Are You Taking Things Away in the Name of Safety? | The Boundary Between Protecting and Restricting

Is that "safety" really for their own good?

Preventing falls versus living life in their own way.
Which one are you prioritizing?

In the field, "safety first" is spoken of as a matter of course.
Preventing accidents is an important responsibility as a professional.

However, behind that righteousness,
we might be taking something away without even realizing it.

For example,

• Telling someone, "Please sit down because it's dangerous"

• Restricting actions to prevent falls

• Prioritizing risk reduction and narrowing down choices

Is that reallyfor their own good?

This time, I will dare to put that sense of discomfort into words.

What happens in the name of safety

In the nursing care field, one of the risks treated most seriously is"falling".

If they fall, it can lead to a fracture.
If they fracture a bone, there is a possibility they will become bedridden.

That is whyfalls should be prevented.
This way of thinking itself is not wrong.

However, the stronger that "correctness" becomes, the more a certain phenomenon occurs.
That is"standardization of restrictions".

• Putting someone who can walk into a wheelchair

• Providing full assistance for toileting

• Stopping actions by saying "it's dangerous"

These kinds of responses are scenes seen in every facility.

What should originally be "individualized support," judged according to the person's condition,
somehow turns into "the premise of restricting from the start" before we know it.

The problem lies here.

■ Why does this happen?

The reason is simple.

Because "responsibility" and "efficiency" are prioritized.

• We must not let accidents happen.

• Staffing is limited.

• It is easier to manage if everyone is handled the same way.

As a result,
"A safe method" = "restricting them"

We unconsciously lean toward this way of thinking.

But at that moment, what are we protecting, and what are we letting go of? Protecting safety and protecting a person's life are not the same thing.

Are you doing this too?

3:00 PM.
At the end of the hallway, about 10 meters away, I saw a resident who had started walking slowly toward the restroom.

Their steps were one by one, with a hand on the handrail.
Although unstable, this is someone who has always moved on their own until now.

However, that day was a little different.
Having mentioned that their legs felt heavy that day, I felt a strong sense of risk regarding a fall.

What came to mind were past fall accidents.
And the words of their family.

"Please make sure they never fall."

Without hesitation, I called out to them.
"It's dangerous, so let's use a wheelchair."

The person stopped walking and said this:
"Am I not allowed to walk by myself anymore?"

The moment I heard those words,
I felt a sense of unease about my own judgment for the first time.

Falls can be prevented.
But what are we making them lose in exchange?

That one remark still won't leave my mind.

■ What are we choosing in this situation?

Protecting safety and protecting a person's individuality.

Perhaps we need to pause and consider whether these two can truly coexist.

Was that choice really for the person's own good?

The boundary between protecting and restricting

So, where do we draw the line between 'protecting' and 'restricting'?
I make my judgments based on three perspectives.

Perspective 1: Is the person's own will present?

Have we confirmed what they want to do through their words or expressions?

Perspective 2: Are we comparing risks and values?

Beyond just the risk of falling,
are we weighing the 'value of continuing to do what they can' on the same scale?

Perspective 3: Is this the minimum level of restriction?

Instead of a total ban,is it a phased approach?

■ Concrete examples (replacements in practice)

• Total ban on walking ➤ Switch to supervised walking

• Long-distance movement ➤ Limit distance to within 10m

• Moving during busy hours ➤ Adjust to times when there are fewer people

What is important is not deciding based on all or nothing.

“Whether you can create a middle ground”
Here lies the boundary between “protecting” and “restricting.”

Even if restrictions are “for safety,”
the goal is ultimately to protect that person's life.

“Invisible restraints” occurring in the field

Another thing that cannot be overlooked is “words.”

“It’s dangerous, so let’s stop”
“You can’t do that”
“Please sit down”

At first glance, these look like considerate remarks.

However, in reality,
they have the power to take away choices of action.

It is not physical restraint.
But it is restricting freedom.
This is “invisible restraint.”

And what is truly scary is
that it is being done as an act of “kindness.”

■ Just by changing your words, your interactions will change

Even in the same situation, you can change how you communicate.

❌ It’s dangerous, so let’s stop
➤ “How shall we do this so you don’t fall?”

❌ You can’t do that
➤ “I will help you with this”

❌ Please sit down
➤ “Shall we proceed while taking a little rest?”

The point is simple.
Change from “words that stop” to “words that think together.”

When words change,

• relationships change

• choices remain

• the person's individuality is protected

Words can support, and they can also restrict.

While saying it is "for safety,"
we might also be restricting them with our "words."

In the previous article,
the moments when verbal prompts take away peace of mind are explored in depth.

👉 By reading it together,
the full picture of "invisible restraint" becomes clear.

Even in situations where safety should be prioritized

Of course, making everything free is not always the right answer.

• When judgment ability is impaired

• When the risk of fracture is extremely high

• When there are clear restrictions from a doctor

In these situations, prioritizing safety is rational.

However, one thing is important here.

It is not about "stopping them across the board," but "continuing to think."

■ Decision-making steps when in doubt (for the field)

① Confirm the person's will
Pick up on "what they want to do" through words and expressions

② Look at the risks concretely
Instead of "it's somehow dangerous," clarify what is dangerous

3. Look for alternatives
Instead of prohibiting, think about whether you can change the method.

4. Share within the team
Do not let it end with individual judgment.

■ Concrete examples

• Prohibiting walking ➤ Changing to supervised walking

• Free movement ➤ Limiting time slots and distances

• Full assistance ➤ Adjusting in stages to partial assistance

Protecting safety is important.

However,
protecting only safety does not mean protecting that person's life.

3 things you can change starting tomorrow

So, what can be done in the field?
What you can do starting today is simple.

1. Articulate why this restriction is in place

Stop doing things "just because."

• Is there a fall risk?

• Is the time of day the issue?

• Is the environment the factor?

👉 Put the reason into a single phrase (30 seconds is fine)

2. Ask the person once

"What would you like to do?"
Just that alone will change the interaction.

👉 If you have the capacity,
take a step further by asking, "How much do you think you can do?"

3. Loosen restrictions by just one level

You don't have to change everything at once.
"Just one level" is enough.

• Full assistance ➤ Partial assistance

• Prohibition ➤ Supervision

• Movement restrictions ➤ Adjusting distance and time

👉 Loosen one thing today
Even a small change has great significance for that person.

Summary | Who is that "safety" for?

A life without falling, or a life where one can walk. Which one is happier for that person?

There is no single correct answer. That is precisely why we
must keep thinking.

The words from that time still remain with me.
"Do I not have to walk on my own anymore?"

How we answer this question is, I believe,
what will determine the quality of care from here on out.

■ In conclusion

Tomorrow, when you encounter the same situation,
try changing that one phrase just a little.

Protecting, and not taking away.

Continuing to think about both is our job.

If you would like to know a little more about me, the person writing this article,
click here.

As an active care manager for over 20 years,
I have compiled the realities I have seen in the field
and my actual experiences as a side-hustle writer.

👉 "You can understand why I am writing about this theme"

To the next article

In this article, I reflected on the unconscious restrictions that occur in the name of "safety."

However, there is another element that cannot be overlooked. That is
a lack of breathing room.

On busy days, we tend to rush our decisions, and as a result, we may end up eroding dignity.

In the next article, I will delve into the realities of the field and concrete improvement measures, focusing on
[The Busier You Are, the More Dignity Is Eroded] Rethinking Care on Days When You Lack Breathing Room
.