It is true that CMS has taken a very firm stand against the use of physical restraints. The use of restraints is captured on the MDS and reviewed by CMS with the resulting emphasis on reducing restraint use to less than 3% nationally by 2011. You will see data stating that that national goal has been met. It is true that the use of physical restraints has been reduced.
However, the use of alarms is sky rocketing. Unfortunately their use is NOT captured on any government document and therefore has not surfaced as a national "area of concern". The negative effects FOR THE RESIDENT as a psychological restraint are just starting to be discussed.
I think the saddest aspect of this approach is these devices are used with residents who already have lost some or all of their cognitive functionality. Not only have they lose their ability to think clearly but their dignity is drastically reduced with this attempt to "help" them.
The answer to mitigating falls lies in understanding the person's motivation for moving. After all, if they didn't move, they wouldn't fall! Unless and until we focus on determining the person's reason for moving AND then use our skills to help them meet their need, not STOP them as we have done in the past, we will continue to be unsuccessful in managing falls.
My approach is truly centered on the person. I work with caregivers across our nation to increase assessments that focus on WHO the person is as a social being. Only when we know who they are, not simply their medical challenges, will we be able to address the motivation that prompted the behaviors that lead to a fall. However, once the person is put into the picture, we have more tools than we can ever imagine to capture their attention, redirect their attention, manage (not control) their behaviors and begin to realize success in reducing falls by addressing the motivation to move.
I stand ready to talk with you as you work toward a truly restraint free environment in which residents aren't physically or psychologically restrained while providing days with purpose and less falls, for those entrusted to our care.
Please feel free to enlist my help via this blog as you address the biggest challenge we face in long term care - residents who fall.