Physical and Pharmacologic Restraints in Long-Term Care Facilities

Abstract

This study examined the effects of education on the attitudes and practices of long-term care staff toward use of restraints. The intervention, a 1-day educational seminar, used a collaborative team of speakers from the Utah Survey Agency and medical professions. Seminar goals were threefold: first, to provide information about best practices for managing behaviors of individuals with dementia in long-term care settings; second, to provide an explanation of the Omnibus Budget Reconciliation Act regulations pertaining to restraint use; and third, to present alternative strategies to link best practice guidelines to the provision of care. Results showed significant changes in participants' attitudes toward use of restraints. Participants reported replicating the seminar for nursing home staff, revisiting facility policies on restraints, and modifying resident care plans.

The Use of Physical Restraints for Patients Suffering from Dementia

“…4 This poses personal and professional difficulties for nurses, who often have to resort to physical coercion. [5][6][7] convenience of the staff, maintaining the good reputation of the institution, response to demands and threats of lawsuits). 6,[20][21][22] Apparently, the fear of legal action is mostly unjustifiable and derives from a lack of knowledge and understanding of the law.…”

The role of psychiatrists in developing the skills of dementia care workers

“…Key studies on training methods Ripich 1995;Palmer 1996;Cohen-Mansfield 1997;Middleton 1999;Burgio 2001;Peterson 2002;Featherstone 2004;Chang 2005;Parks 2005.…”

“…These features should inform psychiatrists and CPNs such as those in the vignette of Mr P, trying to prevent behavioural and psychological symptoms of dementia and reduce the use of antipsychotics (Matteson 1997;Middleton 1999;Testad 2005). They should equally guide the manager of Mr P's care home on an overall approach to developing and sustaining care skills in all his staff (MonizCook 1997(MonizCook , 1998(MonizCook , 2000.…”

“…Key studies on care plans Kihlgren 1990Kihlgren , 1996Ripich 1995;Palmer 1996;Matteson 1997;Middleton 1999;Proctor 1999;Lintern 2000;Wells 2000;Burgio 2001Magai 2002;Roth 2002.…”

“…Key studies on non-pharmacological strategies Marsiske 1989;Williams 1994;Hagen 1995;Palmer 1996;Matteson 1997;Moniz-Cook 1998;Middleton 1999;Wilkinson 1999;Wells 2000;Testad 2005.…”