Positioning CASE STUDY – ENGAGE APOD
Parke View Rehabilitation and Care Center, Burley, ID

Trent Gunnell, MHA, MS CCC/SLP, DOR

Patient: 86 year old male

Primary Diagnosis: Lewy body Dementia, DM, Behavioral disturbance, hyperlipidemia, dysuria,
HTN, glaucoma, depressive disorder, dysphagia

 

Existing Wheelchair Seating: Highback reclining sling seat wheelchair with foam cushion

 

Positioning / clinical Issues: Pt was in sacral sitting and sliding with right lateral lean. Pt had poor
intake (less than 25% of meal) with poor oral control/management and risk of aspiration and
subsequent pneumonia. He was unprepared for the act of eating with poor bolus management
increasing risk of aspiration and weight loss. He presented with oral dysphagia and demonstrated
anterior loss which was exacerbated by poor positioning. His diet texture was downgraded to pureed
by nursing. He was on thin liquids however demonstrated poor intake and a 9% weight loss.

PostureWorks Intervention: Engage APOD Medium Profile

 

Outcome: Pt now demonstrates improved upright midline trunk positioning with no sacral
sitting/sliding or lateral leaning and a midline head position. He demonstrates increased attention and
anticipation with intake because he is in an improved position which decreases his overall risk of
aspiration with improved bolus management. His oral intake increased to 50% or more with each
meal and decreased anterior loss. His diet texture was upgraded to mechanical soft. He now
demonstrates improved ability to manage thin liquids as his head is in midline.

Quality Outcome Measures Impacted by Intervention: QOL*

Feedback from Therapist: “As part of our intervention, the change in positioning when the pt was
placed on the Engage APOD had an immediate impact on my pts ability to anticipate the act of eating
and improve his intake and subsequent safety during the swallow.”

*QOL Studies indicate that 54% of all SNF admissions are malnourished; the range of malnourished elderly in
SNFs range from 20-87%. In addition, 60% of all residents experience an initial weight loss following admission.
Dementia places pts at a higher risk for weight loss and dehydration. Current statistics estimate that 60-80% of all
residents in long-term care have a dementia diagnosis. Dysphagia and Nutrition Management In Patients With Dementia:
The Role of the SLP, S.Curfman, MA, CCC-SLP May 23, 2005

 

Note: This is a representative example; actual user evaluations, and decisions regarding the appropriateness of a
particular product for a particular individual, should always be made by a qualified healthcare professional.

FALLS CASE STUDY – Engage APOD
Camelia Gardens of Life Care, Thomasville, GA

Shelbey Wise, OTR/L
Shelby Collins, COTA

Patient: 87 Year Old Male, LTC Resident, 6 foot 3 in and 174 lbs

Primary Diagnosis: Alzheimer’s Disease, Syncope, Weakness, Impaired
Coordination, HTN, CPOD.

Existing Wheelchair Seating: Patient seated in high back, reclining sling seat
wheelchair with standard foam cushion.

Positioning / Clinical Issues: Patient was in sacral sitting and sliding with (5)
falls from wheelchair over a 2 month period. Pt appeared to be in pain and was
repeatedly attempting to stand from his chair.
PostureWorks Intervention: Engage APOD (Advanced Positioning Orthotic
Device), High Profile

Outcome: Pt is now able to sit in an upright and midline trunk position after the
Engage APOD intervention was put in place. The pt stopped attempting to stand
from his chair and appeared comfortable and content. The Engage APOD
corrected the underlying pelvic obliquities which may have been the cause of his
pain, as well as his repeated attempts to stand that caused him to fall. The pt had
no further falls after the intervention of the Engage APOD .

Quality Outcome Measures Impacted by Intervention: QOL, Falls, Pain

Feedback from Therapist: “The Engage APOD prevented my patient from
falling and improved his QOL as he is no longer in pain.”

Note: This is a representative example; actual user evaluations, and decisions regarding
the appropriateness of a particular product for a particular individual, should always be made by a
qualified healthcare professional.

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