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10 alternatives to fixation

Deprivation of liberty such as bed rails, waist belts or sedative medication are dangerous for people in need of care. They can lead to serious injuries - in the worst case to death. In most cases there are workable alternatives to custodial measures. In the cover story of the April issue "The Nurse's Sister", nursing expert Siegfried Huhn presents important measures as well as their advantages and disadvantages:

1. Motion sensitive sensors: Nurses receive a signal via sensor mats or motion detectors when a person at risk of falling gets out of bed. However, it can take some time from the signal from the sensor mat until the caregiver enters.

2. Movement light under the bed: When you get up, the light subtly illuminates the floor. This makes it easier to move around freely, as the room can be overlooked. However, this measure is only suitable for people who can walk safely.

3. Split bed rail: This allows you to get out of bed in a controlled manner. People who can get out of bed on their own via the end of the bed still have the security of not rolling out of bed while sleeping. Disadvantage: If the divided bed rail prevents you from getting up, the measure can - depending on the individual case - represent a measure that deprives your liberty.

4. Low-floor beds: Special beds can be lowered to the floor. If you fall out of bed, this significantly reduces the risk of injury. However, such a bed makes it difficult for mobile people to get up on their own. Placing a mattress in front of the open side of the bed can also reduce the risk of injury when falling out of bed.

5. Floor care: If you use large floor mattresses, the risk of falling can almost be ruled out. However, maintenance on the ground can be more complex for the staff. Another option is to put two beds together to enlarge the lying area. Here, too, the risk of falling out of bed is reduced, and acceptance is generally good.

6.Adjustable care wheelchair: A wide range of adjustment options prevent the wheelchair from slipping forward or from tipping sideways from the chair. However, it should be considered: Excessive inclinations that make it impossible to get up represent a measure that deprives them of liberty and requires approval.

7th seat guard: Round-the-clock care makes it possible to consistently observe people at risk of falling and to offer immediate support if necessary. However, this measure is very costly and labor-intensive.

8. Hip protectors: Pants with built-in protective material can significantly reduce the risk of a fracture of the thigh neck in the event of a fall. They are comfortable to wear, but not everyone will accept them. There are also products that protect the head and joints. They are constructed in a similar way to a crash helmet, but easier to carry. There are also acceptance problems with these, and they are not suitable for the night.

9. Stopper socks: Special socks that have anti-slip material under the foot reduce the risk of falling. Slipping or slipping is prevented when getting out of bed or a chair. However, there must be a certain degree of gait security, as otherwise these socks can do exactly the opposite and lead to a fall.

10. Physiotherapy / balance training: Exercise and balance training under professional supervision and guidance significantly reduce the risk of falling. They promote mobility and strengthen the sense of balance. This measure is not suitable in the short term, but shows good results in the long term by maintaining and building muscle.