Racial Disparities in the Use of Physical Restraints in U.S. Nursing Homes

Abstract

The use of physical restraints in nursing homes among black and white residents was examined on the basis of data from the 2004 National Nursing Home Survey to determine if black residents were more susceptible to the use of physical restraints. Odds ratios acquired through logistic regression are provided with 95 percent confidence intervals. Findings revealed that black residents are more likely than white residents to be restrained with bed rails, side rails, and trunk restraints. Findings suggest that racial disparities exist in the use of physical restraints. Implications for practice, policy, and research are discussed.

Decomposing Racial and Ethnic Disparities in Nursing Home Quality of Life

“…Racial and ethnic disparities are particularly acute and persistent in the nursing home (NH) industry. NH residents who are Black, Indigenous, and other People of Color (BIPOC) receive poorer quality of care (QoC) than White residents as measured by a number of clinical quality indicators (Arling et al, 2007; Cassie & Cassie, 2013; Fennell et al, 2000; Mor, 2005; Sengupta et al, 2012; Smith et al, 2008; Travers et al, 2017). Quality of life (QoL) is an important aspect of long-term care quality that is often overlooked.…”

Racial Differences in Minnesota Nursing Home Residents’ Quality of Life

“…Few studies explicitly address racial differences in NH QOL. Resident-level differences in NHs’ QOC include more use of physical restraints among Black residents compared with White residents (Cassie & Cassie, 2013), less use of specialized dementia care among minority residents (Sengupta, Decker, Harris-Kojetin, & Jones, 2012), and lower rates of flu vaccination for Black residents versus White residents (Cai, Feng, Fennell, & Mor, 2011). A few, mainly qualitative, studies find generally lower QOL for minority older adults (Engle, Fox-Hill, & Graney, 1998; Ryvicker, 2011; Wu & Barker, 2008).…”

Restraint use in residents with dementia living in residential aged care facilities: A scoping review

“…Included studies were published between the years 2005 and 2017. Eighteen studies included residents with mild‐to‐severe cognitive impairment, and five studies (Allen, Burgio, Fisher, Michael Hardin, & Shuster, 2005; Cassie & Cassie, 2013; Freeman et al., 2017; Mamun & Lim, 2005; Selbaek et al., 2016) reported separate data on restraint use in residents with dementia. Moreover, fifteen studies documented the presence of behavioural and psychological symptoms of dementia (BPSD) in participants.…”

“…Only one study mentioned that residents were restrained to prevent dislodgement of feeding tubes and to prevent falls and restrained for agitation (Mamun & Lim, 2005). Black residents (Cassie & Cassie, 2013), residents with antipsychotic medication (Foebel et al., 2016), residents with high activities of daily living (ADL) dependency (Te Boekhorst et al., 2013) and residents with dementia (Freeman et al., 2017; Luo, Lin, & Castle, 2011; Mamun & Lim, 2005) were more likely to be physically restrained. Furthermore, Konetzka et al.…”