Question
What can you do for those that wander and colleagues or family are asking a restraint? Any tips to limit restraint use?
Answer
With regard to wandering, we see a lot of restraints related to wandering. What can we do here? First of all, make the environment as safe as possible. Be aware of safety issues such as obstacles, inadequate lighting, maybe locks on our doors that do not work. If there is an unsafe area, we should probably lock the door behind there. If you think about wandering, oftentimes what we will do is we will put up stop signs. They might say you STOP, because we do not want the person to go someplace. If you think about that signage when you are driving your car, and you stop at a stop sign, what do you do after you stop? You then go. Sometimes it is about making our signage appropriate so that we do not send people to areas that they do not want to go. Maybe the sign should be Out of Order or Detour or Do Not Enter. Those things can help with wandering. We can place the resident’s name and picture on their door. Make sure that everyone is wearing an identity bracelet. In my own little world, I do not really see an issue with wandering. I have been in places where they will say they cannot wander. They have to stay here. Let them wander, just make sure that it is safe for them to do so. If you really do not want them to wander, modify the environment such that they have a distraction. You can put things on the doors like fake window mullions that actually look like a window. Not too many people are going to try to climb out a window. You can camouflage the doors to make them look like library shelves or bookshelves. You can put mirrors on them. You can put dark tiles in front of exit doors for people who have vision issues, but be careful, it might backfire. Those dark tiles typically will look like a hole. Some people would not even go near that and other people will you go over and try to jump over it, and then we have a hip fracture from a fall. You know your patients the best on how to prevent the wandering. We have talked about some of this as well; provide a safe environment and change the resident’s environment so it does not look like a medical type of environment. Make it homey, make it a place where they want to be.
