Physical or Chemical Restraints

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Whether a resident in a nursing home is restrained physically or through the use of chemicals can either be a positive or negative action on the part of the staff, depending on the scenario and context for the decision to use the restraints. This means that restraining a resident in a nursing home is not necessarily an “all or nothing” option. It is imperative to evaluate the particular situation and condition of the resident in order to determine whether having a restraint will benefit them or cause them harm.

What constitutes physical restraint?

When thinking about physical restraint, images of captivity may come to mind. However, it is not necessary to actually tie someone to the furniture to implement a physical restraint. Specifically, in nursing homes physical restraints can refer to:

  • Vests or trays that keep residents immobile in a wheelchair.
  • Bed rails or belts used to keep residents confined to their beds.
  • Alarms that prevent them from crossing a threshold.

What constitutes a chemical restraint?

For nursing home residents, a chemical restraint would be medication given in order to control their behavior. They could be either antipsychotic drugs or sedatives. Using these drugs to control pacing, wandering, or uncooperative behavior is not the main purpose of these drugs and can constitute inappropriate action.

What drugs are considered chemical restraints?

When medications are used to sedate a patient, and not for medical reasons, they are considered chemical restraints. Some of the medications used to chemically restrain a patient include:

  • Antidepressants
  • Antipsychotics
  • Sedatives
  • Antianxiety medicines

Is diazepam a chemical restraint?

Many people are familiar with Valium® which is the trade name for the drug diazepam. Its purpose is to control anxiety and there is limited evidence to support that it is effective when looking to manage certain behaviors brought on by conditions such as dementia.

In order for diazepam to work as a chemical restraint, very high doses would have to be administered, putting in peril the resident’s life.

What are alternatives to physical and chemical restraints?

There are plenty of actions that can be used in place of chemical or physical restraints. Among them:

  • Using lower beds that don’t need rails
  • Reviewing the resident’s medications
  • Using devices that do not restrain movement
  • Providing massages and physical therapy
  • Offering enough social opportunities and entertainment activities
  • Regularly assessing the individual resident’s needs and how they are being met
  • Lap Buddies
  • Increasing resident monitoring and supervision
  • Ensuring adequate staffing levels are maintained
  • Encouraging family members to be more involved

What are the immediate dangers associated with the use of restraints?

There are many consequences of using restraints. Before applying them, the possibility of creating an even greater problem should be evaluated. Among the effects of restraints, these are some of the most common ones:

  • Decreased muscle strength
  • A reduced appetite that leads to malnutrition
  • Dehydration due to insufficient water consumption
  • Constipation
  • Incontinence
  • Urinary tract infections
  • Sores and bruises
  • Depression
  • Loss of dignity

Other, more serious consequences may also be present, even death.

Are there some positive aspects of using restraints?

Sometimes, the use of a restraining device or medication may be a lifesaver for the resident. They may be used to prevent falls, reduce the risk of elopement and getting lost, minimize behavioral issues, and even as a response to medical necessities. Nonetheless, state and federal regulations require that the least restrictive means of keeping a resident safe are used. 

Has your loved one suffered as a result of physical or chemical restraints?

The team of legal experts at the Rooth Law Firm is ready to assist you with these and any other nursing home issues such as neglect or abandonment. Make an appointment today.

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