An innovative approach to managing the repositioning schedule for patients with dementia

Frontier Medical Group were delighted to attend NAEP 2025 on the 17th & 18th June in Kenilworth. Along with having an exhibition stand, we also hosted two workshops titled: An innovative approach to managing the repositioning schedule for patients with dementia, given by Jo de Clercq.

Jo is a physiotherapist working in Leuven, Belgium, in a residential care setting for patients with dementia.

 In the workshops, Jo presented on his innovative approach to managing patients with dementia to reduce their development of paratonia, which is a form of hypertonia (increased muscle tone) commonly seen in individuals with dementia, particularly Alzheimer's disease. It is characterised by involuntary resistance to passive movement, meaning the person's limbs resist being moved by another person; this resistance is variable and can fluctuate depending on the individual’s level of alertness or anxiety. It often worsens with cognitive decline, making personal care and mobility support more challenging, and ultimately can lead to the development of contractures which contribute to the development of pressure ulcers due to the changes in body structure and therefore increased pressure on vulnerable pressure points, reduced levels of mobility, reduced limb mobility and the associated difficulties in providing hygiene and care.

Jo and his team have successfully implemented these practices for several years, achieving an impressive record of no pressure ulcers developing for over seven years.

Jo’s approach revolves around managing patients' sensory load on the body, ensuring patients are fully sensorily informed. By moving them ‘low and slow’ and avoiding quick, jerky which patients automatically react to, the development of paratonia and hyper muscle tone is minimised This, along with caring for the patient using specialist wash cloths and adapted clothing, in an environment specifically designed for patients with dementia, is a breath of fresh air.

During the workshops, Jo explained that as part of the care, Repose® Mattress Overlay or Repose® Ultracore was utilised to help provide the sensory load required for the patients, as it works by full immersion and envelopment, meaning that the patient lies in the product with all body areas being in contact with a surface. This also redistributes pressure over a greater surface area to reduce the risk of pressure ulcer formation further. Additionally, when required, Toto® Cradle is implemented to give the ‘low and slow’ repositioning they require, preventing fast or dynamic movements, whilst supporting pressure area care.

The feedback from these workshops was overwhelmingly positive, sparking significant interest and prompting many to re-evaluate their practices for this patient group. There is much to learn in the care of patients with dementia, particularly in the prevention and management of pressure ulcers.

Jo de Clercq's innovative methods offer valuable insights and practical solutions for improving the quality of care for individuals with dementia, and we are excited to see the continued impact of these practices in the field.