It is our belief that Residents have a right to be self-determining. Risks are part of life, and as such, we would prefer an individual to move about independently and encounter a reasonable amount of risk rather that to be restrained in any manner and be totally dependent. As such, the Home has followed the Best Practice Guidelines (BPGs) from the Registered Nurses Association of Ontario (RNAO) and is restraint free.

Each Resident will have their fall risk determined at the time of admission, every 3 months and as needed. If a falls risk is present, appropriate fall risk interventions will be suggested (i.e. Falls mat, tabs monitor, clipped call bells, bed alarms, etc.)

Falls Prevention Long-Term Care Home Residents

Falls prevention items are assessed and provided by the facility if deemed necessary. Falls prevention items are funded by the MOHLTC.

Falls Prevention Retirement Home Residents

When a falls device(s) is required or recommended, the Home will to provide price and gain approval to purchase. These items may include raised toilet seats, toilet bars and falls prevention equipment (Alarms, falls mats, etc). These items can be purchased by the Home and billed to the Residents account.

Mobility Aids

Mobility equipment may be required for safe ambulation or fall prevention, such as a walker or wheelchair. Mobility equipment is not provided for long-term use (30 days only) by Long-Term Care or Retirement Homes. To ensure comfort and safety, custom fitting for walkers and wheelchairs ensure each unique need for the Resident is appropriate.

Required mobility equipment must accompany new Residents on admission. This equipment may belong to Resident or may be rented through a vendor (such as: Motion, True North, Home Health etc.). This includes admissions arriving from hospital, as staff must be able to get Resident’s to dining room for meals etc. The Home does not provide walkers or wheelchairs for ongoing use. Arrangements for rental equipment and/or assessments for purchase of equipment must be made within 30 days of admission. Very limited equipment is available (in emergency) for short term use until appropriate rental or purchase can occur. Temporary equipment may not be available for all Residents depending on Residents size/weight.

There is government funding available through the Assistive Devices Program for purchase of this equipment, which includes wheeled walkers and wheelchairs. ADP assessments may be completed within the Home after admission or as mobility needs change. Please refer to the ADP section on the website.

Restraint Use

There are three types of restraints: physical, chemical and environmental.

  • Physical restraints limit a Resident’s movement
  • Chemical restraints are any form of psychoactive medication used not to treat illness, but to intentionally inhibit a particular behaviour or movement
  • Environmental restraints control a Resident’s mobility

While a Resident, POA/SDM, family member, or legal representative may request that a restraint be used, the Home has the responsibility to assess and develop a plan of care that follows the Ministry of Health and Long-Term Cares Acts and Regulations.

The Residents bill of rights states “Every Resident has the right not to be restrained, except in the limited circumstances provided for under this act and subject to the requirements provided under this act”. Which indicates that Restraints are only to be used when immediate action is necessary to prevent serious bodily harm to the person or others. This is assessed by Registered Staff (RN, RPN), utilized only after all alternatives have been exhausted, and is removed and reassessed continuously. The College of Nurses of Ontario (CNO) states: Restraints should be used only for the shortest time when prevention, de-escalation and crisis management strategies have failed to keep the individual and others safe.

Fiddicks has a responsibility to provide care and services that attain the highest physical, mental, and psychosocial wellbeing for each Resident. This does not include the use of restraints and is why the Home is restraint free.

Alternatives to Restraints

  • Bed in lowest position, or proper position for transfers
  • Call bell within reach or pinned to Resident and demonstrate how to use
  • Half side rails for bed mobility
  • Daily routines
  • Proper lighting in the environment
  • Environment that is free of clutter
  • Proper footwear
  • Toileting schedule
  • Medication reviews
  • Physio or Occupational therapy
  • Exercise program
  • Turning and repositioning
  • Encourage participation in activities of daily living
  • Mobility devise in locked position at bedside if appropriate
  • Assessing for basic needs such as hunger, pain relief, heat, cold
  • Assistive aids (glasses, hearing aids)
  • Socializing and activities
  • Use simple commands
  • Involve family in planning care
  • Use diversion, distraction, redirection, or relaxation techniques
  • Monitoring alarms
  • Scheduled naps or downtime
  • Appropriate seating
  • Wheelchair modifications

Bed Rails

Bed rails are only used when the assessed need for bed mobility is present. The Rehab Coordinator will assess each Resident on admission and ongoing to determine if bed rails are required for bed mobility. This includes assessing current bed rail usage (if a Resident can no longer use rail to perform independent movements while in bed, the rail will be removed). Bed rails are only used for a Residents bed mobility and are not used for falls prevention.