|
Presenting Behaviours |
Examples of Suggested Alternatives |
|
Falls |
• Medication review • Toileting regularly • Quad exercise: mobility/ ambulation • Routine positioning (Q2H) • Increased participation in ADL • Pain relief/comfort measures • Normal schedule/individual routine • Assess for hunger, pain, heat, cold • Glasses, hearing aids, walking aids easily available • Increase social interactions • Redirect with simple commands • Call bell demonstration • Involve family in planning care • Diversional activities: pets, music, puzzles, crafts, cards, snacks • Scheduling daily naps • Alarm devices- bed/chair/ door • Clutter free rooms • Mattress on floor/lower bed • Non-slip strips on floor • Night light • Helmet • Acceptance |
|
Cognitive Impairment e.g. dementia |
• Toileting regularly • Normal schedule/individual routine • Assess for hunger, pain, heat, cold • Label environment i.e. bathroom door • Increase social interactions • Redirect with simple commands • Gentle touch • Assessing past coping strategies • Involve family in planning care • Diversional activities: pets, music, puzzles, crafts, cards, snacks • Reminiscence • Scheduling daily naps • Pacing permitted • Alarm devices- bed/chair/door • Clutter free rooms • Night light • Glasses, hearing aids, walking aids easily available |
|
Acute Confusion - delirium |
• Medication review • Work-Up for underlying cause- see Pre-Printed Orders • Pain relief/comfort measures • Glasses, hearing aids, walking aids easily available • Toileting regularly-start q2h • Normal schedule/individual routine • Assess for hunger, pain, heat, cold • Label environment i.e. bathroom door • Increase/decrease social interactions • Redirect with simple commands • Gentle touch • Assessing past coping strategies • Involve family in planning care • Scheduling daily naps • Alarm devices- bed/chair/door • Clutter free rooms • Night light |
|
Agitation |
• Mobility/ambulation/exercise routine • Routine positioning (Q2H) • Medication review • Pain relief/comfort measures • Toileting regularly • Normal schedule/individual routine • Assess for hunger, pain, heat, cold • Increase social interactions • Redirect with simple commands • Relaxation techniques (tapes, dark environment) • Gentle touch • Assessing past coping strategies • Involve family in planning care • Diversional activities: pets, music, puzzles, crafts, cards, snacks • Scheduling daily naps • Pacing permitted |
|
Wandering |
• Assess for hunger, pain, heat, cold • Buddy system among staff/consistency • Label environment i.e. bathroom door • Increase social interactions • Redirect with simple commands • Assessing past coping strategies • Involve family in planning care • Diversional activities: pets, music, puzzles, crafts, cards, snacks • Tape (stop) line on floor • Alarm devices- bed/chair/door • Clutter free rooms • Night light • Room close to nursing station • Glasses, hearing aids, walking aids easily available |
|
Sliding |
• Consults to OT/PT • Routine positioning (Q2H) • Pain relief/comfort measures • Call bell demonstration • Wedge cushions/tilt wheelchairs (consult OT/ PT) • Non slip cushion (consult OT) |
|
Aggression |
• Medication review • Pain relief/comfort measures • Assessing past coping strategies • Normal schedule/individual routine • Assess for hunger, pain, heat, cold • Increase/decrease social interactions • Relaxation techniques (tapes, quiet/dark room) • Involve family in planning care • Pacing permitted • Soothing music |
|
Pulling out invasives/tubes |
• Pain relief/comfort measures • Increase social interactions • Redirect with simple commands • Call bell demonstration • Stimulation/meaningful distraction • Explain procedures/treatments • Gentle touch • Involve family in planning care • Camouflage tubing on IV • Abdominal binder over PEG • Change IV to intermittent asap • Arm splint (prevent elbow bending) |
|
Unsteadiness |
• Mobility/ambulation/exercise • Medication review • Increase social interactions • Call bell demonstration • Scheduling daily naps • Clutter free rooms • Mattress on floor/lower bed • Non-slip strips on floor • Night light • Acceptance of injuries • Glasses, hearing aids, walking aids easily available |
Suggestions to Prevent or Limit the Use of Restraints
Clinical Management
Promoting Safety: Alternative Approaches to the Use of Restraints
Point of Care Resources