Editor—Bliss's plea for elderly people to be freed from the tyranny of having to sit in chairs is laudable.1 She also highlights the dangers of forced sitting in chairs, which is based on a widespread misconception that if we as health professionals get patients out of bed into a chair we are making progress.
Transferring from bed to chair is beneficial only if it enables patients to stand up and walk. Unfortunately most designs of chairs in hospitals and care homes have horizontal seats, which allow patients to slip forwards into a slumped position. Also the arms do not protrude forwards sufficiently to enable the person sitting to bring the centre of gravity forwards over the feet and rise unaided.
Most hospital beds are equally unsatisfactory. All beds should have a head down slope to encourage venous drainage in the legs and prevent the patient from slipping forwards when sitting in bed.
So far as the patient is concerned, most hospital beds have not changed since Florence Nightingale. The patient still has no control. In one respect we have regressed because self help bed poles and handles have been discarded. Why? Presumably because they are not aesthetic.
All hospital beds should incorporate patient operated electrical control of back rests and bed height. Patient autonomy is being increasingly accepted, so why are health professionals depriving their patients of control of their freedom and comfort in bed?
Of course we will be told that ideal chairs and beds for all would be too expensive. But how would that cost compare with the savings in nursing time and injured nurses' backs?
Competing interests: None declared.
References
- 1.Bliss M. Should elderly patients be made to sit in chairs? BMJ 2003;327: 997. (25 October.) [Google Scholar]