Case Study - Phoenix

Profile. 
An 81 year old woman in a nursing home with Alzheimer's, assisted with all transfers, poor sitting balance and low tone in the upper body and head resulting in a very marked kyphosis. History of sacral pressure sores.

Main problems. 
As this lady had poor control of her trunk and upper body, she found it difficult to sit in a chair. She could not achieve the support she needed and her slight kyphosis became more marked as the years progressed. She continually went into posterior pelvic tilt and this resulted in the sacral sores. Due to the poor position achieved in her old seat she spent an increasing amount of time in bed, reducing her social interaction, her ability to digest, respire and eliminate.

Top 3 Goals. 
• To increase sitting tolerance to improve interaction and physiological functions 
• To improve postural position to reduce or slow down the development of kyphosis
• To manage pressure to reduce the risk of ulcers

Solution. 
This lady's family contacted one of our partners for an assessment of their mother. The Phoenix lateral, shoulder and head supports helped hold her head over mid-line. Together with the Tilt in Space, she was able to look around the room and interact with her surroundings. Supported like this, she was able to eat food with a reduced risk of aspiration and choking due to the better position of her head. Gravity worked to her benefit in this case and with therapy and exercise, she was able to bring her head further back over the spinal column. We matched the back recline of the Phoenix to the optimum back angle at her hips and locked this out so this could not be adjusted again. This together with the 45 degree tilt of the Phoenix, which allows off-loading of the pelvis, allowed her to sit up for several hours per day, reduced posterior pelvic tilt and therefore stopped her sliding from the chair. She began to sit out for hours on end – more than had been achieved in the 3 years previous. As her posture improved over the following months, the staff adjusted the Phoenix supports to allow her to be supported in her new and better postural position.