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Restraint as a Last Resort

To Prevent Wandering and Getting Lost

​​​​​We all want safe, compassionate care for those we care about, and those we care for. Sometimes safety requires limiting a person’s activity or behaviour. Restraining a person is a last resort in an emergency or when other things haven’t worked. Many healthcare providers, including Alberta Health Services (AHS), have a Restraint as a Last Resort policy.

When a confused person is at risk of becoming lost or leaving the building the goal is to protect them while allowing as much freedom and dignity as possible. Restraint to limit or stop wandering and getting lost may include codes to unlock doors and elevators. Sometimes changes are made to disguise doors, like painting doors the same colour as the wall, or painting murals (pictures) on doors.

What can be done to use restraint as a last resort?

  • Respond to the feelings instead of only what they’re saying (“you must be lonely”, instead of “you can’t go home”).
  • Redirect in a positive way (“come with me” instead of “don’t go out or there”).
  • Offer positive choices (“would you like a cup of tea, or a glass of water?”).
  • Put photos, signs, names, or familiar objects by the door of the person’s room
  • Put a picture of a toilet on the bathroom door.
  • Have familiar objects in the room (bedspread, quilt, or other items – keep in mind that space may be limited).
  • Provide enjoyable activities.
  • Walk and talk with the person often, provide places to go and things to see and discover.

How Families and Care Partners Can Help

  • Bring in familiar items, and activities the person enjoys.
  • Think about why the person might be wandering (boredom, looking for something familiar). Suggest activities that could help like music, art, gardening, cards, fiddle boards and mats.
  • Walk with the person.
  • Eat and drink with the person.
  • Look at and talk about photos together. Avoid asking the person to remember things. (“This looks like someone’s birthday. You look very happy! I wonder what kind of cake this was.”).
  • Take the person outdoors or away from their room if it’s safe to do so. This helps them to get a break from the surroundings.

Helpful conversations for staff, family, and care partners

  • Look for ways to work together if the person gets upset when visitors leave.
  • What helps the person feel calm and relaxed?
  • What type of music do they enjoy listening to?

Current as of: May 1, 2018

Author: Seniors Health Strategic Clinical Network, Alberta Health Services