Wednesday, August 12, 2009

Restraints

There was a time, when I first went into nursing, that we used restraints (aka lap buddies, posey restraints, etc.) on pretty much anyone who fell, tried to get up without assistance, climbed out of bed, etc. in a nursing home. But, fortunately, the regulations and views changed over the years and we started to try to find better ways of keeping people safe. Why? Because restraints aren't really safe. First of all, they aggravate people more than calm them. Imagine someone putting a cloth belt on you, and telling you that you had to wait for assistance to do anything you wanted (like go to the bathroom). Then, imagine waiting, and then waiting some more.
You start to feel claustrophobic from not being able to move very much, and you pull at it. Then, you try to slide under it (or climb over it). What if you get partway out and get stuck? Or choke yourself? Or fall with even more force than you would have, because you've been fighting the restraint so hard?
Now, imagine that you can't always tell someone what you want (or need), so they treat your behavior with a medication, so that you quit trying to climb over or under the restraint.
Now you're groggy, more confused, and everyone is doing this TO KEEP YOU SAFE.
Sounds awful, doesn't it?
Most long term care facilities/nursing homes, don't have restraints anymore, or a very few. Staff tries to be more vigilant. Medications are reviewed (and reduced) more. Clever interventions like regular TOILETING (imagine that) actually reduced the number of falls and injuries.
Which is why, if you saw them tie your parent to the bed, in the hospital, you won't see it in a nursing home (or rarely).

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