Lap belts on wheelchairs might seem like a good idea in terms of the safety of an elderly person, but sometimes these “seatbelts” can become a nuisance and even a danger, especially if they are not used properly. Studies show that most of the deaths that occur as a result of lap restraints on wheelchairs occur in nursing homes and hospitals, where use of such restraints should be accompanied by the most expertise. The good news is that there are ways to prevent issues from occurring with lap restraints or positioning belts in order to make them safe options, especially if loving caregivers become elderly persons’ advocates.
An Invisible Danger
According to the Minnesota Department of Health, studies show that lap restraints might not prevent injury. They may even cause it. At the very least, they pose a safety hazard. Because of these studies, along with others, the nation is looking to find ways to reduce how often physical restraints are used. This includes both in nursing homes and in home settings. The key to lap belt safety is education about the dangers and the ways to minimize them.
A Medical Prescription
Not just anyone can apply lap belts on wheelchairs. They are considered medical treatments and must be prescribed by a doctor. The doctor is under strict guidelines regarding the use of the belts, including the following:
- Demonstrating the reason that the belt must be used and how it is medical in nature
- Specific circumstances must be enumerated as to when the belt should be used
- Specific time frames of how long the belt should be used must be outlined
Typically, a belt should not be used long term. Every effort should be made to discontinue use as soon as possible. This is to encourage physical independence as early as possible and to protect the patient from reactions to the restraint.
In the past, lap belts on wheelchairs were used much more widely in the United States – a whopping 50% of patients had seat belts in the wheelchairs. Now they are used on only 1 in 10 patients. In European countries, however, only 5 percent of patients use them. This is not because the need for wheelchairs is any lower in these countries or because patients are healthier in other places. Other countries use such restraints more sparingly because they do not consider the practice necessary except in a few cases.
Mental Issues due to Restraints
Technically, many people think of wheelchair restraints as a safety measure. They view it as a way of helping to keep an elderly person secure in a chair. In reality, what this restraint has the potential to do is cause mental health issues. Imagine the degradation and emotional turmoil a person experiences at being “trapped” in a wheelchair with no way out. In addition, some patients can become agitated and start flailing in order to find a way out of the chair. This often ends in injury. In some cases, it even leads to strangulation death as a result of the misuse of the belt. These risks increase dramatically when the patient is not monitored around the clock. The use of these restraints can take away a patient’s dignity. It also hinders the desire to be independent, causing further issues down the road.
Restraints Are Good for Emergencies
The only time that wheelchair restraints are a “good” idea is when there is an emergency situation. This includes times that a patient needs to be kept still for treatment or for special feeding. Beyond that, however, a patient should have the freedom to get up and move around to avoid serious issues, such as a decrease in independence or the ability to move. Using restraints for too long can cause more harm than good. Beyond the mental anguish they cause, falls are an even more imminent danger. This happens when a patient tries to work his or her way out of the restraint.
If a restraint is necessary, the senior and family members have the right to know why. They also need to know for how long they will be used. The person restrained in the wheelchair must be adequately monitored. They should also be consistently assessed in order to determine the necessity for the restraint. This monitoring will also help determine the length of use. While the restraint is in use, it is important that medical professionals look for signs that issues are occurring. These issues could be causing the decline of the elderly person. They could include things like muscle weakness, mental despair, and a decreased sense of independence.
If an elderly person learns that he or she needs a safety restraint on a wheelchair, caregivers can help. They can be advocates in determining the length of time the restraint is necessary. Caregivers can also push for periodic assessments to ensure the elder person’s stability.
Lap restraints have their time and place. A patient’s advocate can ensure safety and well-being during the senior years. This is done by encouraging seniors to enjoy life and independence.
DOWNLOAD AVAILABLE Pederson, J. P. (2014). Wheelchair Restraint Reduction: How Seating Professionals Can Meet Federal Mandates While Providing Appropriate Intervention. Directions, 2014.3. National Registry of Rehabilitation Technology Suppliers. Accessed on June 26, 2016.
Minnesota Department of Health. Safety without Restraints. Available at http://www.health.state.mn.us/divs/fpc/safety.htm. Accessed on June 26, 2016.