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He needs the seat belt so he doesn’t try to get out and hurt himself but fallout onto the foot rest. This rule causes him more Harm than the seatbelt. How can we get around them blocking us from using a seatbelt on his wheelchair? Do I need to get a lawyer involved?
In the nursing home

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There are wheelchairs that recline making it much more difficult to get out of.
There are alarms that they attach part of the alarm to the chair and part to the person. If the person tries to get up the two parts will break away and an alarm will sound. This is not a restraint.
There are also pads that can be put on the seat cushion that makes it very difficult to slide out of the chair. (think of the sticky "window walkers" kids play with it is that type of product. This is not a restraint
Trays that attach to the chair ARE considered a restraint.
Belts are also restraints.
Typically the residents that are more apt to try to get out of a chair are placed very near or right at the Nurses Station in the hall so they are watched much more closely.
If the chair alarm has been tried and it has not worked.
If the pad on the seat that is supposed to prevent sliding or slipping out has not worked.
they may ask that a "sitter" be with him so that it is more of a 1 on 1 case
If all else fails it might be possible that a Doctor can order a restraint.
there are circumstances where it might be permitted. But it would have to be monitored closely and documented.
This would be a discussion to have with Administration and try everything possible before resorting to a restraint.
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It depends on how hard azzed the facility is but one possibility would be a tray that is attached to the chair.
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AnnReid Nov 2020
Either our state considered that a “restraint” and wouldn’t permit it, or this MAY be a federal law.

No attached table or tray, and that was almost 14years ago.
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I think it depends on his cognitive abilities - if he only momentarily forgets he can't get up and the seat belt would only serve as a reminder and he demonstrates the ability to remove it if needed then it isn't a restraint. 🤔
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My mother uses a seatbelt when she is in her w/c for safety purposes. I have no problem using it and if she was in a facility I would ask the doctor to write the order and speak to the director of nursing services. Sometimes it is a must to prevent a patient from getting seriously injured or death in my opinion. I am quite sure there are exceptions. When I am in the hospital with my mom, I put the side rails up or place a table on the side of the bed opening and also use the bed alarm.
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In the US, Seatbelts are restraints. Period. Cognitive ability doesn’t change that. It doesn’t make a difference if the seatbelt serves as a reminder, in fact that just proves the seatbelt IS a restraint because it prevents the resident from getting out the chair.
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I'm not saying that you aren't right Worried but that doesn't make sense, if you have the physical and cognitive ability to remove it it isn't a restraint (of course then you probably wouldn't need it)
I'm glad there is some flexibility where I live, although we have laws prohibiting restraints they can be overridden in some circumstances.
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Fran, take a different approach with the DON; go past the nurses and aides and directly to the DON or Administrator.
Approach it from this angle:  you're pleased with the facility (if you really are) but troubled b/c the issue of keeping your son in his wheelchair hasn't been resolved.  You understand the restraint issue, but he needs assistance to remain in his wheelchair (in order to stay in that facility).

Ask what suggestions they have.   PT or OT might also have suggestions, so I would ask that they be consulted as well.

If you make it clear you understand the situation, but that it doesn't solve the problem, they may be more willing to work with you.   Help them think that they're solving a major problem; flattering them will help in the short and long run, as well as accomplish the goal of keeping your son in the wheelchair.

Good luck, and please let us know if this approach works.
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If you have the ability to remove the seatbelt, it is not a restraint.
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I would ask his doctor to order the seat belt.

My grannie had a heavy foam table, that wrapped around her body, that was used to restrain her in her wheelchair and her doctor had to write an order for it. Without it she would have been on the floor everytime she was left without direct supervision.
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Actually, I think haily and willie are correct. According to my daughter a seatbelt can be used if the person is capable of opening it. For my Mom, her Dementia was too far advanced. But there was a resident using one thats when I asked my daughter about it.

My Mom was given a Geri chair. It looked like one of those beach chairs with the thick vinyl straps. The back could be reclined. The seat could be adjusted so the seat was slightly slanted down in the back. This kept Mom from being able to get out of the chair. It had cushions on each side of her head in case she fell asleep, it kept her head from falling over. And she could scoot around in it. I loved it.
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