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Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

The Kosher Gourmet by Megan Gordon With its colorful cache of purples and oranges and reds, COLLARD GREEN SLAW is a marvelous mood booster --- not to mention just downright delish
April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review July 12, 2005 / 5 Taamuz, 5765

Restraining Mom to protect her

By Jan L. Warner & Jan Collins


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http://www.JewishWorldReview.com | Q: My mother broke her hip and, after surgery, was discharged to a nursing home for rehabilitation. Since her surgery, she has become very combative and now suffers from memory loss. She continuously tries to get out of bed by herself, has fallen twice, and has had several near-falls. My brother and I have hired round-the-clock sitters, who are very costly. We have tried to get the nursing home to restrain her physically and chemically for her own protection, but are told that federal law prohibits restraints. If that's true, is there no way to protect our mother?

A: It appears that you've been told only half the story. To prevent the unnecessary and non-emergency use of restraints when other treatment would be more appropriate, federal and state mandates forbid the use of physical and chemical restraints as discipline for a resident or as a convenience for the facility. They also forbid physical and mental abuse, corporal punishment and involuntary seclusion.

That said, barring emergencies, physical restraints are authorized to ensure the physical safety of the resident — or other residents — so long as prescribed by a physician who specifies the circumstances and the length of time the restraint can be used. The documented circumstances must be such that 1) there is a substantial risk of imminent harm by your mother to herself or to others, and 2) less restrictive means of preventing harm are insufficient.

Similarly, medications with mind-altering effects on a resident can only be administered when ordered by a physician and part of a written medication plan; and the attending physician must review the resident's medication regimen at least every 30 days.

There must be a written doctor's order detailing the reasons for the restraint(s), but if the physician's order is by telephone, the physician must examine the resident and sign a written order within 12 hours.

If there is an emergency where imminent harm would result and the physician can't be contacted, the facility may temporarily restrain a resident until a physician's authorization is received. In no case, however, should a resident remain physically restrained or in seclusion for more than 24 hours without a physician's order. During these periods, a health professional is required to see the resident at least every 12 hours to monitor his/her condition, and appropriate facility staff should check and chart the resident's physical and mental condition at least once per hour. Residents should also be allowed to use the toilet according to their needs, to bathe, and, of course, to be fed and hydrated.

In any event, the use of restraints and/or seclusion can't exceed 24 hours, at which time a doctor must be consulted to determine if continuation is necessary.

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We suggest that you schedule a meeting with the administrator of the facility, the facility physician and the head of your mother's care team to discuss this critical issue. Also, check your state's statutes and regulations because some allow restraints if there is consent by a properly authorized family member and a physician's order.

Because of the federal and state mandates, the fact is that facility physicians may not actually go to the facility regularly, and for liability reasons, some facilities shy away from restraints — even in appropriate situations.

For obvious reasons, neither residents nor authorized family members should consent in advance to the use of restraints that may be included in the facility admission agreement, nor should they sign admission agreements containing language that purports to release the facility from accountability should the resident be injured during the restraint process, as both are contrary to public policy and may violate state consumer protection laws.

Every weekday JewishWorldReview.com publishes what many in in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.

JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.

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