RESTRAINTS IN NURSING HOMES
What is a restraint? Well, I am certainly not going to try to define what a restraint is as facilities and health care providers may disagree on a clinical definition – but, I can tell you the purpose of a restraint in a skilled care setting like a Nursing Home or Hospital. A restraint is any physical device used to prohibit or discourage a certain kind of movement. Example – a Bed Rail (or set of bed rails) is considered a restraint as they are designed to prevent residents from getting out of bed alone. A Meri-walker, or walker that goes 360 degrees around a resident, and includes a chair, strap etc – is also considered a restraint as it prohibits certain activities, such as ambulating through doors, stairs etc.
Many families with loved ones in a nursing home, may have to consider whether certain “restraints” should be used for their loved one – and many are in fact, appropriate (when their use is properly supervised)…. so, as that family member, what should you be thinking about regarding the restraint?
1. Why is it being recommended? (To remedy past falls, or mistakes or incidents?)
2. Who is recommending? (Physician or Nurse)
3. Are they used throughout the facility?
4. Does the restraint restrict movement or simply change it?
5. Does your loved one have the cognitive ability to understand the dangers of the restraint?
6. Who is the maker – manufacturer? Any recalls?
7. Is staff trained on how to monitor or handle the use of the restraint?
When called about an incident or fall involving your resident – ask if the restraint was involved? Is there a restraint commitee that discusses the device and your loved one? Ask to attend their discussions.
These are important issues to discuss because many times injuries will occur during the use or mis-use of the restraint, and the facility may say “but the family agreed we could use it” – and yes, that might be the case, but if you didn’t fully understand the restraint, its uses, etc, then your agreeing to its use, isn’t worth much at all!