Geri-chairs are chairs which recline backwards. They are frequently used as a fall prevention measure for residents who have poor trunk control. They often have higher sides than conventional wheelchairs to keep the resident from falling over the side of the chair and can be reclined backward, reducing the risk of falling forward out of the chair.
However, there are risks associated with the use of geri-chairs. One of the main risks is that the resident will develop pressure ulcers. Pressure ulcers are caused by unrelieved pressure over the bony prominences like the buttocks, coccyx, and sacrum.
When a resident is placed in a geri chair and reclined backwards, there is downward pressure applied to those areas from the weight of the resident’s torso and additional pressure from the weight of the resident’s thighs due to the force of gravity acting down the reclined seat cushion. The net effect is that there is actually more pressure on those vulnerable areas than there would be in a normal seated position.
Compounding the risk of developing pressure ulcers in a geri chair is the fact that the reclined position makes it more difficult for the resident to reposition him or herself, especially if they suffer from muscular or trunk weakness to start with. This means that there is likely to be less movement and pressure relief provided by the resident through his or her own movements.
This means that the resident will be more dependent on the staff to provide pressure relief. This is actually more difficult in a geri chair due to the configuration of the chair. Further, the resident is going to draw less attention from the staff because the use of the geri chair reduces the resident’s fall risk which means that the staff will likely be paying less attention to the resident.
The use of a geri chair involves trading off risks – less fall risk for increased pressure ulcer risk. Those are trade-offs that can be made, as long as the staff is prepared to address the pressure ulcer risk in a focused way by incorporating the increased risk from the geri-chair into the interventions included in the care plan which then must be carried out day to day, shift to shift. The failure to address this can be a basis for a nursing home abuse and neglect suit.