Use of Physical Restraints With People With Intellectual Disabilities Living in Sweden's Group Homes

Abstract

People with intellectual disabilities (ID) often exhibit physical and communicative difficulties as well as challenging behaviors. Physical restraints are one method used to manage challenging behaviors and promote physical safety for people with ID, their fellow residents, and professional carers. However, there is a lack of data regarding the practice of employing physical restraints in Swedish group homes for people with ID. The aim was to investigate the prevalence of physical restraint use in group homes for people with ID, and to identify the characteristics of individuals subjected to these restraints. The study had a cross-sectional design and included 556 people with ID, aged 16-90 years, living in 118 group homes. Physical restraint use and residents' characteristics were surveyed with a questionnaire. Of the 556 residents studied, 99 (17.8%) had been subjected to physical restraint over the previous week. Of these, 99.2% were subjected to more than one type of restraint. The most commonly used type of physical restraint was a belt (73.7%). Using logistic regression analysis, the independent risk factors strongly associated with being physically restrained were inability to walk independently, impaired speech, screaming and shouting continuously, epileptic seizures, and spasticity. Despite the absence of legal authority for physical restraint use in group homes for people with ID, physical restraints are frequently used in Sweden. Both physical impairments and behavioral symptoms are significantly associated with physical restraint use.

Systematic Review of Restraint Interventions for Challenging Behaviour Among Persons with Intellectual Disabilities: Focus on Effectiveness in Single‐Case Experiments

“…; Lundström et al . ). The primary aim of using RIs among persons with intellectual disabilities and CB is to prevent them from harming themselves or others through their SIB or physically aggressive behaviour, and not to impact upon future probability of CB occurring (Allen et al .…”

Can sensory integration have a role in multi‐element behavioural intervention? An evaluation of factors associated with the management of challenging behaviour in community adult learning disability services

“…However, due to the ethical dilemmas (Wilkins, ) and potential risk of injury (Williams, ) their use is controversial (Jones & Stenfert Kroese, ). Lundstrom et al () assert the use of restraint is still an issue in practice. This would indicate there is a disparity between policy and practice in the management of CB (Deveau & Mc Gill, ; Feldman, Atkinson, Foti‐Gervais, & Condillac, ; Rickard, Chan, & Merriman, ).…”

Gendered experiences of physical restraint on locked wards for women

“…Quantitative studies focusing on restraints used with people with intellectual disabilities in community settings have reported high proportions of people being subject to chemical, physical and mechanical restraint, and a minority of people being subject to frequent and multiple restraints (for example, Emerson et al 2000;Lundström et al 2011;Merineau-Cote and Morin 2013;Webber, McVilly, and Chan 2011). However, these studies have not routinely included gender analyses and have tended to conclude that gender differences are relatively minor.…”