Articles Posted in Restraints

The use of physical restraints in nursing homes is a very controversial issue because it presents a situation in which a person’s fundamental rights may be violated and elder abuse may be taking place. According to the Joanna Briggs Institute, a physical restraint is defined as “any device, material or equipment attached to or near a person’s body and which cannot be controlled or easily removed by the person and which deliberately prevents or is deliberately intended to prevent a person’s free body movement to a position of choice and/or a position of person’s normal access to their body.”

Caretakers argue that physical restraints are necessary to maintain the safety of the staff and other residents and are only used on residents who have a high risk of falling, display signs of cognitive decline, or are impaired in their activities of daily living. While some of these reasons may appear to be valid, evidence from past studies have shown that over an extended period of time, restraints actually do not have any effect on the prevention of falls in nursing homes.

There is also evidence that suggests restraint-free nursing homes, on average, do not have an additional amount of staff in comparison to those that use physical restraints. Therefore, the use of physical restraints in some facilities may be a result of a lack of motivation and training on how to properly supervise residents with high risks of falling on the part of the caretakers. This presents issues not only of adequate staffing, but also brings to light issues concerning quality of care.

A recent study in the February 2011 volume of the Journal of the American Geriatrics Society titled “Effectiveness of a Multifactorial Intervention to Reduce Physical Restraints in Nursing Home Residents” took residents from forty-five different nursing homes and examined three hundred and thirty three elderly adults, all of whom were using physical restraints. They divided the residents into two different groups. In the intervention group, the residents were no longer physically restrained, while the control group consisted of those who continued to use physical restraints. The study found that after three months without using physical restraints, the intervention group was more than two times likelier than the control group to permanently be free of restraints. Additionally, the intervention group also experienced a twice as likely chance of reducing their use of physical restraints by 25-75%.

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