Assessing Plus-Size Patients for the Right Bariatric Chair: Key Considerations

Introduction

In the world of healthcare, selecting the most suitable bariatric chair for plus-size patients is no simple task. It requires a deep understanding of the patient's needs, physical measurements, and goals. In Part 1 of this series, we explored the challenges faced by healthcare professionals in choosing the right bariatric chairs. Now, in Part 2, we will delve into the essential considerations when assessing a plus-size patient for the perfect bariatric chair.

Meeting the Patient's Needs

The primary objective of any assessment is to meet the patient's needs effectively. However, this is easier said than done when it comes to plus-size patients. Their needs can be complex, and a multitude of factors must be taken into account. Some of these factors include:

• Patient Preferences: Understanding what the patient wants is fundamental to selecting the right equipment. It ensures enablement, choice, and dignity.

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• Patient Goals: Each patient may have different goals, such as mobilization, falls prevention, skin protection/healing, comfort, respiratory management, and more. All these goals influence the choice of the bariatric chair.

• Patient Measurements: Accurately measuring the patient's height, shape, size, and weight is crucial. An incorrect measurement can lead to discomfort, pressure damage, and an increased risk of falls.

• Changing Needs: Throughout the day, a patient's physical and psychological needs may fluctuate. It is essential to consider their requirements for leg elevation, backrest reclining, or leg positioning based on their activity and clinical condition.

• Long-Term Considerations: Will the bariatric chair still be appropriate if the patient's mobility improves or deteriorates over time?

• Environmental Limitations: The size and shape of the room, placement of furniture, and the ability of caregivers to work safely around the chair are all environmental factors to be considered.

Seat Width, Depth, and Height

Accurate measurement of the patient determines the dimensions of the bariatric chair. The chair should be wide enough to accommodate the patient comfortably, without exerting pressure on the thighs and hips. However, it should not be so wide that it fails to provide adequate support. The depth of the seat is critical to ensure that the patient can sit fully back with their knees touching the seat, preventing the risk of being pushed forward. Additionally, the seat height should align with the patient's popliteal height, allowing their feet to rest flat on the floor for safe mobilization and reduced falls risk.

Popliteal height

Configurability

A bariatric chair with easy configurability can adapt to meet the changing needs of plus-size patients. For example, a riser-recliner chair can provide calf elevation for managing edema, upright positioning for meals, assisted standing, and a reclined backrest with elevated calf section for resting. Adjustable leg height ensures that the chair can provide the correct seat height for each patient. A tilt-in-space chair allows the patient to alter their sitting angle while keeping them in a full seating position, offering additional comfort, upright positioning benefits, and pressure redistribution.

Arm Rests

The width, firmness, and height of the armrests play a crucial role in safe mobilization and transfers. A static chair with drop-down arms aids in lateral transfers, while sturdy wooden arms provide grip and support. Armrests that are too high or too far apart can hinder mobilization and compromise safety. Spreading armrests out, such as in a tilt-in-space chair, can provide extra space and added comfort.

Static, riser-recliner, and tilt-in-space bariatric chairs

Safe Working Load

To ensure patient safety, it is crucial not to exceed the bariatric chair's safe working load. This requires accurately measuring the weight of the patient. Unfortunately, this step is often overlooked due to practical difficulties or a lack of suitable weighing equipment. It is also important to consider the weight limits of individual sections of the chair. For instance, a riser-recliner may have a weight limit on the elevated calf section, which could be exceeded by the weight of the patient's legs and abdomen.

Conclusion

Assessing plus-size patients for the right bariatric chair involves considering multiple factors and accommodating frequently changing needs. It requires ongoing assessment and adjustment as the patient's requirements evolve. Providing the right equipment at the right time ultimately leads to improved clinical outcomes, along with physical and psychological benefits.

References:

1. Martindale D (2021) Calculating bed height for hospital patients using popliteal measurement. Nursing Times [online]; 117: 10. Accessed online 17/01/2021.