A Restraint is a Restraint is a Restraint

While postural supports that assist a client to maintain posture are allowed with CCL approval, restraints are not. Licensing takes restraint use very seriously, do you?

Oftentimes providers find themselves with a licensing challenge, simply because they overlooked a restraint in use by a client. An item that limits the use of a body part or movement is a restraint, and these can come in many shapes and sizes. Oftentimes, we only think of restraints as “ties” or vest restraints. Listed below are some items CCL currently views as potential restraints. If you have any of these in your community, review carefully if they may be used for your client.

Lap Buddy

These are slide in lap type pillows that help a resident sit up straight and stay in a wheelchair. Because these limit the ability of the resident to get up, these are restraints.

Merry Walkers

These are walkers with a PVC chair and surround rail that prevents clients from falling. The resident may be fully mobile in these, but because they cannot easily exit the device, it is considered a restraint.

Hip Wedge

Sometimes called a hip “pillow” this is a triangular foam that goes between the resident’s legs and uses a soft tie to keep in place. Held by velcro, some residents can easily exit these, while others cannot. If the client cannot easily remove the device and move, it may be considered a restraint.

Seat Belts

Some wheelchairs have seat belts, much like what is on an airplane. IF the resident is voluntarily using this and can demonstrate full competence to release, some LPAs will allow these without a problem. However, if there is a convoluted release and/or resident is cognitively impaired and cannot immediately exit the wheelchair, it will be considered a restraint.

Bed Rails

A bed rail may never under any circumstances be used to “keep a resident in bed.” Even if the resident will fall out of bed, it is not an acceptable device to restrain a resident. The use of high-low beds, mats on the floor, etc. can be used. Always consult with a medical professional for other devices.


While some residents can successfully exit a reclining type chair, if it is used to keep the resident from getting up, it will be considered a restraint. Routinely evaluate your resident’s ability to voluntarily exit the chair.

Like any assistive device, a physician order is necessary before implementing any program or device for our resident. However, just because the MD wrote an order, or the family signed an agreement for use, does it guarantee licensing will not find it to be a restraint. Always consult with your LPA for approval.

5 Responses to “A Restraint is a Restraint is a Restraint”

  1. What is the point of a bed rail if not for the prevention of falls?!! I don’t understand how it can be against the rules?!!! Please let me know!!

  2. Historically, skilled nursing has the greatest amount of actual data to support that bedrails cause more falls than they prevent. I believe the initial purpose of bedrails was fall prevention. But after decades of documentation involving falls and other mishaps, it was decided that bedrails were more likely to cause injury than prevent it. Bedrails are a good thing for people who already know not to fall out of bed. Residents can use the rails for “postural support” to steady themselves when getting in and out of bed or turning and positioning while in bed. But when a resident lacks safety awareness, bed rails are considered a restraint and can be dangerous.

  3. Very valuable comments Peggy

  4. Hi I have a resident that continues to slide out of his WC hospice suggested using a pompel? Is that considered a restraint? I was told it is not like the triangle it’s smaller and keeps them from sliding forward. Please advise.

  5. Hi! Is a child lock considered a form of restraint?

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