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Long Term Care Restraints

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Over the years, there has been various debates over how the elderly is being treated in long term care facilities. Each and every year the number of the elderly people living in the U.S continues to grow immensely and whether or not we have the right systems in place to deal with this overwhelming number of baby boomers remain questionable. This number is projected to continue to grow and it is important that the right care is provided and also that the elderly is properly taken care of as they make this transition. As the number of elderly people in long-term care facilities continue to increase, different and various issues arise. One of the many serious issues involved with the elderly in long-term care facilities is the use of chemical …show more content…

While patients may benefit from restraints, they can also be harmful. There are various types of restraints, but the most common ones are physical and chemical restraints. Physical restraints are different from chemical restraints. Chemical restraints are psychoactive drugs given to a patient to potentially keep them from doing voluntary movement (Hoffman,2011). Restraints are used in various medical settings such as acute care hospitals and long-term care facilities. However, the Department of Health and Human Services reported that a majority percentage of the use of restraints on patients happen in a nursing home. Although there has been a decrease in the daily physical restraints used in nursing homes, however, in most nursing homes, restraints are fairly common. The use of physical restraints in long term care facilities or nursing homes is not something that is new. As a matter of fact, restraints have been used on the elderly in nursing homes dating back to the 1980’s. Before the year of 1990, the U.S Food and Drug Administration estimated that about 40 percent of patients of patients in nursing homes were restrained. (FDA …show more content…

This act created a major revision of standards of care for nursing homes. This legislation also changed the expectations and the quality of care that patients should receive in long term care facilities. This Nursing Home Reform Act passed by congress specifically stated “that each residents have the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms”. While there may be some benefits to using restraints in nursing homes, however, studies have shown that using restraints in nursing homes negatively impacts patients and for the most part does not prevent them from falling or from other incidents that may occur. There are very high levels of risks associated with the use of restraints (Lapane,150). The OBRA act has encouraged providers to use other alternatives and methods other than restraint because it has been proven to be quite harmful. There are various risked associated with restraints and of these risk include patients potentially patients even losing their lives. Because of the nature of the restraint on patients, patients sometimes end up losing muscle and bone density which then results to immobility and immobility itself results in loss of endurance and muscle strength (Lane 2008). When a patient has lost endurance and muscle strength, they have problems

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In 1991, the United States government initiated the Nursing Home Reform Act, also known as the Omnibus Budget Reconciliation Act (OBRA) of 1987 that outlined “a set of national minimum set of standards of care and rights for people living in certified nursing facilities” (ncmust.com). OBRA requires all nursing home residents have a complete health evaluation upon admission to a long-term care facility, and to be re-evaluated quarterly or after any major changes in health or functional status. This evaluation process is called the Resident Assessment Instrument (RAI) which is composed of three components; Minimum Data Set (MDS), Care Area Assessment Process and RAI Utilization Guidelines. Together, the components of RAI provide information

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Reading this article for the elderly care, I feel that ethical issues commonly occur anywhere in the treatment of older patients. I had a clinical experience both in an acute-care hospital and in a long-term care facility. Before working in a long-term facility, I was not aware of how many ethical principles were violated in the treatment of older patients as a daily routine as stated in the article. In reality, there are many situations in which older patients don’t completely exhibit their autonomy because they are vulnerable physically and emotionally and dependent on others. Therefore, they become more conscious of caregivers or healthcare professionals.

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Since nursing homes tend to provide care to a vulnerable population they can be taken advantage of, overlooked or mistreated by staff and with residents potentially underreporting these incidents due to fear of retaliation by staff identifies this as significant ethical issues among nursing homes. The use of restraints that restricts a resident, whether physical or chemical applies to the ethical considerations within a nursing home as it not only impacts the resident, it can affect staff members and other resident’s safety. There is always the conflict between providing the resident with a fair amount of decisions regarding their activities of daily living, special accommodations, and independence. However, there is also the reflective issue of whether these freedoms impact the safety and the ability to comply with the institution's policy and how they are handled to deliver ethically appropriate customer service to those

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Physical restraints, is to hold the patient by two or more stuff members to prevent him from leaving. The other type is mechanical restraint, which involve the use of some equipment such as, mittens, heavy belt which will restrict the movement from chairs, and raising the side rails of the bed for geriatric patient. Moreover, the chemical restrain is the easiest way which involves the use of medications. Making a decision to use the restrains is not straightforward or easy for nurses. It is need daily legal and ethical decision making.

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