Can a nursing home tie my dad to a wheelchair if he has had episodes of wandering around the facility?
"Can a nursing home tie my dad to a wheelchair if he has had episodes of wandering around the facility?"
-Sam, Memphis, TN
After a recent post about a nurse tying a resident to a wheelchair with a bed sheet, I received several emails from concerned people regarding the use of restraints in nursing homes with their loved ones. Restraints among nursing home residents are only permitted when a physician orders them to protect the resident and with the approval of the resident or his representative. Federal law prohibits nursing homes from using restraints for the convenience of the facility or as a way of punishing the patient. (Code of Federal Regulations, 483.13(a).
A restraint is considered to be: "any manual method or physical or mechanical device, material or equipment attached or adjacent to the resident's body that the individual cannot remove easily which restricts freedom of movement or normal access to one's body." According to this definition, almost all medical equipment found in a nursing home could be used in this capacity to restrain a patient.
Rather than rely on restraint devises, staff in the nursing home should re-direct patients who have a tendency to wander. If staff are unsuccessful in their attempt to re-direct, they should use electronic devices such as bed / chair alarms to alert them when a patient begins to move from the area where he was sitting / sleeping and the help the staff keep track of his whereabouts.
Compared with the nursing homes of the past, the use of restraints in nursing homes today is relatively uncommon. Much of the reduction in use of restraints can be credited to studies that have demonstrated that the use of restraints in nursing home patients can be not only de-humanizing, but also downright dangerous.
Restrained nursing home patients are at risk for injury in the following situations when restraints are used:
- Falls
- Pressure ulcer / decubitus ulcer / bed sore
- Strangulation
- Loss of mobility
- Reduction of bone and muscle mass
- Incontinence
- Constipation
- Increased stress
Related:
Nursing Homes Curtail Use Of Physical Restraints With Residents
Nursing Home Sued After Resident Fractures Both Hips In Separate Falls
California Nursing Home Issued Most Severe Citation After Patient Fall And Death
