I have a question with regards to older people (65+) sleeping in their riser recliners (RR).
I have a service user who sleeps in his RR out of choice. He has a perfectly good bed which he can get in and out of very well. But choses to sleep in his chair, he says he sleeps well and is happy with it. What are the most common issues/concerns about sleeping in a RR?
I was thinking pressures needs & postural concerns.....What can you share with me?
I have noticed that many elderly people who are admitted to hospital with swollen lower limbs, red hot shiny lower limbs, lower limbs with oedema, both with and without cellulitis, happen to sleep in raiser recliner chairs or arm chairs. I am trying to find evidence or research to make an information sheet to advise patients that bed is best. It could be argued that the raiser recliner chair is not a reason for the patient to have the problem. It may be that the problem occurred first and the legs became so heavy and deconditioned that the patient finds it easier to get to sleep on the chair as they simply can no longer get onto the bed any more, therefore resorting to the chair.
I understand a slim repose mattress can be placed on the raiser recliner to reduce risk of pressure sores but its more that I would like to understand if the positioning of the patient in the chair, especially in heart failure patients or any cardio problem, exacerbates the oedema and cellullits directly though sleeping in a chair as apposed to a bed.
For more information, https://www.reclinerland.com/best-recliners/ this guide may help you.
Recliners are best for sleeping.
I get pads through the continence service Beate. The OT said not to get one as a hoist can't be used with the riser recliners but I can see the benefits of him sleeping more comfortably with the chair and I can worry about the hoists later.
It's a dual motor one that I want so I can lean the back part separately from the leg part as he can get up quite easily some days. I'll only use raise his legs if someone is sitting in the room with him.
For me, recliner is a life savior. I sleep in the recliner, except I have my own, lol. But aren't we lucky that we have a place to find relief?
my husband is not too happy with me as I've spent the last 5 nights in this laz-e-boy recliner! It seems to relieve my pain, and sleeping is easier, although I do deal with a rotating menagerie of fur faces who want to share the chair with me!
I get pads through the continence service Beate. The OT said not to get one as a hoist can't be used with the riser recliners but I can see the benefits of him sleeping more comfortably with the chair and I can worry about the hoists later.
It's a dual motor one that I want so I can lean the back part separately from the leg part as he can get up quite easily some days. I'll only use raise his legs if someone is sitting in the room with him.
I am aware this is an old chat but have just joined the OT hub and saw this. I work with the elderly and I find this a regular issue and thought I would add my perspective/ things that i find with these patients. Many patients that I have found it is first sometimes motivation to go into bed and would rather sleep in the chair that they have been sat in to watch TV. I also had a lady which had a dog and she basically weighed up the decision that the risk of her sleeping in a chair was less than the risk of coming downstairs to let the dog out in the early hours of the money when dark. I also find that people who either can't manage the stairs anymore or would rather not don't want their living room changed into a bedroom for aesthetic purposes and would thus therefore stay on the chair. If a person has capacity we can only advice but there is deffo many reasons that I may not have not thought about before speaking to some patients about there reasonings
Just wanted to say that this has been a great chat ! Lots of input from people. I’ve really enjoyed seeing all the contributions. Thanks everyone
I agree with all the comments listed above. Only additional bit to suggest
is to explore his sleeping a bit further. Whilst he’s able to transfer, what’s his body shape like? If he’s carrying extra weight around his middle, when lying flat this additional weight spreads out putting pressure on other internal organs, such as heart and lungs. It can make sleeping both uncomfortable and difficult, as not breathing properly means not sleeping properly. It could be he would be more comfortable sleeping propped up and therefore able to get back in bed. As everyone else said, document it all, with a clear indication around capacity and ability to weigh up and understand risks.
Thank you all, I feel confident about my clinical reasoning and how to further support my service user who is relatively mobile, regular toileting and prepping own meals. Thanks again. @Jo-Anne good shout about the research maybe i could start something? Need to find time write up all these assessments :)
Hi I would be really interested in someone doing a piece of research On this. Looking at sleep analysis, pressure mapping, and swelling. At the moment we have no facts and figures and a lot of clients who see no negative impacts to sleeping in a riser recliner.
Pressure care, lymphatic drainage, circulation, contractures, posture management all considerations xx I had a lot of service users who used to prefer their chair, often due to feeling more secure in sleeping position due to the arms, an ax with a sleep system consultant was helpful for a few. Others found an air mattress really uncomfy, so work with nursing team to look at alternatives and to weigh up pros and cons of going back to a mattress without air. Xx
Similar response to those above with several of my own patients over the years. Tissue viability, oedema, Pressure relief, managing continence needs , personal care, bowel care and so on. There is pressure relief available for riser recliners. If your patient is mobile and functional within his home his pressure areas may not be such a problem. Some patients sleep in a chair as they can get to the toilet faster than getting out of bed, perhaps this is why they are sleeping in the chair. It could be that pain is better controlled in this sleeping position. At the end of the day if they make the choice, have capacity and you have given them information within your own ability and competence then it sounds like you have done all you can. It is unlikely in my experience that one person or professional is involved with the patient. Maybe it is worth seeking an opinion from a TVN.
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I work for Adult Social Care and I find this to be very common amongst the older adult population. As others have mentioned, I would discuss my concerns such as skin integrity issues, musculoskeletal injury, poor posture etc but ultimately if someone has capacity to understand the potential risks associated with sleeping in a RR, there is very little that can be done. I always document the conversation that has taken place and I will send the individual a copy of their adult needs assessment which will suggest some solutions to overcome the associated risks with sleeping on a RR
I get this on a fairly regular basis within Care of the Elderly and T&O. I recently had a patient who declined a hospital bed when she would need all care with a full hoist etc because she has slept in that chair for years. Obviously this leaves someone with limited mobility at risk of pressure damage and infections as there's only so much pressure relief you can provide for them.
I wouldn't personally advise it but if the person has reasonable mobility, can relieve their own pressure areas and toilet themselves I don't see the harm in it if its a personal choice. I would be very concerned in the case of a very high risk pressure patient though! Obviously for someone who requires hoisting and all care its completely inappropriate as carers will not attend to then in the chair (back care needs for carers) and extremely high risk of pressure ulcers forming and becoming infected for patients in that situation. They're the main issues I come across. Another would be when patients come in with grade 3 or 4 pressures ulcers and insisting on returning home to sleep in a riser recliner., it's going to be very hard for that ulcer to heal with insufficient pressure relief care as we can't provide alternating air pressure relief on these systems.
Good question! We'll bring this to the attention of Members across social media today - and in our upcoming Member Newsletter next week.