A: The heels are one of the most vulnerable areas on the body for developing pressure areas due to the high amount of pressure being exerted over such a small area of the body.
Whilst sitting in a care chair, the most common mistake is to over elevate the footrest and place a normal pillow under the heels and lower legs. This has several effects:
- Due to shortened hamstrings being put on full stretch the client will tend to slide into posterior pelvic tilt and flex the
knees causing the heels to push into the supporting surface. - Clients with hip and knee contractures have cushions placed under the knees for support neglecting the position of the
heels and the pressure on the supporting surface. - When clients are uncomfortable they may rub their heels/feet in an effort change position but in effect they are causing
shearing on the heel area. - Some care chairs do not have adequate pressure care properties built into the heel/legrest section and standard pillows
do not adequately disperse pressure from this high risk body area.
The optimum position in a care chair is where all body surfaces have maximum contact with the supporting surface with
minimal or limited extra pillows and positioning aids.
To alleviate heel pressure look at lowering the legrest and supporting the feet on a footrest to offload pressure.
If it is necessary to elevate the lower legs try to ensure the heels have minimal contact with the legrest by supporting the lower leg and allowing the heel to be free from contact with the supporting surface.
Always consider all the situations and surfaces a client spends time on in a 24hr period as optimal pressure care should be observed constantly to promote healthy skin condition and healing.