Medicine>>>>>Geriatrics
Question 5#

An 80-year-old nursing home patient has become increasingly confused and unstable on her feet. On one occasion she has wandered outside the nursing home. In considering the issue of restraints for this individual,

which of the following is correct?

a. A geri-chair would provide the best approach to safety and restraint
b. Physical restraints are the best method to prevent falls
c. Restraints cause many complications and increase the risk of falls
d. Sedative medication should be used instead of restraints
e. Wrist restraints are more effective than ankle restraints

Correct Answer is C

Comment:

Restraints are being used less and less in nursing homes as their complications and alternatives become more appreciated. The four Ds— deconditioning, depression, disorientation, and decubiti—are all complications of restraints. A geri-chair is just another form of physical restraint and promotes the same difficulties. Effective alternatives to restraints usually require an individual care plan. In this case, alarm bells for the institution’s exits and evaluation of the patient’s gait would be important. All physical restraints, either wrist or ankle restraints, should be avoided if possible. Sedation leads to complications such as pneumonia and may, in fact, also promote falls.