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Elderly person requiring restrains (belt)
Good day everyone. I was wondering about belt restraints nursing homes uses for the elderly and the number of accidents related to wheelchairs.

Are accidents involving wheelchairs and elderly persons a significant problem in today's nursing homes? I was just wondering what are the causes of them falling them from wheelchairs and possibly even is there a rising number of accidents related to wheelchairs?

Can any doctors help me on this?
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From what i understand most of the falls come from an elderly person that does not walk good, and they try to get out of bed and fall, if they are not restrained, they must have a DR order to have a restraint.I have not heard about the accidents with the wheel chairs, maybe someone can enlighten us on this  jo
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Hi, my late dad had posies (restraint) at night, so he would not get out of bed.  He was never restrained in his wheelchair.  My mom has one on her sitting moving chair, she no longer can walk, but she tries to get up.  Hope this helps.  
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There have been incidents in the past where an elderly person slid down out of the chair with a seat belt on and was strangled.Some of these incidents in the past ended in death, otheres ended in the patient suffering anoxia(lack of oxygen to the brain,

To prevent this form occurring, the regulations now require that no form of restraint should be used, thus the development of the seat and bed alarms.

It is the same reasoning for half side rails on a bed versus the full side rail. All of these regulations and safety measures are the results of deaths or severe injury suffered by others in the past.        
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Dianecarbo, this makes a lot of sense, also thanks and also  thanks to kobuk what you said makes sense   jo
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547368 tn?1440545385
Dianecarbo is correct. The use of any restraints, either chemical or mechanical requires a physicians order.

There are many new devices such as she describes, bed, seat and mat alarms. These tools were developed with the safety of our elderly in mind and due to tragic accidents and occasional misuse. Staff must be especially alert and quick to respond to any of these alarms or they are useless. Poesy restraints are rarely used. In most facilities in our state they are banned.

Chemical restraints are often used in conjunction with alarm devices for the residents that are still felt to be a danger to themselves.

Tuck  



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314833 tn?1263263099
I know some persons that are in wheelchairs seem not to be able to stop their selves from sliding down...causing them to fall out of their wheelchairs...This is the same for those who have cognitive disabilities. The restraints can also be called pelvic positioning device.
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They should consider drugs such as antipsychotic drugs (which destroys the frontal part of the brain) for the Elderly (used for behavior) as restraints, too. My boyfriend was given Haldol which caused hemiplegia and his death within 2 months.
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Mom has fallen out of her wheelchair twice while wheeling it with her feet resulting in big head bumps and bruising.  What should we be demanding to prevent these accidents. Making sure her chair always Locked, seat belts but I am told those aren't all of withon dr. Orders and he said no.  Seeing her bruised fave is disturbing what can be done to stop these falls. She is in advanced stsges of vascular dementia and seems to have a need to roll her chair up and down the hall.
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547368 tn?1440545385
Hi Marigold,

Welcome. I'm so sorry to hear about your mom's fall. My heart goes out to you!

What a good question - I wish you would have began a new thread (question). It would allow better visibility and responses. I almost didn't see it. Sorry.

Sadly the choices to avoid falls in your mom's case are not many - and bring some difficult choices. I've seen dementia patients that need to be mobile or move, just as you say you mom does.  If you take away that ability than you have to consider the emotional effects on mom. So locking the wheelchair or insisting she be placed in a chair she cannot move may be a very harsh option.

Do I understand you to say that her physician is against physical restraints?  I understand his concern. Some years ago the government (federal and state) came down hard on any device, even a lap belt that prevented or restricted motion of a resident - they are all now called restraints.  This happened for the most part (not exclusively) from a some bad incidents - and actually some deaths - most in not so great facilities.

The government also included some medications as chemical restraints - justifiably so. Chemical restraints are also referred to as a "Psychopharmacologic Agent", "Psychotropic Drug" or "Therapeutic Restraints" in certain legal writing. Drugs that are often used as chemical restraints include benzodiazepines, antipsychotics, and Dissociative anesthetics.

Seat or lap belts can help, but if they aren’t easily removable, they’re considered a restraint, and therefore many facilities won’t use them. Investigate what's available. If your mom can take the belt off, for instance if it's Velcro it  - shouldn't be considered a restraint. Ask lots of question.

Chair-exit alarms can also help, but they’re dependent on a very quick response. If the facility is smaller and/or well staffed this may be an good option. It simply means when weight is taken off the seat an alarm rings. Your mom's wheelchair should be equipped with one at the very least.

Restraints when appropriate and needed can be utilized with a physician's order. I certainly would not want to see your mom medicated (chemical restraints). It's not warranted.  

Your mom has a Care Plan that addresses her fall risk - along with the "plan" to avoid falls. Make sure you're aware of it and have input. Your mom has a right to be safe, and protected from falls.

Last but not least see the S.W. and whom ever is in charge of developing Care Plans. Make sure you express your displeasure that she is falling and demand that she be protected. Someone must be your mom's health care POA. It's up to that person to be her advocate. If that's you, all the better. Be very involved and visible, days and evenings.

I know the heartbreak of a declining parent. Seeing your mom's facial bruising must pull at your heart and cause sleepless nites. I'm so very sorry. I've also been in the health care providers position. Good facilities listen to families - especially those with squeaky wheels.

I hope something I have said will be helpful. Please keep in touch and let us know how things are going.

My Best to You and Your Mom,
~Tuck
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