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Postural supports, restricted conditions and hospice teams: the steps to remember

The short step lists from each lesson of Postural supports, restricted health conditions and working with a hospice team, on one page. Print it for the station or the break room. Each list points back to its lesson, where the sources are linked.

Open the coursePrint a poster with a QR code

Decision guide

Can this device be used as a postural support?

Does the device tie her hands or feet, or limit their use?

  • Yes

    Do not use it. A postural support positions rather than restricts, never ties or limits hands or feet, and full-length rails need a hospice plan that calls for them. Tell the administrator.

  • No

    Is it used to help her position, balance or movement, rather than to hold her back?

    • Yes

      Is it a bed rail that runs the full length of the bed?

      • Yes

        Is she getting hospice care now, with a hospice care plan that says she needs full bed rails?

        • Yes

          Can she release it quickly by herself?

          • Yes

            Is a physician's written order for this support in her record?

            • Yes

              Could she leave the building on her own in an emergency now, but not with the support on?

              • Yes

                Wait. Before a support makes her non-ambulatory, the licensee secures the fire clearance. Tell the administrator.

              • No

                Use it as ordered. Check each time that it still meets these tests, and tell the administrator about any change in her condition.

            • No

              Do not use it yet. Ask the administrator to get the physician's written order into her record first.

          • No

            Do not fasten it this way. A support is fastened or tied so she can release it quickly. Tell the administrator so it can be changed.

        • No

          Do not use it. A postural support positions rather than restricts, never ties or limits hands or feet, and full-length rails need a hospice plan that calls for them. Tell the administrator.

      • No

        Can she release it quickly by herself?

        • Yes

          Is a physician's written order for this support in her record?

          • Yes

            Could she leave the building on her own in an emergency now, but not with the support on?

            • Yes

              Wait. Before a support makes her non-ambulatory, the licensee secures the fire clearance. Tell the administrator.

            • No

              Use it as ordered. Check each time that it still meets these tests, and tell the administrator about any change in her condition.

          • No

            Do not use it yet. Ask the administrator to get the physician's written order into her record first.

        • No

          Do not fasten it this way. A support is fastened or tied so she can release it quickly. Tell the administrator so it can be changed.

    • No

      Do not use it. A postural support positions rather than restricts, never ties or limits hands or feet, and full-length rails need a hospice plan that calls for them. Tell the administrator.

This guide follows 22 CCR 87608 as read on 2026-10-22. It does not decide a case: when a device is unclear, ask the administrator, who can ask the licensing office.

Step through it one question at a time: alwbeta.com/training/courses/postural-supports-restricted-conditions#decision-guide

Lesson 1

Postural supports: what they are and when they are allowed

A resident's chair has a tray that clips in front of her. Another resident wears a brace. Before you fasten any device, you decide one thing: is this a postural support the rules allow? This lesson names what a postural support is, the order behind it, and how it must fasten.

  1. Positions her, helps balance or movement: not holding her back
  2. A physician's written order is in her record
  3. She can release it quickly herself
  4. Prescribed braces and casts count too
  5. Could it make her non-ambulatory? The licensee checks fire clearance first
  6. No order, or in doubt: tell the administrator before use

Lesson: alwbeta.com/training/courses/postural-supports-restricted-conditions#lesson-psr-what-supports-are

Lesson 2

Postural support or restraint? Telling them apart

Some devices look like supports but work like restraints. A restraint holds a person back. On shift you may be asked to fasten a tie, raise a bed rail or block a chair. This lesson gives you the tests that tell a support from a restraint, and what to do when a device fails one.

  1. Positions her, or holds her back?
  2. Never tie or limit hands or feet
  3. Half rail at the head: only to help her move
  4. Full rails: only on hospice, when the plan says so
  5. Restraints are prohibited in community care facilities (ALW waiver)
  6. A device fails a test: do not use it, and tell the administrator

Lesson: alwbeta.com/training/courses/postural-supports-restricted-conditions#lesson-psr-support-or-restraint

Lesson 3

Restricted health conditions: the list and your part

Many residents live with a health condition that needs some medical help: oxygen, a catheter, diabetes, a wound. The rules call these restricted health conditions. Before you help such a resident, you decide whether you are trained for it and who does the rest. This lesson sets out the list and your part.

  1. On the section 87612 list? It is a restricted condition
  2. Hands-on training from a licensed professional before you give the care
  3. Her condition changes: ask what new training is needed
  4. Read the record of care: who does the procedure, who to call
  5. Big change or refusal: tell the administrator at once

Lesson: alwbeta.com/training/courses/postural-supports-restricted-conditions#lesson-psr-restricted-list

Lesson 4

Restricted conditions: what staff may and may not do

Each restricted condition has its own section. It says what the resident does, what a skilled professional does, and what trained staff may do. This lesson walks through six of them, so you can tell a task that is yours from one that is not.

  1. Oxygen: no smoking where it is in use; tanks secured; portable source outside her room
  2. Catheter: empty the bag only if taught and listed; never insert, remove or irrigate
  3. Ostomy: change the bag and adhesive only if taught; give privacy
  4. Injections, enemas, suppositories: the resident or a skilled professional
  5. Incontinence: scheduled toileting, checks at night, clean and dry, fluids never withheld
  6. Wounds and exercises: only as the professional directs and taught you

Lesson: alwbeta.com/training/courses/postural-supports-restricted-conditions#lesson-psr-condition-tasks

Lesson 5

Working with the hospice team

When a resident gets hospice care in your home, two teams care for her: the hospice and your home. On shift you decide which tasks are yours and what you must pass on. This lesson covers who chooses the hospice, what the care plan tells you, your training, and what to report.

  1. The resident or her surrogate chooses the hospice; staff name none
  2. Follow the plan: your tasks, how often, the 24-hour hospice number
  3. Hospice training on this resident before her care begins
  4. No professional-only procedures, even on hospice
  5. You may help with her self-administered medications
  6. Stop, deviation or safety threat: tell the administrator at once

Lesson: alwbeta.com/training/courses/postural-supports-restricted-conditions#lesson-psr-hospice-team

Beta’s ALW team, course version 2026.10.4, text checked against its sources on October 22, 2026. Educational only. Not continuing-education, licensure or regulatory credit. Follow your employer’s current procedure and the person’s current plan. Call 911 for a medical emergency.

Call the ALW teamFit check