{"id":6814,"date":"2017-01-25T17:09:43","date_gmt":"2017-01-25T12:09:43","guid":{"rendered":"http:\/\/blog.seatingmatters.com\/using-restraint-in-care-homes"},"modified":"2017-01-25T17:09:43","modified_gmt":"2017-01-25T12:09:43","slug":"is-it-ever-acceptable-to-use-restraint","status":"publish","type":"post","link":"https:\/\/wheelchair-experts.in\/is-it-ever-acceptable-to-use-restraint\/","title":{"rendered":"Is it Ever Acceptable to Use Restraint?"},"content":{"rendered":"

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Every so often a very sad story appears on the news about cases of abuse of elderly patients in care homes, having being restrained in their chairs.<\/span><\/p>\n

Late last year we read about the case in Northern Ireland where an elderly gentleman with dementia was tied to his chair by two care home employees and left unattended for at least two hours. <\/span><\/p>\n

This was a horrific ordeal for the gentleman and a tragic situation for his family to learn, who were absolutely devastated when they discovered what happened, days after the incident had occurred.  On examination they found bruises and marks on his arms.  This obviously caused the gentleman great pain and distress, and the incident affected his personality afterwards, leaving him nervous and withdrawn.  The care home in question has since closed and the member of staff found guilty of assault.  <\/span><\/p>\n

\"Elderly<\/span><\/p>\n

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Unfortunately this is not an isolated case.  Often with late stage dementia patients and patients with other neurological conditions; they can pose a safety risk to themselves and to others.  They might impulsively try to stand up whilst forgetting that they cannot weight bear, therefore they are a high falls risk.  Another key concern is when patients might become agitated and lash out, as they risk injuring themselves or others.  As a result of this, we see restraint being used more often, and most commonly, the use of belts\/lap belts as a safety measure.<\/span><\/p>\n

When a patient is individually assessed and matched with a chair to meet their needs, often the need for restraint is drastically reduced and incidence of falls from chairs is also greatly reduced.<\/span><\/span><\/a><\/span><\/h3>\n

Click here to request a free demonstration of the Seating Matters chairs at a time and place that suits you and your patient, letting the patient trial the chair.<\/span><\/a><\/h3>\n

Consider this situation:<\/em><\/h3>\n

Your elderly mother has dementia.  She now lives in a care home specially catering for neurological conditions.  She uses a wheelchair for mobility.  On occasion she has been known  to stand up and stumble from her wheelchair.  She needs help completing this task but sometimes she forgets that she is not strong enough to stand up on her own.  Just a few days ago she unfortunately had a nasty fall, which resulted in an open head wound and a trip to the Emergency Department.   You were devastated when you saw the after effects of this fall and vowed you would do whatever possible to ensure it doesn’t happen again. You talk to the staff at the care home about the various options to prevent this and keep her safe, which include restraint.<\/em><\/p>\n

Weigh up the pros and cons of the situation.<\/em><\/p>\n

Restraint is holding your mother in her chair against her will, impeding her independence, dignity and possibly increasing agitation.  <\/em><\/p>\n

Without restraint, you’re terrified that your mother will fall again, inflicting further pain and suffering.  <\/em><\/p>\n

It is a difficult, emotional situation with no easy answer.<\/em><\/p>\n

The Issue of Restraint<\/h2>\n

Restraint is a complex subject.  At Seating Matters we know that when patients are matched with seating appropriate to their size and clinical needs, the need for restraint is often greatly reduced.  We have seen the difference a proper chair can make to a patients’ quality of life, comfort and safety.  If a patient is sitting in an oversized standard chair which is not tailored to their requirements, they are more at risk of falling out and causing injury or harm.  When they are safe, supported and snug within their chair, exactly matched to their needs, they are less agitated, more likely to sit peacefully and be safe, enjoying their surroundings.  This can allow the patient a greater sense of independence and dignity, rather than being restrained which can have psychological as well as physical side effects.<\/p>\n

Restraint and the Law<\/h2>\n

In different countries and in different regions, the regulations and rules around restraint differ. Sometimes even within one facility, the guidelines can differ from unit to unit depending on the patient groups.  In this blog, I’m aiming to outline some of the issues around restraint and ways that proper seating can help reduce some of the risks around this contentious issue. However, please bear in mind that you must follow the guidelines set out in your own place of work and comply with your internal, regional or national laws and regulations around restraint.<\/p>\n

The Dangers of Using Restraint<\/h2>\n

The real danger with restraining a patient is where the use of restraint is abused to the extent where it is used as a result of convenience rather than necessity.  Sometimes as a result of desperation we hear of extreme examples where shocking and unacceptable levels of restraint are applied to the most vulnerable members of our society.  Although it can be abused in some extreme cases, most often it is used by a carer as a last resort when they wish to protect the patient from doing physical harm to themselves or other patients. Sometimes the carer may know of no other way to prevent such harm, and therefore they see a temporary restraint as the least harmful option.<\/p>\n

What is Considered Restraint?<\/h2>\n

Anything which restricts free movement of the patient can be considered restraint.  <\/p>\n

In terms of specialist seating the following things can be considered as restraint:<\/p>\n