Question
How would you approach a situation when an actual client is requesting something that may be considered a restraint? For example, someone, who has had a stroke, requests a full lap tray because they find that more comfortable, even if they cannot independently remove that lap tray. How might you address that?
Answer
That is a great question and it comes up more times than you would imagine. Oftentimes it is not client, it is family. Particularly with our elderly clients, adult children who cannot come to visit as often and do not really understand what the functional abilities are of this person request something that is considered a restraint. I think this is where it goes back to the policy of your facility and your protocol in how you want to handle that.
How I have always handled that the past is by giving that person the risks of that piece of equipment and the benefits. We provide that to them in writing. Then asking them if they fully understand this. We could try this instead or that instead. You give them different options. If they say absolutely not, this is what I want, then you say okay you have been educated.
I know the facility that I work in we had them sign off in our care plan that they were educated to risks and benefits, and this is in fact what they wanted in place. Again whether or not signing that would hold up in a court of law if something happened, that is another topic because I have never had to go that direction. We always educated and had them sign off that they understood what they were embarking on.
I will tell you honestly, in the many years I have practiced in long-term care, I have only had one situation where I absolutely could not convince the family otherwise. That one case is where the person tried to get out of the restraint, ended up falling, broke a hip, etc. Almost every other time, we were able to say let’s at least try it. Give me three days and if it really does not work, then we will go your direction. Every single time, the interdisciplinary team seemed to know what the resident needed.
