1. STAY ACTIVE
STAY INDEPENDENT
STAY ON YOUR FEET

2. Module 4: Additional areas of concern

3. Learning objectives
Increased knowledge on the definition of a restraint as well as alternatives to using them
More understanding on communicating with residents with dementia and how to decrease their fall risks
Increased knowledge related to safe toileting practices

4. restraints Using the least amount of restraints is the best practice
Address behaviors before considering the use of restraints
Some alternatives to restraints:
bed and chair alarm systems
low beds
moving the resident closer to the nursing station
increased monitoring
regular toileting
assistance from family
Retrieved from: Ref: Safer Healthcare Now! (

5. restraints
Restraints that limit movement or decrease physical activity can:
Cause Confusion
Decrease mobility and muscle strength
Cause physical agitation
Address Behaviours - if the individual is restless/agitated, find out if they are cold, need to use the washroom, dehydrated, lonely, in pain, frightened, have an infection, started on new medication etc.
Alternatives– employees need to use an interdisciplinary (multiple professionals) approach in order to keep work loads reasonable
Retrieved from: Ref: Safer Healthcare Now! (

6. Communication tips for residents with dementia
Use your knowledge of what the resident likes and dislikes, and their daily routine to discover the meaning behind their behaviors
Pay attention to the resident’s non-verbal communication when they are speaking to you
Reassure residents who are agitated and be positive. Remember there is a reason for the behavior
Accept the resident’s reality and do not challenge it. Instead, redirect resident toward a positive thought or activity
Reference: Alzheimer Society. (2010). Day to day series: Communications.

7. Communication tips for residents with dementia
Be aware of your own non-verbal communication
Use clear, plain language but avoid talking down to the resident
Use non-verbal communication with residents who do not understand verbal communication
Use touch when appropriate to show reassurance
Use a positive photograph or video with calming scenes
Speak softly, read to the resident or play music that they enjoy
***CHANGES***
Removed second point for non verbal – we have a no sent policy
Reference: Alzheimer Society. (2010). Day to day series: Communications.

8. SAFE TOILETING
Using safe toileting practices can help reduce the risk of falls
The bathroom should be well lit, especially at night. A night light is a good option to guide residents in the dark
Remind residents not to hold onto the sink, door frame, or any other unstable support when walking to the bathroom. Encourage the use of mobility devices if needed
Residents should be encouraged to use the grab bars on either side of the toilet to help in sitting and/or standing from the toilet. This will provide stability and help maintain balance
Retrieved from: Ref: Safer Healthcare Now! (

9. SAFE TOILETING
Toilet seats need to be at an appropriate height for each resident
Low toilet seats can cause problems for residents when transferring to and from the toilet because they may have difficulty bending down and have less lower body strength
High toilet seats can cause unsteadiness when sitting if the resident cannot place their feet on the bathroom floor
Toilet safety frames, commodes, or raised toilet seats can be used to increase the height of the seat
Always make sure the clamp or locking mechanism on the toilet seat, frame, or commode is secure and stable for use
Retrieved from: Ref: Safer Healthcare Now! (

10. SAFE TOILETING
Applying a toileting schedule can prevent residents with poor mobility and balance from trying to go to the bathroom unsupervised
A call bell should be within easy reach for the residents in case they need assistance
Retrieved from: Ref: Safer Healthcare Now! (

11. Module 4 Quiz

12. Which of these recommendations is NOT an alternative to using restraints?
Monitoring the resident more closely
Moving the residents room closer to the nursing station
Using bed rails when the patient is in bed
Bed and chair alarm systems

13. ANSWER
Which of these recommendations is NOT an alternative to using restraints? c) Using bed rails when the patient is in bed

14. Choose the most correct answer: Restraints that limit movement or decrease physical activity can…. ?
Help a person sleep
Decrease muscle strength
Cause dehydration
Be a positive reinforcement

15. ANSWER
Choose the most correct answer: Restraints that limit movement or decrease physical activity can…. ? b) Decrease muscle strength

16. Which of the following is NOT a tip for communicating with residents with dementia?
Provide reality teaching
Provide reassurance when the resident is agitated
Pay attention to non-verbal communication
Look for meaning behind the resident’s behaviour

17. ANSWER
Which of the following is NOT a tip for communicating with residents with dementia?
Provide reality teaching

18. Which of The following are important communication strategies when interacting with residents with dementia?
Use clear, plain language being careful to not talk down to the resident
Use appropriate touch to provide reassurance
Speak softly, read to the resident or play music
All of the above

19. ANSWER
The following are important communication strategies when interacting with residents with dementia ?
d) All of the above

20. Modules created by: North Bay Parry Sound District Health Unit Please fill out the evaluation form here

21. References
Safer Healthcare Now! ( alls%20Getting%20Started%20Kit.pdf
Alzheimer Society. (2010). Day to day series: Communications.