| Needed: Seating that supports the aging process |
Interview with Roger Leib, furniture designer and former proprietor of ADD Specialized Seating Technology
| Peck: In designing seating for elderly nursing home and assisted living residents, what would the ideal specifications be?|
Leib: If you’re talking about seat height, depth, and other dimensions, you are asking the wrong question. I think anyone who focuses on that sort of thing is missing the boat. Basically, furniture design for the elderly is a question of providing musculoskeletal support, of supplementing a weakened musculature by assisting the person in exiting and entering the chair and holding oneself upright while sitting (figure 1, A and B, figure 2). We are endoskeletal beings, with the body keeping the spine, nerves, and blood vessels in proper alignment through most of life. As muscles weaken with age, however, problems are created up and down the skeleton. Which is why I’ve changed my view of things. When I started out, I thought the main function of seating was to accommodate people comfortably in the curved position as they grew older. I have since learned differently.
When one slumps in a chair, adverse effects are created such as irregularities in breathing, sleep, and excretory function, as well as anxiety and pain. This is why I’ve been concerned to see some modern design taking a backward step, with chairs getting wider, arms splaying out beyond reasonable support, and not enough attention being paid to preventing an older person from slumping. Designers are looking too much at form and shape, which is actually icing on the cake, and when you’ve got a bad cake….
Peck: And the “cake” is furniture taking a more active role in supporting older people musculoskeletally?
Leib: Yes, which in turn will motivate people to remain upright and active, as opposed to going back to bed as soon as possible, a disastrous outcome. Also, people-and busy staffs-tend to rely more than they should on wheelchairs, which are at least more convenient for moving about. But wheelchairs started as an option for relatively healthy paraplegics, not frail elderly. Today’s wheelchair use is based on perceived risks, such as falling, and on staff convenience in moving people about, as opposed to genuine physical need. The wheelchair encourages people to remain seated, in a relatively static position-and, in my view, a static resident is a dead resident.
A chair should encourage people to continue moving even while in place, and to feel energized to get up and out of it now and then. My company initiated an attempt at this with the Warren chair (named after my father), which was spring-loaded to gently push back as the occupant leaned back, encouraging him or her to use core muscles in moving back and forth (figure 3). It was what we called “Dynamic Seating«,” providing vestibular stimulation that, for reasons still unknown, results in a calming, sedative effect. It’s because of concepts like these that I say-when you talk about seating height, depth, etc.-well, let’s not go there.
Peck: Have you seen any advances of late in seating design that you find encouraging?
Leib: I’m more concerned about people focusing on the wrong things-for example, an overemphasis on coverings to provide infection control. I was amazed recently to learn, while visiting a fancy long-term rehabilitation hospital filled with patients from a nearby prestigious teaching hospital, that more than 99% of its patients, mostly hip and knee replacement patients, are admitted with pressure ulcers. This is, of course, a very high-risk situation for cross-infection. For this you just don’t turn to fabric treatment-you need seating that is easily cleanable and breathable. I have also heard of problems in VA hospitals (and I’m guessing it is not uncommon in some smaller nursing homes) of vermin infestations in seating, which indicate a need for eliminating all the nooks and crannies that encourage this by, for example, reducing stuffing without compromising comfort. There are ways to engineer this, it’s just that they aren’t talked about much.
Peck: What other features would you look for or recommend in geriatric seating?
Leib: On retractable lounge chairs, I would look for unbreakable leg- or footrests. These tend to break when staff use their feet to retract them while holding a resident, for instance, which leads to an endemic need for servicing of these chairs. These legrests also tend to be too short for some residents, leading to heel drop and the resulting painful elongation of tendons. Legrests need to have a longer throw, yet be able to fold easily under the chair when someone gets up from the chair. Also, seating pads should be long enough to prevent cutting into thighs and causing circulatory and neurological problems. Because of inadvertent results such as these, I sometimes think we’re manufacturing injuries and falls with our seating design.
A couple of innovations I would like to see would be V-shaped couches, with armrests in the V, so that people seated on them can lean in toward each other for conversation. I’d like to see dining room chairs with high backs to augment hearing with reflected sound and block ambient noise from behind. I’d like to see more use of chairs with built-in controllable swivels so that a person can easily move about and, when done, have the swivel default to lock.
There are so many things that chairs can do to help people age comfortably and healthily, and it would be nice to see more attention paid to developing these possibilities.
|For further information from or about Roger Leib, phone (213) 400-0817 or e-mail email@example.com. To send your comments to the editors, e-mail firstname.lastname@example.org.|
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Sunrise Medical’s Joerns« Chesapeake collection reflects the elegance and beauty of the 18th century. The distinctive borders on the door and drawer fronts enhance the collection’s classic style and rich mahogany finish. The Chesapeake collection is available in 17 distinct pieces that will add style to any healthcare environment.
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Forbo Flooring’s Comfort Program is a collection of linoleum and vinyl floor-coverings that incorporate an acoustic layer to provide sound insulation and comfort underfoot. The Comfort Program is composed of three collections: Marmoleum Decibel, Eternal Wood Decibel, and Quartz Decibel.
Marmoleum Decibel is a natural, bacteriostatic linoleum floorcovering with a polyester backing for dimensional stability and a polyolefin layer for sound insulation and comfort. Eternal Wood Decibel is a “wood-look” vinyl floorcovering, and Quartz Decibel is a vinyl floorcovering with an acoustic layer. All three collections are easy to clean and maintain.
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| Bench Seating|
Country Casual designs solid teakwood site furnishings, including the Windsor bench. The Windsor, with a clean, unadorned style, is appropriate seating for a terrace, walkway, or atrium.
Country Casual’s benches and chairs have properly spaced, generous back slats; raised seat heights; and well-proportioned timbers. Crafted with traditional mortise and tenon joinery of kiln-dried premium teak, the company’s furnishings are constructed for strength and durability.
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Direct Supply’s Eldercare Interiors is a team of professional designers and project consultants who can plan renovation or new construction from start to finish. Eldercare Interiors offers interior design services, kitchen and laundry design, product consultation, and other services exclusively for senior living environments.
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| Modular Flooring|
Interface Flooring Systems manufactures modular, soft-surfaced floorcoverings featuring award-winning designs and high-performance construction, with permanent antimicrobial preservative protection. Modular products by Interface Flooring Systems are designed for superior performance in the most demanding healthcare settings, while helping to create and maintain a healing environment. They also install with less waste and require no “attic stock” for refurbishment.
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