Scooting down question

May flowers

So far, my FIL is doing well in his Geri-chair but I have a question about the future. So, in his chair, we have to use a seatbelt to keep him sitting upright enough to eat.  It goes between his legs and around his waist much like a baby car seat. When he finishes eating, we undo it and he scoots down immediately to almost a full laying down position (it doesn’t matter if the chair is an upright position or reclining he scoots down until his bottom is nearly off the chair) He does this in any chair or recliner or bed. Then he tries to scoot back up but can’t. As soon as I pull him up, he is down again in a minute.

(As a side note, if we do not use the seatbelt, he slides down until the tray is nearly at his chin - not good for eating or safety!)

Anyway, when our caregiver helper was late today (eventually a no-show) I got him changed and cleaned up and was going to start him on drinking his juice while still in bed until she got there to help transfer him. Well, as soon as I raised the head of the bed, he scooted down until he was flat again. He said he wanted to eat, but I could not get him to stay in an upright position to eat in bed. I moved him up several times but could not even grab the cup before he was down again. 

It is not a weakness thing, he is using his arms and legs to scoot himself down. He’s not sliding down. I’ve seen him use his arms to push up to sitting and even try to stand.

So, as I think about the future, what in the world do we do when he is bedridden and still wants to eat? How do we keep him from scooting down? We have tried raising the feet, but then he just scoots sideways u til he is flat again. Also, any ideas why he is doing this? He’s been doing it ever since his surgery in January. He does not complain of pain but obviously this is the most comfortable position for him. 

ButterflyWings

Oh May flowers, I feel like our LOs must be consulting with each other some days!

My DH does this in the bed, though not yet in his geri-chair. He won't stay in the chair long though. Has to be eating something with the tray there to sort of keep him in, or be listening to the radio with magazines in front of him or something. But this scooting down below the pillows to lay flat in the bed...It is to the point that hospice suggests we get the hospital bed in, so we can keep his head elevated at least 45-80 degree angle to help with his severe asthma. For the time being there are 3-4 pillows and a wedge thing to help prop him up. All kinds of strategies we have tried through the years with that, (before AD) and it helped a lot. 

Now, though, he continues to slide or scoot down in the bed until he's lying flat which is not a good position for his lungs and you can hear him wheezing from 2 rooms away. (But I'm right next to him, so here we go...then I'm trying 4-5 times a night to remind him to scoot back, move up, etc. and he is confused at my words. Looks "up" to the ceiling when I say move up. Scoots a little, but totally planks if I try to help him scoot up on the pillow. Very tiring. Sleepless nights.

The nuttier thing is DH increasingly wants to eat while reclining in bed. Even when he is sitting up (ish) just relaxing in bed during the day, it is not the right angle to eat. Lots of dropsies and spills, plus he is trying to drink from a cup and pours some on himself or the bed. The chair is better - even when reclined to the first level, but he won't always do that either.  Interestingly, he was sitting up straight at the dining room table this week when he almost choked to death so, go figure.

Does your FIL have a hospital bed? It is narrower so at least he cant shift cross-wise I don't think? And it can be inclined a little to his comfort, plus the footboard/rail might keep him from scooting down too far. It sounds like he is trying to avoid some pain or discomfort though, maybe? Good luck on a solution. I will be paying close attention as we need it here too!

M1

For both of you, I'm wondering whether there are Gerichairs with a tilt feature?  Where you can tilt them back at a slight angle, which would prevent the slipping down?  I don't know the answer, but it might be worth asking Hospice or a medical equipment provider.  It wouldn't solve the bed issue, but it might help in the chair.

May flowers

 Butterflywings - pour LOs definitely have a lot in common. My FIL at first was trying to get up and move constantly which led to some falls.  Now he does a thing where he pushes up with his arms like he’s going to stand or rocks back and forth but isn’t trying to get up.

He does have a hospital bed. We raise the head slightly when he’s sleeping and he does ok with that. It is the full sitting that is a problem. When he turns sideways, his head is on the side rail and legs are hanging over the other side rail. He has already started choking on liquids even sitting up in the chair (even using thickener) so I can’t imagine feeding him in bed!

M1 - the Geri chair has 3 settings, upright, then recline which lifts his feet and body back (maybe 130 degrees) and the third is probably 150 degrees, but not flat. Even with a full recline feet up, he still manages to scoot down to the point that his head is nearly in the bend of the chair and his legs off the end or side of the footrest. Of course he has slid right out of the chair too, which is why I don’t dare walk away when the tray is on or when his seatbelt is not buckled 

 The only solution I have found for the chair for eating is the seatbelt I mentioned. It is a safer design, because it goes between his legs and buckles in the back. The hospice nurses all feel it is the safest setup for him (even though of course they can’t use it in facilities). He still scoots so far against the middle strap that it is really tight against his crotch, so I don’t leave it buckled  - just when he eats or if I have to walk away for a few minutes. We tried a soft pommel but he lifted his bottom and went right over it.

Here is the seatbelt I use: https://www.amazon.com/gp/product/B07KR6SST9

We had to make some modifications to make the straps long enough for the gerichair so it would buckle, we bought a strap with a buckle, cut it in half and sewed each end to the existing strap. So the original buckles are still there for wheelchair and the longer one for the gerichair.

harshedbuzz

This device is intended to keep someone from sliding down, and potentially out of, a chair. There are also wedges that can be added to create the "tilt" M1 mentioned.

Buy Skil-Care EZ Transfer Slider Pommel | Transfer Aids (healthproductsforyou.com)

May flowers

harshedbuzz, that is the pommel we bought. My FIL went right over it as it has some give, so it didn’t work for him (and might not work for anyone with strength). Items that create tilt for him just cause him to scoot “uphill” until he’s almost on his head.

I think that the difference in effectiveness of products lies in whether the LO is just sliding due to loss of strength, or is intentionally using their arms, legs and core to scoot down and over obstacles. The nurses and caregivers cannot get over how strong he is, and how fast he manages to get himself to horizontal (or to the floor).

Linda_Miami

Hi May Flowers.

I just signed on to ask a similar question.  My mom keeps slouching down (but not on purpose) or to the side in her recliner.  She has the strength to scoot herself back up but sometimes doesnt understand what I want her to do when I ask her to "sit up better".  Her recliner is actually part of a sofa and is against a wall so I cant go back there to try to scoot her up myself.  She also tends to lean drastically to one side.  I have searched high and low and cannot seem to find a chair that will offer adequate support.  Does anybody know of one?

ImMaggieMae

My DH started doing this just a couple of weeks ago, both in bed and when sitting on the family room sofa. He will put his feet on a foot stool at the edge of the sofa and just “scooch” down using his feet on the footstool, until he’s almost in a lying down position on the sofa, head against the back. He’s fully ambulatory and can get up, sit down, and walk fine. He also does this in bed. (reguar foam mattress bed. We sleep together.) We have one of those large  memory foam wedges in the bed which he’s used for years, long before dementia, which worked well and got him off reflux meds. But he now often scooches down below the wedge as well. He doesn’t seem to know why when I ask him. 

It isn’t every day that he does does this. I’ve been telling him he’s going to rub the hair off the back of his head when he’s sliding down on the sofa. (Actually just messes it up.) I can’t lift him in bed to reposition him because he isn’t overweight he’s a lot taller than I am. So I tell him to get out of bed and get in again higher up.

So strange that 3 of you are having similar problems. It’s the weirdest behavior, isn’t it?  DH is somewhere near the end of stage 6.

May flowers

MaggieMae - It is a weird behavior and I used to wonder if it’s related to some sort of discomfort but I think now I think it’s just a weird symptom of dementia. Before we had the gerichair he would also put his feet on a stool and scoot until his feet were on the stool, head on the chair and bottom on the floor!  Sometimes it looks like he is trying to sit up but is going further down.  He is in backwards world anyway, he cannot walk unassisted anymore and telling him to take a step forward results in a step backwards. We ask him to lean forward to help him stand and he leans back instead. I ask him to let go and he holds on tighter. I suggest a spoon and he uses his fingers or I tell him it’s fine to eat with his fingers and he uses a spoon. I don’t know, maybe it is all somehow related?  I’m sure there is a medical term for it lol

I normally just out the seatbelt on for meals but the other day I was taking it off and he said he wanted to leave it on. Go figure.

My FIL is mid stage 7

Linda - other than the scooting, the Geri chair has been better for him than the recliner and wheelchair. I know they make supports - head, feet and lateral for example. We are considering a lateral support as he is starting to lean a lot now. I am putting pillows on the side he leans on, but he ends up pulling it out.

ImMaggieMae

May Flowers, my husband eats at the kitchen table most of the time, in a normal chair, and sits normally. Of course he isn’t sitting there for a long time. He eats a little on his own and then says he’s finished. I feed him the rest of the meal. He has some difficulty with swallowing, so I make soft foods in small pieces. Ground Turkey is the basis for a lot of his meals.

He’s up and awake all day and usually sleeps well at night, thanks to Risperidone.

May flowers

Maggiemae, my FIL has not been able to sit up in a regular chair for a while, but new wheel his gerichair to the table to eat with us. He even prays with us (and then we have to remind him to open his eyes after, lol)

We are also on a relatively soft food diet. We do a lot of meats chopped up in gravy with potatoes. He does better with cooked veggies like carrots and green beans. He was also put back Risperdone recently and I am amazed at how much it has calmed him, but not made him sleepy all day.