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In a message dated 4/28/2004 5:19:46 AM Pacific Daylight Time, [EMAIL PROTECTED] writes:
I donât think itâs a matter of seeing those exact words in print but a concept of evaluating the âeffect of the deviceâ on the resident. One has to make a determination that a resident has the cognitive and/or physical ability to remove a device to perform whatever task they normally would be able to do. Many people who can remove something as a âbehaviorâ cannot put the âtask together in their mind to perform same when it comes to having âintent and purposeâ. Also there is more to movement than transfer and ambulation. There is readjusting weight in chair, adjusting clothing, scratching to name a couple. Also, letâs not let the semantics of the word âcommandâ raise red flags as certainly no one is âcommandingâ anyone but if the resident cannot perform the task when you ask them to demonstrate how to remove the device there is a reasonable possibility they can not do it unaided when they âwant toâ. When my staff had trouble with this I asked the womenâHow would you like to be sitting in your room with a velcro lap tray, your skirt up around your waist and be unable to remove the device to pull your skirt down? I asked the men: Same scenario but zipper down. I think the idea is âif the resident is dependant on staff to remove and/or assist with removal of device no matter how minor even verbal cueing it has the âeffectâ of restraining.
I feel the "effect of the device" has little to do with whether or not it can be removed. That's only valid if it prevents them from doing something they are able to do. Once again, if they could take it off and still not ambulate, or transfer, it is not a restraint. Conversely, if they cannot take it off, and yet are able to transfer or ambulate, but cannot due to the belt/lap buddy/lap tray being in place, this is a restraint.
True, "there is more to movement" than ambulation and transfer, I simply used these two examples for brevity, applying these two ADLs for siderails as being restraints.
I successfully argued these points at IDR 7 months ago.
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something,
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