Seating Perspectives

Do Priorities Change with the Seating Surface?

• By Laurie Watanabe
• Nov 01, 2020

In our cover story, we asked veteran clinicians (and a veteran ATP supplier) how they prioritize positioning goals when Complex Rehab wheelchair seating is expected to achieve so much (see what they said starting on page 6).

We posed the same question to Raz Design’s Clinical Director, Emma Friesen, Ph.D. Raz manufactures mobile shower commode chairs, including chairs for clients with complex positioning needs; how should a clinician prioritize positioning goals when the seating surface is a hygiene system instead of a wheelchair?

Priorities Can Change

“As a clinician, I’m talking about seating goals in the same way I would fit any seating surface,” Friesen said. “I use a diagram that came out of the New South Wales spinal cord injury unit in Australia. One [area] is function, and safety is included in that. The second component is pressure and skin integrity management. The third one is posture and looking at the physiological issues around posture and supporting the body. And the fourth one is comfort.

“When I’m training this, I’m using the same explanation in terms of seating goals. For these goals in different points of our assessment and with different people and different situations, the priorities are going to change slightly. In spinal [cord injury] seating, we would say function is important, but skin integrity is absolutely the most important thing. For people with larger bodies [such as bariatric clients], safety from a clinical perspective and an engineering perspective is probably one of the bigger concerns — not just safety for the person sitting in the chair, but also for caregivers who are assisting with various activities and tasks.”

While funding sources sometimes downplay the significance of comfort in a seating system, Friesen said it’s typically a very important consideration indeed to the person who’s ultimately spending hours, days and years on that seating surface.

“As I’ve been doing this more and more years, I’m more and more believing that comfort — and I take a very broad definition of the word comfort — is absolutely critical to getting people to be happy to use the equipment and use it well,” she noted. “When I talk about comfort, I don’t just mean comfort and discomfort. I also include things like dignity and their privacy and their individual wants and needs for using this equipment for independence and having assistance.”