Why do we use physical restraints in the elderly?

Abstract

The use of physical restraints in the elderly is a common practice in many countries. This paper summarizes the current knowledge on the use of restraints in home care, hospitals and nursing homes. Between 1999-2004 the reported prevalence numbers range from 41-64% in nursing homes and 33-68% in hospitals; numbers of restraint use in home care are unknown. Bed rails and belts have been reported as the most frequently used restraints in bed; chairs with a table and belts are the most frequently reported restraints in a chair. It is evident that physical restraints in most cases are used as safety measures; the main reason is the prevention of falls. In the hospital setting, the safe use of medical devices is also an important reason for restraint use. Predictors for the use of physical restraints are poor mobility, impaired cognitive status and high dependency of the elderly patient and the risk of falls in the nurses' opinion. Furthermore, there are indications that restraint use is related to organizational characteristics. Finally, many adverse effects of restraint use have been reported in the literature, like falls, pressure sores, depression, aggression, and death. Because of the adverse effects of restraints and the growing evidence that physical restraints are no adequate measure for the prevention of falls, measures for the reduction of physical restraints are discussed and recommendations are made for future research.

Do frailty and cognitive impairment affect dual-task cost during walking in the oldest old institutionalized patients?

“…The CDRs of the patients of the present study were between 1 and 2. All of the patients with dementia had experienced at least 9 months of physical restraint (14±3 months) defined as any limitation of an individual's freedom of movement (Hantikainen 1998;Hamers and Huizing 2005) including restraints worn by the person (belts and chest and arm/leg restraints) and those attached to beds (fullenclosure bed rails) or chairs (locked table) (Gulpers et al 2010). The complete physical characteristics of the participants are presented in Table 1.…”

Clients’ Physical Restraint Management: Nursing Approach

“…With the purpose of organizing the shift, managing the time, and on the other hand, to prevent clients bother the other clients, and also, in most cases, to prevent clients to externalize the medical devices or removing clothes, restrictive measures are implemented (DGS, 2007;Costa, 2013). The same stated Choi et al, 2003 andHuizing, 2005 in their studies.…”

“…However, and despite the clients' physical restraint minimizes some risks, its adoption can lead to others, like to adverse events. Hamers and Huizing (2005) and Demir (2007), in their studies define physical restraint as any restriction on the freedom of the person's movement. Marques (2012) state that the use of the clients' physical restraint is common in acute clients care facilities, as well as the continuing care, being these measures used constantly in order to prevent damage and protect clients.…”

“…Hamers and Huizing (2005) state that the motivation for the adoption http: //dx.doi.org/10.15405/epsbs.2016.07.02.17 eISSN: 2357-1330 Hamers (2004). According to the authors, the risk of falling is a determining factor to immobilize clients.…”

The ethics of coercive treatment of people with dementia

“…13 Various types of coercive measures, such as mechanical and non-mechanical restraint, compulsion to take part in nursing and medical treatments or activities of daily life (ADLs), seem to be common practice in institutional care in most Western countries. 7,[14][15][16][17][18][19] Coercive measures have been associated with severe adverse effects. 12,14,17,18 Despite coercive measures' harmful effect on quality of life, use of them is probably primarily based on lack of education and unawareness of alternative measures.…”