elderly from sliding down in chair. Addressing physical issues with therapy and exercises, choosing proper seating, and using adaptive equipment are key steps. Regular monitoring and safe repositioning techniques further enhance safety and comfort. These measures not only prevent falls but also support overall well-being. For further information on the risks of poor seating, the Mayo Clinic provides a guide on bedsores.
