Excellence in Action! – Comfort First: Positioning and Specialty Wheelchairs

The application process for specialty wheelchairs in SNF/LTC facilities can be lengthy, complicated, and can often require quite a bit of effort from therapists who advocate the need for these chairs for residents.  These efforts can include documentation to support skilled need, organization to attend physician visits, counseling and education for the resident, family, and staff. 

Our Rehab Team in Jackson, MS have embraced this challenge, and have begun a Wheelchair Positioning Program in their facility.  Our team has really enjoyed helping our residents obtain and reach their optimum level of comfort and quality of life, through providing patients specialty chairs and improving their overall positioning in their wheelchairs.

Many of the residents who receive specialty chairs are repeated fallers, some residents previously presented with agitation and other disruptive, or “responsive” behaviors due to pain and discomfort in their previous chairs.  Others were at increased risk for weight loss, malnutrition, compromised skin integrity, and aspiration pneumonia, due to dependent status and/or positional challenges, impacting residents’ abilities to self-feed and safely swallow at meals.

Residents are evaluated depending on individual needs, using TMC’s person-centered, Quality Measure-focused Specialty Programs, including:  Balancing Act (Fall Prevention); Comfort First (Positioning and Contracture Management); More than a Memory (Dementia); Mission Cognition (Cognitive-Communication); Dysphagia (Weight Loss Prevention through Swallowing intervention); and Skin Integrity.

Since implementing this Positioning program, the residents of this facility have demonstrated a drastic decline in falls, a reduction in disruptive/responsive behaviors, improved intake at meals, decreased weight loss, and more positive dining experiences due to improved wheelchair positioning.  Families have expressed their appreciation for these initiatives, which have positively impacted the quality of life of their loved ones.  Patients have also experienced improved interaction with the world around them, including increased socialization and activity participation, as they are now able to get out of bed more often.  

Additionally, through implementation of their positioning program, the Rehab Team has established a positive working relationship with a Durable Medical Equipment (DME) company. The company works directly with our team to help assess a patient’s need for a specialty wheelchair or positioning device, and mentors our therapists through the process of ordering specialty chairs when needed.

The Facility Administrator was quoted as saying, “I really think this is one of the best things that has happened for our residents. These efforts have allowed the residents to become more comfortable and social! They are able to ride in vans now and attend visits and family outings, in addition to how it has impacted the way they feel on a daily basis.”

The Director of Nursing commented that the specialty wheelchairs have also impacted the ability of the Nursing staff to safely transfer residents into the general public. The wheelchairs have also reduced costs of non-emergent ambulance usage, as these residents can now be taken to appointments in the facility van, and they are no longer bed-bound or a significant fall risk when in a chair.

Many of the residents have commented about how thankful they are that their wheelchairs allow them to sit-up for longer periods of time, attend activities, and attend appointments in their chair, rather than on a stretcher. Other comments consist of how comfortable their bottoms feel.  Some residents who received these specialty chairs have even been able to choose the color of their chair, adding a more personal touch. This makes patients proud to own their chair because they were a part of the customization!

One of our patients commented about her chair, “I feel wonderful in my chair!  I like how I sit in it. I get a lot of compliments on how it rolls, and I like how easy it is to maneuver. I like sitting in the chair now better than riding an ambulance and attending my physician visits.”   Some residents have even nick-named their chairs!

Our team continues to assess our residents’ need for specialty chairs, and they actively screen new and existing residents for declines or changes in risk related to wheelchair positioning.

Kudos to our Team for taking the initiative to think outside of the box to make a positive difference in the lives of their residents who have wheelchair positioning needs.

ALL IN, Jackson, MS!