A Healthcare Worker’s Guide to Seating Assessments – eBook

We wanted to give you a sneak peek of what to find in The Healthcare Professional’s Complete Guide to Specialist Seating Assessments eBook, so read on to become a master of seating assessments…

Why is Seating So Important?

Sitting is a major part of our lives. We work, relax, talk, read, and eat whilst sitting. Many of us don’t even think about it, but we constantly make little adjustments to our posture whilst we’re sitting.

When movement is reduced due to illness or disabilities, people can’t make these adjustments so easily.

And when you consider that the elderly and disabled are often sitting for even longer than most, it begins to dawn on you that getting seating right for these individuals is crucial.

Now picture this: you are unable to move, or shift position all day, and there’s no getting up and stretching your legs. You can’t adjust your backrest, change the lumbar support setting, or slide your chair back and forth.

Uncomfortable?

In fact, there’s a whole list of unpleasantries that come with incorrect seating:

• Poor posture
• Joint, muscle, back, or shoulder pain
• Irritated tissue or pressure damage
• Poor circulation
• Difficulty in getting up
• A lack of independence
• Reduced confidence, or social isolation
• Contractures and deformities

We could go on, but these numerous factors boil down to one thing: reduced quality of life.

The impact of correct seating and good posture

The flip side and more positive way of looking at this is simple: you can have an impact on improving people’s lives, through carrying out a detailed seating assessment.

At its core, according to Pauline Pope, this is what good posture looks like:

1. It facilitates effective functional performance
2. It’s energy efficient
3. It does not harm the body systems.

Seating Goals

Many of us are all too quick to rush into the seating assessment without looking at the bigger picture.

By talking to the staff and family, we can create a wishlist of things the client wants to achieve through better seating. If we pause and ask ourselves the question, “what do we want to achieve with a new chair?”, there’s a whole list of possible outcomes.

Factors to consider with specialist seating

Before trying the client in a chair, these are some of the factors you might want to think about (in no particular order):

• How mobile are they? How do they transfer?
• Can they sit up without support? If so, how long for?
• Can they alter their position themselves whilst sitting?
• How long will the person be sitting for?
• How comfortable can we make them? Where and how do they experience discomfort at the moment?
• Is it safe to leave them in a chair? Are they at risk of sliding out? Is it safe to let them operate the chair themselves? Can they stand unaided? Will they try to stand even if they can’t? Are there pets or children in the house?

To see the full list of factors, download The Healthcare Professional’s Complete Guide to Specialist Seating Assessments.

Posture and the pelvis

A proportion of the time spent in most seating assessments should be devoted to pelvic positioning – it’s that important.

The pelvis is the foundation of seating — good posture starts with the pelvis, and the pelvic position dictates how the spine and legs are positioned.

The position of the ASIS and PSIS in relation to each other is the basis of your postural assessment. In an ideal situation, the ASIS and PSIS must be level, with the pelvis tilted ever-so-slightly forwards (known as minimal anterior pelvic tilt). It’s worth mentioning at this stage that of course, some people have a fixed deformity which makes it impossible to get complete alignment.

For further information on the posture and the pelvis, download the eBook.

Common postural abnormalities

When it comes to abnormal positioning, there are lots of fancy phrases that get thrown around — I’m sure you’ll have heard of some of the conditions we mention below. However, don’t be intimidated — they aren’t as complicated as you may think.

We’ve also covered other postural deformities like:

• Abduction and Adduction
• Contractures
• Leg Length Discrepancy
• Windswept Hip

To see even more hints and tips on how seating can help to alleviate postural conditions and abnormalities, download our Seating Assessment eBook.

Pressure care in seating

If you’re a healthcare professional, you’ll know that pressure care is a huge subject.

The interesting thing is, seat sizing has a huge impact on both posture and pressure care. So if you get seat sizing correct (we’ll go into this in more detail later), you’re over halfway there.

So always bear in mind that all three — posture, pressure care and seat sizing – are closely linked.

Causes of pressure ulcers in seating

There are many factors that contribute towards the formation of a pressure sore. It may be one of these factors, or it could be a combination of several:

For more information on how pressure effects seating and see a more comprehensive list of causes, download our eBook.

How to prevent pressure ulcers in seating

Everyone knows the famous phrase for buying a property: ‘location, location, location’. When it comes to pressure care, the catch phrase is slightly different:

Prevention, prevention, prevention.

So always remember: prevention is better than cure.

Pressure ulcers cause considerable pain, discomfort and cost, and they take much longer to heal than they do to create.

So if a patient is at risk, ensure you do something about it. It’s much better to overcompensate and be safe than sorry. Make sure you prescribe something that will suit their future needs as well, particularly if their condition is likely to deteriorate.

This leads us nicely onto our five seating pressure prevention strategies…

To see our full five-fold pressure prevention plan, download The Healthcare Professional’s Complete Guide to Specialist Seating Assessments.

Medical conditions and how they impact on seating needs

Many people have specific disabilities, diseases and conditions, and often there are specific seating hints and tips for patients depending on their diagnosis.

Whilst these observations and ideas are based on years of experience of working with clients with these conditions, it’s important to note that everyone is different, and what works for most people won’t work for everyone. It’s down to the seating specialist to assess the situation.

We’ve not gone into a huge amount of detail here as we have specific blog posts on each condition in relation to seating, and we’ll keep adding the links to new articles as they get written — so keep checking our blog to see what we’ve covered.

Stroke Patients

A stroke, otherwise known as a Cerebral Vascular Accident (CVA), is usually caused by the blood flow to the brain being cut off, often due to a blood clot. It’s important to note that many people recover from strokes, so a specialist chair may only be needed for rehabilitation.

Often a good level of lateral support will be needed, as will head support, a tilt-in-space action, and a mobile base, as detailed in this blog post.

You may want to look for something with flexibility which can be altered to suit the patient’s needs over time.

Spina Bifida

When a baby’s spine and spinal cord don’t develop properly during pregnancy, defects such as a gap in the spine can occur. This is known as Spina Bifida.

Symptoms can include weakness or total paralysis of the legs, incontinence, and a loss of skin sensation in the legs and bottom. Some people with Spina Bifida also have learning difficulties.

As the condition is from birth, consider a chair that can easily be adjusted in terms of size and support, particularly if they are still growing.

Chairs with fully adjustable backrests are great for Spina Bifida patients, as they can be ‘moulded’ to the shape of the spine to ensure support and comfort and reduce the risk of pressure damage.

Bariatric Clients

Obesity is becoming a challenge to healthcare systems throughout the world, and the UK is no exception.

Bariatric or plus-sized patients obviously need chairs with a higher weight limit, but your considerations shouldn’t stop there.

Ensure the weight limit includes a safe margin to cope with any fluctuation in body weight over time (you may be wise to check previous medical records to see if this is likely), and to withstand any sudden movements, such as sitting down in the chair suddenly.

Bariatric Body Shape

Also think about the distribution of weight; clients with oedematous legs may need a reinforced legrest to cope with the extra weight of the swelling. Tilt-in-space with high legrest elevation is a must for clients with oedema.

Tilt-in-space functionality

We’ve also taken a look at conditions like:

• Arthritis, Osteoarthritis, and Rheumatoid Arthritis
• Osteoporosis
• Multiple Sclerosis (MS)
• Dementia / Alzheimer’s Disease
• Brain Injury
• Cerebral Palsy (CP)
• Huntington’s Disease
• Motor Neurone Disease (MND)
• Parkinson’s Disease
• Spinal Cord Injury (SCI)
• Incontinence

To find out more about how numerous other medical conditions affect seating, download our free eBook.

Chair types, categories, and features

When thinking about the type of chair needed, we always ask one question:

Is the patient hoisted?

As a general rule, if the person is hoisted for transfers, a care chair offers better support, is easier to hoist from, and can be wheeled from room to room to cut down on hoisting transfers.

Lento Trio care chair

If the patient is still standing for transfers, you’ll likely be looking at a riser recliner chair or a high back chair.

Riser recliner chair

However, as with any rule, there are exceptions.

Sometimes the client will need the support of a care chair even if they are still standing, and some care chairs will accommodate this.

Other patients may have on and off days — ie., days when they can stand and days when they need to be hoisted.

In these circumstances, it’s best to make a decision based on:

1. Priorities (eg. is support more important than easy standing transfers?)
2. What will be most suitable for them for the majority of days?
3. Will their condition change over time – what will be needed in the future?

How to measure for seat sizing during a seating assessment

A tape measure should be used to take the required measurements

Before we start, here’s a few tips:

• A tape measure with both inches and millimetres is an important part of a seating assessor’s arsenal. Make sure you keep one in your bag!
• Care chairs are often measured in millimetres, with high seats and riser recliners measured in inches. Don’t ask me why, it’s something to do with traditional craftmanship versus modern manufacturing methods for care chairs!
• If you are using a fabric tape measure, don’t let it bend around the body as this can produce a very different measurement.
• It’s best to carry out the assessment in the chair you are prescribing wherever possible. Alternatively, a dining chair works well. In some situations, you may have to measure up whilst the client is in bed, but it’s advisable to work with someone who has done this before if you’re not experienced in this.
• Explain what you will be doing before starting measuring or touching the patient.

To find out all the details about measuring for seat height, depth, width, armrest height, and back height, download our Specialist Seating Assessment eBook:

Justifying your seating prescription decisions

If you are a healthcare professional, there’s a few reasons why you should document your findings and justify the decisions you’ve made:

• Legal reasons — As part of your duty of care towards your client, you need to record why the seating was chosen.
• To aid future care – You may want to refer to your prescription in the future to see how their needs have change.
• To obtain funding – If you are applying for funding, most funding providers will need to see a seating justification
• To outline your reasoning – It can be helpful for all parties involved to revisit why seating features were specified in the first place.

To see a full list of hints and tips for writing seating justifications, download our specialist seating assessment eBook.

After the seating assessment

Seating provision doesn’t stop at the assessment!

There are still a few important steps to take:

• Chair setup — Make sure the chair is adjusted correctly for the patient, otherwise it won’t do its job properly!
• If relevant, create a seating care plan to document how the chair should be setup, how the client should be seated, and how long for.
• Train the patient, carers, or family members on the correct use of the chair.
• Schedule return visit(s) to reassess the client and adjust the chair if necessary.

Let’s look at these steps in more detail…

Download the eBook to see the full step-by-step guide.

A final word…

Some specialist seating companies will arrange free seating training events to help you expand your knowledge further. These can be lunch-and-learn sessions or more in-depth events.

Alternatively, you can learn at your own pace by watching online training videos.

Once you’ve absorbed all the information in this guide, you’ll want to keep up to date with the latest seating hints and tips as well, which you can do by following the Vivid Care blog or by signing up to our e-newsletter.

Download the full 88-page Healthcare Professional’s Complete Guide to Specialist Seating Assessments for free right here.

Frequently Asked Questions

What is a specialist seating assessment?

A specialist seating assessment is a detailed evaluation of an individual’s seating needs to ensure comfort, safety, and postural support. It considers factors such as mobility, posture, pressure care, and medical conditions to recommend the most suitable seating solution.

What is included in a seating assessment checklist?

A seating assessment checklist typically includes:

Medical history and mobility status
Postural seating evaluation
Risk of pressure ulcers
Functional needs and daily activities
Seat sizing (height, depth, width, armrests)
Transfer methods (standing, hoisting, or assisted transfers)
Environmental considerations (home, care facility, or workplace)

How does a chair assessment help with patient comfort?

A chair assessment ensures that the chosen seating solution meets the patient’s physical and medical needs. It helps prevent discomfort, pressure sores, and poor posture by selecting the right chair type, size, and features.

What is postural seating, and why is it important?

Postural seating refers to seating solutions designed to support proper spinal and pelvic alignment, reducing pain and preventing deformities. It is crucial for individuals with limited mobility, neurological conditions, or musculoskeletal disorders.

What is a care chair, and who needs one?

A care chair is a specialist seating solution designed for individuals who require high levels of support and assistance with transfers. These chairs often include tilt-in-space functions, pressure relief features, and adaptable positioning to enhance comfort and safety.

How can I get a specialist seating assessment?

A specialist seating assessment is typically conducted by an occupational therapist, physiotherapist, or seating specialist. Contact your local healthcare provider or a specialist seating company to arrange an assessment.