Physical Restraints In Older Adults

When it comes to abuse and neglect, we automatically think of children. Children are not the only ones who deal with being abused. In fact, this happens to the elderly as well. While some elderly may be productive enough to care for themselves, others are not. One in four elders are at risk of abuse and only a small proportion of this is currently reported (Cooper, C., Selwood, A., Livingston, G., 2008). The use of physical restraints in older adults is associated with negative outcomes: physical decline, cardiovascular stress, decreased peripheral circulation, incontinence, social isolation, loss of self esteem, and even death (Gastmans, C., 2006). However, physical restraints are sometimes necessary to protect the patient, staff, and

Often the use of restraints has an opposite effect of the intended purpose, which is to protect the patient. The risk of using a restraint must be weighed against not using the restraint and the right decision should occur. Uses of restraints should be documented, be on a time limit, and be frequently re-evaluated. Basic education of professional staff who orders restraints is another missing element in position to statements and recommendations. Successful removal was grounded in staff education, commitment of staff, residents and families, and in alternative equipment (Wang, W., 2004). When not using restraints properly or not having the right education on how to use physical restraints it leads to abuse. Studies show that health professionals are largely unaware of the various forms of elder mistreatment that take place, and of the proper course of action to pursue when mistreatment is suspected (Baigas, J., Falk, N. L., Kopac, C., 2012). Whether abuse is caused for misuse of physical restraints, or whether a caregiver is overwhelmed with their combative patient, abuse happens for unethical reasons. Federal law prohibits unnecessary use of restraints and specifies that some reasons for using restraints are unacceptable. Nursing facility staff may not use restraints to: punish or discipline a patient, make patient care easier or more convenient, substitute for other activities or treatment, permanently control the patient. Currently, about 10% of nursing home residents are restrained. This is a huge drop from before 1990, when nursing homes used restraints on 30-40% of their patients (Gastmans, C., 2006). Fortunately the right practices and training, nursing homes can reduce their amount of restraints even