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Experts agree that older adults should not be placed in a physical restraint or sedated just because they are old. Use alternatives 1st
. However, if all other interventions (e.g., reminding patients to call for assistance when needed; asking a family member to stay with patients) are not effective in fall prevention, a physical restraint may be required for a limited period. Check the patient in a restraint every 30 to 60 minutes, and release the restraint at least every 2 hours for turning, repositioning, and toileting. vests have caused serious injury and even death.


Using Restraint Alternatives
• If the patient is acutely confused, reorient him or her to reality as often as possible.
• If the patient has dementia, use validation to reaffirm his or her feelings and concerns.
• Check the patient often, at least every hour.
• If the patient pulls tubes and lines, cover them with roller gauze or another protective device; be sure that IV insertion sites are visible for assessment.
• Keep the patient busy, with an activity, pillow or apron, puzzle, or art project.
• Provide soft, calming music.
• Place the patient in an area where he or she can be supervised. (If the patient is agitated, do not place him or her in a noisy area.)
• Turn off the television if the patient is agitated.
• Ask a family member or friend to stay with the patient at night.
• Help the patient to toilet every 2 to 3 hours, including during the night.
• Be sure that the patient's needs for food, fluids, and comfort are met.
• If agency policy allows, provide the patient with a pet visit.
• Provide familiar objects or cherished items that the patient can touch.
• Document the use of all alternative interventions.
• If a restraint is applied, use the least restrictive device (e.g., mitts rather than wrist restraints, a roller belt rather than a vest).