Increasing Comfort in the Alzheimer’s Wing

My grandmother lives in the Alzheimer’s Wing. She no longer recognizes me or most of the people around her. She spends her days in a wheelchair because she forgot how to walk. Many of her basic functions are now beyond her. This is true of a lot of other residents of the place.

 

The goal of the residence seems to be to make the inhabitants as comfortable as possible. In the Feldenkrais Method, we work a lot with how to make people comfortable, so I can see that some of the attempts at making the residents more comfortable are actually making them less so.

 

The problem with most of the wheelchairs I saw in the residence was that they encouraged the sitter to lean back and to recline. This makes sense to most people. To most of us, the idea of reclining is more relaxing, more comfortable. The design of seats in cars, planes and movie theatres all reflect this idea. And for a little while, reclining can be comfy. But the constant reclining will eventually take its toll on the spine. It will curve the back in such a way that the recliner will start to have back trouble or other muscular complaints.

 

As a caregiver wheeled one resident out of the dining room, she encouraged the resident to lean back in her chair. “Lean Back!” she said, “Lean back!”

But the resident, who was sitting quite upright and bright eyed, would not lean back, no matter how many times she was told to and actually looked the most comfortable I’d ever seen her. Being able to sit up – balanced on her sitting bones – she was more alert and in her body. She reached out for the things and people around her.

 

The same was true for my grandmother. When she leaned back into the curve of her chair, her eyes closed and her spine rounded. She became less engaged with the world around her, uninterested even in her cake. When she sat up however, she suddenly took interest in her lunch and became much more alert. She ate her salad, played with her roll, wondered who was rolling past her. When she found a way to sit up, she was happier, too.

 

It is, however, quite difficult to maintain an upright sitting position without some support in two places.

  • Behind the back – a straight surface behind a back, encourages and allows an upright position, The wheelchairs I saw there had panels for the back as curved and as flexible as a canvas directors chair. The residents ended up sunk back into the bend of the back of the chair.
  • Under the feet. Unable to put her feet on the floor, due to the height of the wheelchair, my grandmother had to struggle mightily to be comfortable sitting upright in the softness of the wheelchair’s seat. It is very hard to be comfortable when one’s feet are dangling. Try it. Sit on the edge of an uneven surface that is too high for you – notice that you have to lean back in order to compensate for the precarious feeling in your legs.

If I could, I would place supports both behind the back and under the feet whenever the chair was stationary. Perhaps yoga blocks under the feet and gardening kneelers behind the back. (Or, get a better designed wheelchair, that would be ideal!)

 

With the proper support, who knows how much more able to engage with the world these residents might be? Certainly it makes me happier when I can see my grandmother enjoying her cake!

 

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