Elder restraints can be much more subtle, and complex, than bed rails and seat belts. Consider the mental functioning, and the physical limitations of seniors. Each is unique.

Additional examples for awareness:

Tables and Seat Trays
• Pushing someone in a wheelchair up to a table and locking the chair in position can also be a restraint since it prevents the person from moving about freely. Not only are they snuggled into dining table, but their seat is locked. This can be quite dangerous as a person may push backwards and tip the wheelchair (and themselves) over. Likewise, placing a locking seat tray in front of someone is considered a restraint if it inhibits the person’s ability to get up and/or move.

• Medications may cause somewhat abnormal behavior in elders. They may be confused, fatigued, and cognitively impaired. They may lose an understanding of their surroundings, and respond with an institutional memory or action which is not appropriate for their current environment.

Nurses (and staff)
• Sometimes if person who is a fall risk and is getting up from bed or a chair, a nurse will yell at the person “to sit back down and not get up”. If the nurse does not follow up with finding out why the person is getting up and/or not assisting them with their needs, then this action represents a restraint.

• Older eyes respond more slowly to the glaring lights of institutions and may perceive the shiny, well-buffed floors as slippery, causing many elders to stay put and not move about; another form of restraint.

– John D. Miller is the founder/owner of Home Care Partners, LLC, a Massachusetts business providing private duty, personalized in-home assistance and companion care services to those needing help in daily activities and household functions. He can be reached at: (781) 378-2164; email: jdmiller@homecarepartners.biz ; or online at: www.homecarepartnersma.com