Seating in Care Homes: Design features identified by care home residents

What We Did

Sixteen care home residents from four different care homes, participated in a study with University of Dundee researchers to tell them what, in their experience, contributes to a good care home environment.  A visual game was designed to encourage and support conversations with residents. It acted as a starting point for discussions which progressed into feedback on various aspects of their living environment.  These conversations were transcribed and subject to a thematic analysis process. The game images reflect a journey through a mythical care home depicting built environment related topics mainly and a few lifestyle topics. Card images were bright and comic book style to emphasise the game element. Seating was depicted with an initial couple of images of a hard-backed dining chair and a sofa.  Then as we moved on’ the journey’ through the home, seating arrangements in the lounge and the dining area were portrayed on a series of card.

Residents were keen to discuss seating and were comprehensive in their detail regarding seating.

 

What We Found

‘Well as I say we do a lot of sitting around here’’ 

Sitting was described by residents as being the main activity and therefore seating was of great importance in a care home.  Conversations covered a wide range of requirements and desirable qualities for appropriate seating. Our images of seating were criticised in terms of comfort, function, and safety. Style issues were referred to by some residents but the majority were concerned about functionality.

 

Accessibility - Safety and ease of use

Accessibility was described in terms of leverage as well as ease of getting in and out of seats safely and independently.

“It hasn’t got any arms. It would be difficult for some people to get up from that altogether.”

Chair arms were described in detail and as a necessity for this population.  They should be at the right height and firm as well as comfortable, so that the support holds true when leant on. Chair arms with soft cushioning, that gives under pressure, were described as deceptive and dangerous especially for people with low mobility and vision.

 

Comfort -  Ergonomics and suitability for sitting

Residents described the importance of back and neck support. They highlighted seating with high backs, wings, and arms as necessary to support sitting comfortably for long periods as well to enable relaxing.  Low seating was an issue for anyone with back problems.

“ I just like a comfy chair… I could do with it a little bit bigger so you could slump down, you do slump don’t you?”

Adequate cushioning was highlighted as important for physiological fit and palliative support for bone conditions.  Many care home residents live with chronic conditions which affect their lifestyle and daily comfort and need to be managed. They require particular seating types, for example, one resident with a digestive problem described how a recliner allowed him to take pressure off his stomach.  Another mentioned specific back supports for a curved back.   One resident explained her dilemma when managing swollen legs, requiring feet to be raised, yet also requiring regular movement. She had a stool positioned for raising her legs however the act of positioning and repositioning when she needed to move was ‘a performance’. 

Residents identified many other aspects of seating that affect comfort and noted consideration should be given to, for example, age-related skin sensitivity or height loss. Floor to seat height and depth were often an accessibility problem for people of short stature and could also affect comfort.

“Not too high because it hurts your legs and your knees . . .  Hmmm and be careful of that bit at the front, if it’s too high it gets your legs underneath”

 

Function - Variety of Layout and flexibility

Residents described different demands for seating as well as the advantages and disadvantages of layouts and arrangements.  The weight of seats was highlighted as affecting flexibility of use, allowing them to be rearranged or not.

Residents wanted to be able to access seating that addressed particular needs. When dining they argued that long banquet type tables were no good for people with low hearing and vision, as effective social interactions were hindered. They described round tables and seating (with arms) for four, to enhance interactions and encourage familiarity between residents. The availability of comfortable armchairs and sofas close to the dining room encouraged resident to resident socialising with tea after a meal.  Seating in communal areas that catered for in-home interactions, visiting and personal space was universally described as being important for independence of choice, in managing communal life and supporting personal preference.

Alternative areas or rooms with choices of seating arrangements that were flexible and comfortable for visitors, as well as residents, were highly desired.  Seats that offered opportunities for private reading or reflection was valued. Single seats indicating privacy but not exclusion, were prized by residents.

Seating arrangements reflecting domestic and public communal spaces like libraries, clubs, hotel lobbies, and one’s own living room were all described to us. Different needs and interactions required a range of seating options for care home residents and their visitors.

Researchers