Exercising restraint: Clinical, legal and ethical considerations for the patient with Alzheimer’s disease

McBrien, Barry

doi:10.1016/j.aaen.2006.12.007

Cited by 15 publications

(25 citation statements)

References 31 publications

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“…Nursing staff may need to restrain a patient in order to protect the patient from injury, or protect him or her from unnecessary risk or harm. Also patients have a right to be free from physical restraint except in an emergency or when isolation or restraint is a part of a treatment program (McBrien, 2007).…”

Section: Proponents Of Physical Restraint Usementioning

confidence: 99%

Alzheimer's and Geriatrics in the Middle East

Abyad¹

2015

MEJPA

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Middle Eastern countries have certain cultural, social and economic characteristics in common with similar aspirations. The percentage of elderly in the Middle East is expected to increase with improvement of the health care delivery in the area. Countries of the region, like other developing countries, need to define the policies and programs that will reduce the burden of aging populations on the society and its economy. There is a need to ensure the availability of health and social services for older persons and promote their continuing participation in a socially and economically productive life.

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Section: Proponents Of Physical Restraint Usementioning

confidence: 99%

Alzheimer's and Geriatrics in the Middle East

Abyad¹

2015

MEJPA

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“…Specific recommendations are presented such as encouragement of oral fluids, analgesic strategies, and clear, disability‐related toilet signage. Physical restraints are described as a last resort but outlined in the list of options for management in another study …”

Section: Resultsmentioning

confidence: 99%

Clinical Care of Persons with Dementia in the Emergency Department: A Review of the Literature and Agenda for Research

Clevenger

Chu

Zhou

et al. 2012

J American Geriatrics Society

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The segment of older adults who present to the emergency department (ED) with cognitive impairment ranges from 21% to 40%. Difficulties inherent in the chaotic ED setting combined with dementia may result in a number of unwanted clinical outcomes, but strategies to minimize these outcomes are lacking. A review of the literature was conducted to examine the practices undertaken in the care of persons with dementia (PWD) specific to the ED setting. PubMed and Cumulative Index to Nursing and Allied Health Literature were searched for published articles specific to the care of PWD provided in the ED. All English-language articles were reviewed; editorials and reflective journals were excluded. Seven articles ultimately met inclusion criteria; all provided Level 7 evidence: narrative review or opinions from authorities. The articles recommended clinical practices that can be categorized into five themes: assessment of cognitive impairment, dementia communication strategies, avoidance of adverse events, alterations to the physical environment, and education of ED staff. Many recommendations are extrapolated from residential care settings. Review results indicate that there is minimal guidance for the care of PWD specific to the ED setting. There are no empirical studies of the care (assessment, interventions) of PWD in the ED. The existing (Level 7) recommendations lack a research base to support their effectiveness or adoption as evidence-based practice. There is a significant opportunity for research to identify and test ways to meet the needs of PWD in the ED to ensure a safe visit, accurate diagnosis, and prudent transfer to the most appropriate level of care.

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“…A single study that asked patients about their perceptions of physical restraint, focused on the cognitively intact [37]. People with cognitive impairment can have periods of lucidity and competence, and where this is not the case, a proxy decision maker should be involved in any decision making [42].…”

Section: Autonomymentioning

confidence: 99%

“…Increases in medical litigation are a source of distress to all caring for patients, especially older people and those with cognitive impairment who may be at risk of injury [42]. Physical restraint is sometimes applied due to fear of litigation [28].…”

Section: Legal Issuesmentioning

confidence: 99%

Australian and New Zealand Society for Geriatric Medicine Position Statement Abstract: Physical restraint use in older people

2016

Australas J Ageing

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Exercising restraint: Clinical, legal and ethical considerations for the patient with Alzheimer’s disease

Cited by 15 publications

References 31 publications

Alzheimer's and Geriatrics in the Middle East

Alzheimer's and Geriatrics in the Middle East

Clinical Care of Persons with Dementia in the Emergency Department: A Review of the Literature and Agenda for Research

Australian and New Zealand Society for Geriatric Medicine Position Statement Abstract: Physical restraint use in older people

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