Show restraint when using restraints…
We recently had a lecture on restraints (physical, chemical). The following is MY understanding of it, I could be wrong as always. 🙂
Ideally, nobody would be restrained, but in reality, it is sometimes necessary. However, surveyors will raise an eyebrow if a hospital has a high rate of restraint use. Hospitals are often understaffed, but convenience is never a reason to restrain someone.
Restraints can cause more problems than they solve. Physiologically it can lead to loss of muscle tone, pressure ulcers, etc. Psychologically, it can lead to frustration, agitation, etc. And if a person is really determined to remove the restraint, it may end in the death of the patient due to strangulation or other similar problems. Often times staff are frustrated and short-handed and don't understand why the patient in Room 402 won't stop going into Room 408, for example. It may turn out the problem is that Room 408 triggers memories because of a previous hospital stay, or that the patient in 408 reminds 402 of his mother, or who knows what…the point is, steps should be taken to understand and potentially solve the behavior, before using restraints. Restraints should always be a last resort. Occupational therapists can sometimes be the detectives that figure out why a behavior is happening and taking steps to prevent it, so that restraints don't have to become necessary!!! Like the woman who kept climbing her dresser in the afternoons…it turned out her roommate's daughter had given her mother a crystal to hang in the window, which made beautiful displays on the dresser when the afternoon sun hit it. The woman had some dementia and the crystals were too much temptation for her. Moving the crystal solved the problem and prevented an accident. Only the occupational therapist was able to pinpoint the problem – all other staff hadn't figured it out. (I read about this on th Gerontology SIS Listserv, I was like AWESOME….if my mom ever ends up in a nursing home, it would totally be her with the crystals and rainbows everywhere).
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