There is a book entitled “Atarashii Kaigogaku Seikatsu
Dukuri no Seating (The New Nursing – Seating as Life Establishment) (Kirara Shobo)” Mr Yuji Mitsuno who is involved in the Snow White Project has sent it to me. Three authors have written the book. Mr Haruki Miyoshi who is a physiotherapist and the author of “Atarashii Kaigo (The New Nursing)” and “Rehabili Taiso (Rehabilitation Exercise)”; Ms Setsuko Fukube who wrote “Fukube-ryu Chikara no Iranai Kaigojutu (The Way to Nurse Without Physical Strength: Fukube Style)”; and our project member Mr Yuji Mitsuno.
What is “seating”? It is explained in a preface in the book. Quotation from the preface:
This book is published because we strongly believe that “seating”, that is the idea and method of how to sit, should be known to nursing on-the-job.
Sitting is not a conscious act for us and we do it routinely. However, it is not the case for handicapped and elderly people.
Handicapped and elderly people have the danger of becoming “bedridden” by a moment’s incident. The “seating” is the starting point to avoid the bedridden situation should it happen.
Nevertheless, chairs and wheelchairs are not suited for handicapped and elderly people in Japan. There is nothing suitable that exists for the Japanese people who have a small build. Therefore, we have to begin with Western chairs and wheelchairs to make them fit the Japanese. And then considering the defects, specific characteristics of illness, and level of aging, we have to make “seating” for individual cases.
Fortunately the importance of changing the lives of bedridden people to a “sitting position” as their main life style is becoming accepted and established by the efforts of nursing practice. For that reason, people are now keen to learn the knowledge and technique of “seating”.
In the book, I have stressed the necessity of “sitting” from the nursing point of view. Ms Setsuko Fukube talked about the issue enthusiastically as a physiotherapist to convince the people in nursing practice. In addition, Mr Yuji Mitsuno, who has been informing and practicing the importance of “seating” for a long time in the establishment of handicapped people’s lives, conveyed his thoughts, valuable experiences and general information.
We would like you to use the book as a starting point and join us to change nursing practice.
I thought indeed that this is a very necessary book for the Snow White Project. In the preface it is said that “the importance of ・・・“sitting position” as their main life style is becoming accepted and established”. I guess that it has been changing a lot, but in reality it still has a long way to go. There are so many people who are bedridden for 24 hours a day for various reasons.
If they can have time for a proper “sitting position”; and if people understand that bedridden people all have thoughts and need to communicate those thoughts; and if people understand that those are the most important things for them; then there would be so many things that can be changed.
And what is more, we cannot say that this is nothing to do with us.
Even if we are healthy today, ourselves, our family or our loved ones may become bedridden and find ourselves in a situation where we cannot find a way to communicate.
I am very keen to introduce this book into the Snow White Project
Browsing through the book, almost all contents are necessary and helpful for Miyapu in his present situation. For example…
“Leaning forward is the best position while eating to protect against pulmonary aspiration (ingesting into the lung). This position is well based in physiology”
I did not know why Miyapu choked when he leaned forward. However I now understand when he does that the tracheotomy tube gets in the way and caused him to choke. It is regrettable if people do not realise such a small thing and remain ignorant.
“Before I talk about excretion posture, I would like to emphasise one thing, changing diapers are not excretion care. The fundamental excretion care is to help elderly people to use the toilet, and empty the bowel and discharge urine. This is what we aim for in life establishment nursing.”
Miyapu can feel the bowel movements and urge to urinate. There is a toilet in his room. He is using the urinal while I am with him, but I still ask him to use adult diaper for emptying the bowel at this moment. I have tried to put a little bedpan in place while he is on his side. However, he felt pain in his body, and being on his side position it is not good for catching feces. After I read the book I started to think about the possibility of putting him in a wheelchair and somehow transferring him onto a toilet seat.On another issue, he could not operate his Panthera wheelchair at all by himself. However, when I readjusted the axle position backwards a little and reset the foot rest, it looked promising that he would be able to operate it with practice. These methods were also shown in the book. I would urge you to look at the book carefully.
The New Nursing – Seating as Life Establishment