Physical or Chemical Restraints in Nursing Homes
The Nursing Home Reform Act of 1987 gives all nursing home residents the right to be free from physical and chemical restraints used for the purpose of discipline or for the convenience of the nursing home staff.
The use of restraints as punishment, laziness or under staffing is not only ethically wrong, but also against the law.
Has your loved one suffered injuries or trauma as a result of being restrained without their consent?
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The Nursing Home Reform Act
The Nursing Home Reform Act of 1987 stated, among other things, that:
The resident has the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the residents medical symptoms (7).
While the Nursing Home Reform Act did not prohibit the use of restraints entirely, it did set up strict guidelines and parameters that must be met before the use of restraints is considered appropriate.
Restraints may be used only to ensure the physical safety of the resident or other residents and, except in an emergency, only when a doctor writes an order that details the duration and circumstances under which restraints can be used.
Those most often restrained include residents limited in their ability to carry out three or more activities of daily living, those with:
- Residents with low cognitive performance,
- Residents taking antipsychotic medications, and
- Residents with a history of falls.
Often there are too many patients for too few employees. Unfortunately, this situation is too often remedied by the use of physical or chemical restraints. The unnecessary use of restraints in nursing homes is a form of nursing home abuse; and, in most cases, restraints are not necessary.
A physical restraint is a manual method or a physical or mechanical device that is attached or placed next to a persons body that restricts freedom of movement and cant be controlled or easily removed by the patient. Examples of physical restraints include:
- Hand mitts
- Restrictive chairs, like Geri Chairs with lap trays and small wheels that limit mobility
- Vests that tie nursing home residents to their chairs or beds
- Wrist restraints
- Ankle restraints
- Bedrails when used to keep a resident from getting out of bed when desired
- Bed sheets tucked so tightly that a resident cant move
- The placement of a wheelchair-bound resident to a wall that prevents the resident from getting up
The combination of bedrail restraints and any other physical restraint attached to the body, like a vest or wrist restraint, can be deadly. The likelihood that a falling resident will become suspended in the restraint when attempting to climb over, under, around, through, or between the rails increases, and possible resulting injuries include strangulation, suffocation and death.
Chemical restraints are psychoactive drugs given to control such things as pacing, restlessness and uncooperative behavior. Although many psychoactive drugs can be useful to treat depression and dementia, they can be extremely harmful when used to restrain a nursing home resident.
Effects of Restraints
Restraining a nursing home resident needlessly can result in a variety of emotional, mental and physical problems, including:
- Increased cognitive dysfunction, such as disorientation and confusion
- Decreased activities of daily living
- Increased agitation and loss of autonomy and dignity
- Urinary incontinence or retention
- Chronic constipation
- Loss of muscle function
- Increased bone fragility
- Cardiopulmonary de-conditioning
- Lower extremity edema
- Fractures that result from a fall caused by the use of a restraint
Research supports the conclusion that restraints are not effective in preventing falls and resulting injuries. In actuality, the use of restraints prohibits people from moving around and getting sufficient exercise. Therefore, muscles become weaker and gait and balance worsen. In addition, many restrained nursing home residents become disoriented and confused.
Preventing Injuries due to Restraints
- Review the residents plan of care to determine the risk for using restraints. Risks factors include problems with falling, positioning, elopement and/or wandering.
- Learn about the drugs your or your loved one is taking. Many books are available that contain easy-to-understand descriptions, adverse side effects and what medical conditions certain drugs are used to treat.
- If a restraint is used, remember that the law requires the doctor to write an order for the restraint that details the duration and circumstances under it can be used. Ask to see the order.
- After reading the order, discuss the restraint use with the physician and ask how the restraint will help the residents function. If you are dissatisfied with the explanation and believe the restraint is unnecessary, contact authorities.
Approximately 200 nursing home residents die each year as a result of strangulation or suffocation caused by restraints, even in cases where the restraints were correctly applied.
Contact our Team of Lawyers Today
If you or your loved one is the victim of any type of nursing home abuse or neglect, you may like to consider contacting a nursing home injury attorney to protect your rights and make sure you receive compensation for harm suffered at the nursing home.
Taking legal action against an abusive or negligent nursing home is one of the best ways to raise awareness, improve quality of care and effectively improve the life of your loved one and other victims of nursing home abuse/negligence.
Our entire team of legal professionals are dedicated to preventing negligence and abuse from occurring in nursing homes.
We work with a team of medical experts, investigators and other attorneys. Our team of attorneys, nurses and paralegals has taken on many nursing home abuse cases over the years. Our team helps clients and their families obtain financial restitution for their pain, suffering, financial loss and medical expenses. We provide each client with extensive resources, aggressive representation, personalized attention and compassionate legal care.
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