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Let Them Stand!

“The Perch”

 

Attention all senior living architects, designers, directors, caregivers, family members, insurance companies, litigators, and law makers…

Standing is a normal human condition.  And if you’re a underused pair of legs and a sore bum, you might even say that standing is your right.

Can we please build environments that encourage standing?

Good “senior design” should include opportunities for normal human movement like the act of standing- not just barrier-free rolling around.

Designers, we need to make all movement accessible, including standing.  It seems your focus is on wheeled devices, not human legs.  It is a lovely consideration to have a chair or bench at the end of every hallway, and a seating group in every room for socialization for those who can ambulate.  And wide doorways and flush thresholds for the wheelchairs is an important consideration for independent mobility. However, it seems you’ve decided, together with the risk management team, that sitting is preferable to standing.

Have you ever sat all day long?  Did you get the urge to stand and stretch your legs?  Maybe gaze out the window and check the weather?

Here are a few reasons why standing is important:

  1. Skin integrity- prolonged sitting increases the risk of skin breakdown.  Periodic standing allows tissues over the sit-bones to receive good blood flow.
  2. Bone health- weight bearing keeps bones stimulated and strong
  3. Organ function- digestion, breathing, and cardiovascular function benefit from standing upright
  4. Fall prevention- strength of the lower extremities and good balance are key factors in fall prevention
  5. Brain health- vestibular and proprioceptive stimulation from position changes are key to feeling comfortable during movement.  When a person loses the familiarity of standing, fear and apprehension can lead to increased dependence.

How many times have I watched a senior living resident crane her head from her chair toward the window? Standing at the window, gazing and dreaming at the landscape, is one of life’s simplest pleasures.

Let’s build an environment that provides that experience, and keep residents stronger and healthier in the process.  What would that look like?  Oh, I’m glad you asked:

  • Standing stations directly in front of windows
  • Standing height countertops with bars to pull up
  • Ballet bars in front of mirrors for exercise
  • Grab bars near sinks to allow for safe pull to stand (have you ever brushed your teeth from wheelchair level?  It’s very difficult and messy!)
  • Outdoor standing stations near fountains, bird feeders, and gardens

So if they build it, will they stand?  That’s up to you, facility leadership and care staff.  Are you comfortable letting your residents stand?  Is the risk of injury or negligence too great?

Well let’s ask the insurance companies and the litigators… is the act of standing too risky to qualify as a basic human need?  Will you punish the facility for letting their residents stand?

Get your therapy team involved to make your residents stronger, then continue to encourage standing opportunities to keep them strong and healthy.

Thank you for your attention to this matter.  Amen.

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2 comments

  1. I always enjoy your articles which challenge the ideas that we have grown to accept as normal and required. Definitely sharing this one 🙂

  2. Great ideas, thanks.

    Also required is a mindset that believes in better care: http://myalzheimersstory.com/2017/10/22/stand-up-for-better-care/

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