Doris is a lovely 78 year old lady who lives at home. She has Alzheimer’s disease and has 24 hour care at home. Doris is able to follow clear guidance, but can become agitated at times during the day.

Doris has a comfortable and familiar armchair that she sits in during the day. She transfers between chair, commode and bed using a ReTurn with assistance of one. Concerns were identified as Doris slides down her chair during the day and tends to sit on her sacrum.

The carers noted that her skin was becoming very red around her sacral area and she was at very high risk of developing a pressure ulcer. Carers try to reposition Doris regularly during the day,however she sometimes becomes agitated and refuses this.

Doris was provided with a 4” medium risk foam pressure cushion, which did not meet her needs because:

• The cushion made the seat height too high for Doris, which affected her positioning her chair and increased pressure through her sacrum and ischial tuberosity.
• The cushion raised the seat height, which caused increased difficulty with transfers using the ReTurn. Due to the cushion height, Doris’s feet could not reach the floor. Carers had to assist with this, which increased their moving handling.
• The armrests height of the chair were also too low, which inhibited transfers.
• The cushion tended to move/slide down the chair and Doris was at higher risk of sliding out of her chair.

A dimensional gel pad was issued.

Shearing reduced. Redness cleared and no pressure ulcer developed. Dimensional pad stayed in place. Did not slide on the chair, which reduced Doris’s risk of sliding out of her chair.Transfers improved. Seat height and armrest height maintained, which made transfers easier with the ReTurn and reduced moving and handling for the carers.

Doris continues to use the Dimensional Gel Pad to meet her pressure care needs and reduce her risk of developing pressure ulcers.

By Danielle Base, Occupational Therapist and Gel Ovations Clinical Consultant