Therapeutic Positioning and Effective Problem Solving

Managing night-time health complexities and simultaneously providing and managing the multidimensional health and care needs of children with complex neuro disability within limited day and night-time hours can be challenging for caregivers.

While the literature recommends that 24-hour postural management plays an integral role in hip surveillance, limits secondary musculoskeletal deformities and improves function and quality of life, the evidence to inform decision-making and prescription of sleep system positioning is limited.

This night-time complexity creates an unsolvable dilemma for caregivers who need to prioritise their children’s immediate health needs over a multitude of competing demands, only one of which is the use of sleep system positioning. Complex night-time care needs often negatively influence caregivers' ability to implement an effective sleep system. Findings suggest that managing children's complex and changing health challenges, particularly getting enough sleep for both the child, themselves and the wider family, had the most significant impact on caregivers' capacity and willingness to implement sleep system positioning.

Understanding wider MDT goals alongside carers and family viewpoint while making a gradual shift and adaptation over time plays a key to meaningful impact using day and night time positioning. We will discuss assessment criteria and strategies and share some real-life case studies on how the clinical team can make a meaningful change to a child’s overall well-being.