GERIATRIC SEATING AND POSITIONING WITHIN A WHEELED MOBILITY FRAME OF REFERENCE IN THE LONG-TERM-CARE SETTING

Often the wheelchair is the necessary mode of mobility for the older a dult with cognitive impairment as well as with single or multi-system sensory defect or lower extremity instability. Over a lifetime, the ol der adult usually has acquired a number of musculoskeletal limitations that affect sitting posture in a wheelchair. However, the standard nu rsing home wheelchair is frequently ill-designed to meet the postural, functional, restraint reduction, or mobility needs of the nonambulato ry or nonfunctional ambulatory older adult. This article emphasizes a seating assessment and treatment approach that addresses the whole of the individual while encouraging a restraint-reduced environment. Spec ific aspects of treatment for frequently noted seating deficits are al so addressed. Lastly, program development and equipment funding mechan isms are reviewed.