Restraints put residents at risk for complications like falls, other injuries and incontinence. They restrict freedom and rob residents of their dignity. Further, restraints present a physical and emotional barrier to bowel and bladder continence. Bowel and bladder elimination in our society is considered a “private process”; and adjusting to the need for help during elimination can be quite stressful to your residents. Restraints make this adjustment even more traumatic.
Changes in musculoskeletal ability, cognitive ability and/or balance can create a fear of falling for some residents. To help residents sit and stand safely without using restraints, nursing staff should develop a comprehensive care plan to meet the resident's safety needs.
In our April restraint tip, we clarified The Centers for Medicaid & Medicare Services (CMS) expectations for restraint use and falls, which states that falls alone are not a medical symptom and do not warrant restraint use.
It is likely you have encountered confusion when deciding if a device is a restraint, enabler, or something else. Accurate identification of a device is critical because it will impact your Quality Measure Report, but most importantly it can affect how you address your residents’ care planning needs.
We have a long history of using restraints for the 'safety' of residents to prevent falls and referring to all devices as restraints, but our knowledge has evolved to understand that restraints have potential to cause harm.
As your home attempts to reduce restraints, you may face resistance from family members. Family members often do not realize that restraints are dangerous and can cause pressure ulcers, depression, anxiety, pneumonia, constipation, loss of appetite, bladder infections, incontinent and more.