Elders who are confined to bed or wheelchair may develop complications due to decreased mobility of the limbs; for example, chest infection, pressure sores (or decubitus ulcer) and muscle contracture. All these complications are related to improper positioning. Caregivers can improve their nursing skills and assist elders in changing their positions regularly to minimize their risk of developing these complications.
Pressure sore is an ulcerated area of skin over bony prominences. When localized parts of the body are under continuous pressure, blood supply to that area is hindered and a pressure sore develop as a consequence.
Prone position | Lying position |
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Lateral position | Sitting position |
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Sheep Skin | Air mattress |
Muscle contracture is the result of prolonged immobility and improper positioning leading to joint stiffness and decreased range of movement (especially in patients with Stroke, Parkinson’s disease or those who are bedridden).
Prevention of muscle contracture
Adopt proper positioning and change positions every two hours
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Lateral position | ![]() |
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Sitting | ![]() |
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Prone position | ![]() |
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Caregivers should encourage and assist elders in performing regular active or passive stretching exercise in order to maintain good circulation, joint flexibility, and prevent muscle contracture.
· Use firm pillow with a suitable thickness of approximately 5 cm to 10 cm.
· Use firm mattress to provide adequate support.
· Choose wheelchair with back and neck rests.
· Choice of chair:
- the width of seat = width of pelvis + 5cm;
- the height of seat = 39cm to 50cm;
- the depth of seat = the length of client’s thigh – 5cm;
- the seat should be firm and well supported.
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A suitable chair |