What's the best cushion for comfort and to prevent skin breakdown?

October 24, 2017 2:38 PM

My elderly dad has terminal cancer and is receiving hospice services. He's not yet at the end stages, but has lost a lot of muscle, especially his backside. He spends most of his time sitting on his couch, or using his walker to sit at the dining table for meals, and he just cannot get comfortable.

His nutrition is not bad, though not what it was. He's of normal height/weight. I know good nutrition is key in preventing skin breakdown (none so far), as is re-positioning frequently, but he can't really sit for more than about 10 minutes until he needs to stand for a bit, especially if he's in his transfer wheelchair. He uses that for excursions out of the house.

I'm investigating therapeutic cushions and have looked at both Roho cushions (kind of super-duper air capsules to support the buttocks when sitting) and Jay cushions (a gel cushion used for the same reason). I'm not sure which is better, but boy, are they expensive! Like several hundred dollars each! There is a "basic" Jay cushion at $84.00, which I can do, but is this sufficient? What's the improvement in a $300.00 cushion? I feel lost!

Also, I see only wheelchair cushions listed, and I'm looking for one that is perhaps not as narrow as a wheelchair seat that can also be used on a dining chair, or on his couch. A typical couch cushion sags with his weight, and isn't much help. I rigged up a cushion of several times folded-over large-cell bubble wrap, which seems to be a little better, but I know there must be a better solution out there. I'd appreciate any first-hand advice!

posted by citygirl to Health & Fitness (9 answers total)

If you have not done so talk to hospice. They may have similar cushion options available that are covered by insurance.
posted by fluffy battle kitten at 2:51 PM on October 24, 2017 [2 favorites]

Hospice may have one or more that you can borrow.
posted by amro at 4:28 PM on October 24, 2017

Best answer: I have direct experience of both the basic Jay and the high-price Roho, and the comfort and pain relief factors alone make it worth the additional $230. Roho cushions are available in a wide range of sizes, and they bend readily, so don't let the transport chair's seat dimensions limit you.

Roho and competitors make full bed size cushions, with air circulation to obviate the need for frequent turning. Hospice would know about that, as well.

If Hospice doesn't have contacts, reach out to disease-specific charities, like ALS or other muscular dystrophies. The life cycles of those diseases mean folks get set up with equipment and pass away within five years. No health insurance ever pays for used equipment, so the second hand market is way cheaper -- basically whatever the original purchasers' co-pay.
posted by Jesse the K at 4:36 PM on October 24, 2017

Something else to consider in conjunction with some types of cushions (not a Roho air chamber one though) is adding a sheepskin. You can buy medical grade ones which are highly washable. We used one under my gran for years when she spent a lot of time in bed, and it helped hugely with keeping her skin comfortable and intact. They do offer a bit of cushioning, come in a bunch of sizes and are very breathable.
posted by Northbysomewhatcrazy at 6:03 PM on October 24, 2017 [1 favorite]

Best answer: The Roho cushions really are the best, in my family members' experiences, and my patients'. Nthing talking to his hospice - this is something that significantly impacts his comfort. They will either have one that you can borrow, or since it sounds like he still has some time, pay for one outright.
posted by honeybee413 at 6:44 PM on October 24, 2017

I can't recall the brand cushion my mom had when she was in hospice. It may well have been Roho. But I remember well that the rehab center staff put me onto their supplier which was significantly cheaper than any other price I could locate. Like just under $100 instead of over $250.
posted by DrGail at 8:18 PM on October 24, 2017

I can't speak to the comfort, but the wound care nurse at my hospital is a fan of this kind of waffle cushion for preventing pressure injuries.
posted by MadamM at 8:53 PM on October 24, 2017

Response by poster: My stepmother spoke with the hospice PT, who had a recommendation for a model of a Roho cushion (which I don't know yet, specifically) but she was told that unless a person is permanently confined to a wheelchair insurance will not cover the purchase. It's called a wheelchair cushion, so I guess that lets them off the hook on alternate (if necessary) uses. The hospice does not stock cushions to borrow, (which seems like a terrific idea -sharing economy, there are vistas to consider. Seriously)! So she will purchase it.
posted by citygirl at 6:15 PM on October 26, 2017

That’s a shame that they don’t stock them to share. My mom had ALS, and the local ALS Association had a good amount of durable medical equipment available to loan. I wonder if it would be worth checking with a local cancer charity.
posted by amro at 7:53 AM on October 27, 2017