mbld3207 Asked July 2017
How effective is the Lap Buddy cushion to help keep a loved one in their wheelchair?
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Mom is living in a memory care facility close by. She is very weak and cannot walk alone at all. She was alone for a few minutes (whole different issue) and had time to get up from her wheel chair and fell backwards hitting her head on the floor. After visiting with the director I ordered her a lap buddy cushion. Mom loves it and I found a way to attach it on one side so it "swivels" out when needed but is secure while she is seated and will force the staff to use it for her. Falls come naturally no matter how much supervision there is, but I'm hoping this will help us all feel more secure! Have any of you had experience with the Lap Buddy type cushion and did it help?
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If a person of your mother's age and physical condition would, all things being equal, be able to move the buddy off her lap and rise unhindered by it, then it's not a restraint. If she can't figure out how to do it, because she has dementia or some other sensory or mental impairment, well you can't help that, can you?
One thing to bear in mind, though. If your mother can't in fact get up when this thing is in use, and she either can't or won't use a call button, then she must be attended to far more frequently than when she was able to move around freely. Otherwise you have a frail elder potentially left helpless and trapped in discomfort or distress. I hope the facility's thought this through.
This is what they had to say;
What Is a Restraint?
A restraint is anything that hinders movement or restricts freedom.
Years ago, restraint use was much more common and included extremely restrictive restraints such as straight jackets and vests. While these restraints aren't used today in nursing homes, it's important to recognize that other equipment can act as a restraint even if the goal in its use is to keep someone safe.
Examples of Restraints;
Lap Buddies
A lap buddy is a cushioned devise that fits in a wheelchair and assists with reminding a person not to get up by himself. Lap buddies can also be used to help with positioning if a person tends to lean forward in his wheelchair and is in danger of falling out of the chair.
Dangers of Restraints
Let's put ourselves in the place of the person with dementia. Perhaps she needs to use the bathroom or stretch her legs, or she's feeling hungry or bored. When she tries to move around, she's unable to and consequently, can't tend to that need.
Restraints affect a person's mental health. People who have been restrained report feelings of depression, fear, anger, humiliation, anxiety, and helplessness. Not surprisingly, a person might also experience a significant negative reaction to a restraint such as screaming, fighting and extreme agitation which can be traumatic for that person and her caregiver.
According to the March 2006 issue of the Journal of Medical Ethics, the negative consequences of restraints include:
bruises, decubitus ulcers, respiratory complications, urinary incontinence and constipation, poor nutrition, increased dependence in activities of daily living, impaired muscle strength and balance, decreased cardiovascular endurance, increased agitation
increased risk for mortality caused by strangulation or as a consequence of serious injuries—for example, fracture, head trauma.
In addition to those physical consequences, restraints are frequently ineffective and don't prevent falls. Rather, research has shown that injuries are escalated because of the force the person needed to use to escape from the restraint.
(Me) I'm not trying to rain on the Lap Buddy parade but I've had patients almost hang themselves on restraints. I guess it's a matter of perception. The caregiver may not perceive it as a restraint but, if the patient perceives it is holding them back and becomes agitated because they can't figure out how to remove it, then it may do more harm than good.
It would need to be evaluated on a case to case basis.
Just my 2 cents.
My aunt just passed away in a facility two weeks ago, in a different state. She could still walk. My cousin said she was walking into the family room, fell and hit her head which killed her.
They both have/had Alzheimer's. My mom's was much farther along at stage 7, my aunt was about stage 5.
I think restraints are a difficult subject as they may be helpful for safety but can also be easily abused. It is such a fine line.
I think these things are to be evaluated on a person by person basis and there is no "one size fits all". Mom and I are satisfied for now with this friendly Lap Buddy for her, and the facility is willing to have her use it.