Monaco Case Study

Lily was a 75 year old woman in a care home environment; she suffered a stroke 10 years ago with a mild loss of function on the left side and could walk with assistance over short distances. Lily was part of a knitting club within the care home and loved attending her daily knitting classes with other residents.

Main problems. 
Having suffered a stroke 10 years ago which affected the functionality of her left arm, Lily learned to adapt and still take part in the activities she loved, like knitting. Needless to say she was a very determined and independent lady who wanted to maintain this for as long as possible. Staff found it difficult to help Lily transfer from a chair without a stand-aid hoist which Lily did not like as she was determined to remain as independent as possible. Her limited tolerance for walking meant that she spent most of her time in her wheelchair, particularly if she wanted to attend her knitting meetings or visit some of her friends within the care home. This was extremely uncomfortable and limited the amount of time she would spend in different environments throughout the home. She often was in posterior pelvic tilt and slid from this chair. She also had a tendency to lean to her affected left side, especially when fatigued, and the chair didn't provide the external lateral support that she needed to prevent or minimise this.

Top 3 Goals. 
• To facilitate stand transfers 
• To give support to the left, affected side when sitting
• To allow easy mobility around the home

We visited Lily and a Monaco was chosen for a one week trial. The staff noted that when Lily wanted to stand from the chair, they could easily adjust the angle of the seat and encourage her to a standing position. This avoided the need for the stand aid hoist and reduced the amount of carer time needed for transferring. Lily was delighted that angle adjustment of the seat gave her that little bit of extra help needed to stand, without any extra adaptive equipment. When she was seated in the chair, lateral supports and a concave head pillow supported her in maintaining a midline position and prevented Lily from falling to her left side when fatigued. As the back was reclined to the optimum angle and the seat angle increased, staff noted that she seldom presented with a posterior pelvic tilt and stopped sliding from the chair. This was also a comfortable position to rest in, then when Lily was more active they could alter the angle of the seat and back to a more upright position for functional activity or knitting. When Lily wanted to be moved around the home and attend knitting meetings or visit friends, she rested her feet on the sliding footplate and the care staff were able to move her around the home easily without the need for transferring into a wheelchair. Lily could enjoy her favorite pastimes for much longer in her new comfort chair and would often spend hours chatting with friends or sitting by the window with the nice view. It was hard to disguise Lily's delight at her new found independence!