Alternatives to Restraints

Physical and Emotional Impact: Restraints can lead to injury, agitation, loss of independence, and a decline in mobility. They can also cause feelings of fear, humiliation, or isolation.

Promotion of Well-being: Avoiding restraints helps maintain resident dignity, comfort, and trust.

Legal Protections: Hawai'i law and OBRA regulations specifically protect a resident's right to be free from unnecessary restraints. 

Physical Needs: Provide frequent hydration and toileting breaks.

Emotional Support: Offer companionship and reassurance through the "talk story" (kōkua) approach or by encouraging family visits and familiar items from home.

Environmental Adjustments: Ensure proper lighting and temperature, and use low beds with floor mats for fall safety.

Monitoring and Technology: Use bed and chair alarms to monitor residents without physically restraining them.

Engagement: Involve residents in meaningful activities and adjust daily schedules to match their personal preferences for meals and rest.

Supportive Tools: Utilize adaptive devices like mobility aids, lap cushions, or supportive pillows.

Root Cause Analysis: Always reassess the cause of a resident's agitation, looking for underlying issues like pain, hunger, or loneliness

Observation: Monitor and report any changes in a resident's behavior to the nurse.

Communication: Document which specific interventions are most effective at calming or comforting a resident.

Advocacy: Act as an advocate for restraint-free care whenever it is safe to do so.

Care Standards: Provide care with patience, compassion, and respect (aloha).