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Use of Restraints on Residents in Nursing Homes


It is estimated that nearly 20% of nursing home patients given psychoactive drugs do not have a mental condition that warrants the treatment. These drugs are used as a restraint rather than a treatment.

Since 1987, The Nursing Home Reform Act has limited the use of physical and chemical restraints. Restraints now must be medically necessary or to ensure the patients safety, and specifically authorized on an ongoing basis. Prior to this Act, patients might be restrained as a method of keeping residents quiet, and reducing the home’s workload.

A doctor needs to authorize restraints, and only certain types may be used. Physical restraints have developed over the years from archaic methods such as leather straps and chains to devices that are comfortable yet secure, including special foam pads used by residents in a wheelchair along with seatbelts. A special design walker/wheelchair is also currently used where the resident sits in the chair and is restrained by a bar running across the front. It has an extra large base to reduce any chance of a fall. The use of this device is reserved for patients with a history of falling, who are nevertheless still mobile. Other approved restraints include bedrails, clothing that ties to chairs or beds, hand coverings such as mitts, and also wrist and ankle tie-downs.

Any use must be limited and approved by a doctor’s orders and with continuous reevaluation and re-approval. Use of restraints has been linked to reduced quality of life, contributed to accidents, and led to loss of muscle tone, freezing of joints and reduction in cardio-pulmonary efficiency.

If you believe that someone you love may have been subjected to improper treatment in a nursing home, please seek professional malpractice advice immediately.

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