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Restraint Definition and Examples

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

April 7, 2015

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Question

Can you explain the definition of restraint and examples of restraints?  

Answer

The definition of a physical restraint is any manual method, 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.  I will give you several examples of restraints.  A reclining geri-chair would be considered an example of a restraint.  An upright geri-chair with a lap tray, any standard wheelchair or any other seating that prevents the resident from rising from the seat due to physical functioning deficits; basically what we mean by that is if you have a person who can stand up, but if you change the angle at the hip such that it is a very acute angle, they are not able to stand up.  You make your seating system or your wheelchair such that you really recline the patient and you wedge them in there, that could be considered a restraint, even though they do not have a lap belt, a lap tray, or anything else.  Other examples would be devices that hold the resident in the chair that cannot be easily removed by the resident like a seatbelt that is not self-releasing.   You can even have a self-releasing seatbelt that can be considered a restraint if the resident is unable to remove it in a timely fashion.  Lap buddies are often times used because a lot of facilities and nursing homes will think they could just use a lap buddy because they can pull it out of there, but in fact it is a restraint if the resident cannot remove it in a timely fashion.  Lap trays that the resident cannot remove are considered restraints.  Again that could be one that attaches in the back as a full lap tray or it could even be a half lap tray.  It could even be a half lap tray that swings away, if the resident is not able to swing it away. Using bed rails to keep a resident from voluntarily getting out of bed and placing a resident in a wheelchair close to the wall to prevent rising are additional examples. When you are considering a restraint, you always want to consider is it taking away some movement or some ability to move that the patient might have?  If you are restricting their freedom of movement, then yes, it would be considered a restraint.  For example, there is an individual, lying in the bed, who is contracted.  All four extremities have no active movement.  In order to get in and out of that bad, they are a total lift.  You physically need a lift them out.  If you place those bed rails up, are you taking away any sort of function or movement of that patient?  The answer would be no.  In that case, they are not considered any sort of restraint.

 


kathleen d weissberg

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

In her 30+ years of practice, Dr. Kathleen Weissberg has worked in rehabilitation and long-term care as an executive, researcher, and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; and has spoken at national and international conferences. She provides continuing education support to over 40,000 individuals nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner, a Certified Montessori Dementia Care Practitioner, and a Certified Fall Prevention Specialist.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Action Committee and adjunct professor at Gannon University in Erie, PA. 


Related Courses

Supporting the LGBTQ Senior in Healthcare
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4096Level: Intermediate2 Hours
  'Excellent research backed information'   Read Reviews
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Dementia Management: Techniques for Staging and Intervention
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Recorded Webinar

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Course: #3649Level: Intermediate2 Hours
  'Very relatable'   Read Reviews
This seminar provides an overview of types of dementia including characteristics at each stage, protocols for staging clients with dementia and related treatment strategies. Documentation and treatment planning based on dementia staging results is reviewed. Behavior management and communication strategies for this population are discussed as well as techniques for nursing to follow. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Bullying Among Older Adults: Not Just a Playground Problem
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

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Course: #4692Level: Introductory1 Hour
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In this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.

Fall Management: Evidence-Based Interventions for Screening and Intervention
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Course: #3704Level: Intermediate2 Hours
  'Good basic info, focus on few key elements of balance training for community based individuals'   Read Reviews
This session will review evidence-based screening and intervention strategies applicable to a balance and falls management program including research-based exercise programs, environmental modification, patient and caregiver education and balance retraining activities. Falls management program rationale and implementation is also discussed as well as interdisciplinary techniques and strategies to reduce fall risk in the elderly. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Tools to Optimize Quality Alzheimer’s and Dementia Care: Tackling Loneliness and Social Isolation
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This session will review practical and cost-effective strategies care providers can implement to impact these areas. Following the framework of person-centered care, providers will hear about meaningful and purposeful activity, sensory, technology, and wellness strategies they can implement to mitigate the potentially harmful effects of isolation. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

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