The Australian government has recently moved to regulate the use of physical and chemical restraints in aged care facilities. Certainly this is a step in the right direction — but banning physical restraint is unlikely to remove it from practice.
Read more: There's no need to lock older people into nursing homes 'for their own safety'. The rate of physical restraint in Australia is difficult to ascertain. These figures suggest a substantial, ingrained issue with multiple contributing factors. Issues might include inadequate staff knowledge and skills, insufficient resources, and difficulty accessing specialist services. Empirical evidence demonstrates that physical restraints cause premature death as well as other serious physical and psychological harms.
While injuries caused directly by physical restraint could include falls and nerve injury, the impacts go beyond this. Behavioural and psychological symptoms of dementia can be managed by strategies such as improving sleep, controlling pain, music therapy, orientation therapy, and, if required, one-to-one care. Preventing falls requires a multi-pronged approach including strengthening, balance training, medication review and co-ordination of care between doctors, nurses and therapists.
Our recent review of studies into the practice identified deaths of nursing home residents due to physical restraint. The eight studies reviewed came from the US and Europe between and This research reaffirmed the view that restrained individuals still experience falls , which the restraints often seek to prevent. But perhaps most compelling were the findings that physically restraining patients with dementia increases agitation , worsens behavioural and psychological symptoms, and hastens their cognitive decline.
This uncovered only five deaths due to physical restraint. Maccioli, G. Mion, L.
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- Chemical and physical restraint use in the older person | British Journal of Medical Practitioners.
- The Removal of Restraint.
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Reigle, J. Critical Care Trauma Centre. Definition: Restraints are any mechanical, chemical or environmental means which are intended to prevent injury or bring under control behaviours or physical movements which could cause bodily harm to patients or others. Top Stories. London ranks in the top 10 for hospital-based research. Study gives Ontario men access to advanced prostate cancer imaging.
Chemical and physical restraint use in the older person | British Journal of Medical Practitioners
Making an impact with United Way at work and the community. Traffic disruption near Victoria Hospital. Breakfast Club one of 92 programs funded by United Way. Donor Impact. Help reduce the five-month waitlist for youth in crisis. Run For Peace of Mind in support of brain health. Effective restraint reduction requires innovative substitutes for the use of restraints.
Evidence also shows that the use of restraints contributes to depression, anger, nosocomial infection, and pressure ulcers. An assessment for alternative measures is done prior to the use of restraints. A universal definition of what constitutes physical restraint enables consistent reporting and comparability in nursing homes. Secondly, when there are no viable alternatives to physical restraint, any use should trigger mandatory referral to a specialist aged care team. This requires improved access to health professionals with expertise in dementia and mental health when a nursing home calls for help.
Thirdly, nursing home staff competencies should be appropriate to meet the complex needs of residents, particularly those with dementia. This is the long term solution to eradicate the need to apply physical restraint and is achievable with national education and training programs. The harm from physical restraint is well documented, as are the potential solutions. Changing the legislation is a necessary step, but will not change practice on its own.
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Edition: Available editions United Kingdom. There are several methods by which elderly people are physically restrained in nursing homes.
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Read more: There's no need to lock older people into nursing homes 'for their own safety' The scope of the problem The rate of physical restraint in Australia is difficult to ascertain. Care staff need to be better equipped to look after patients without resorting to physical restraint. Current processes Most would expect the use of physical restraints would be closely monitored, with any harm reported to a regulatory or professional body.
You might also like Healthy people now in their 50s and 60s will be the first generations to benefit from reform. For people already in care, changes will come too late. Australians are full of good ideas.
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