Nursing Home Blog
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Canadian Nursing Homes overuse `Restraints`
Posted on Fri, March 20, 2009 at 5:18 pm
In a recent article in the National Post, we learned that while almost 30% of those in nursing homes and chronic care hospitals in Canada are restrained with, among other items, bed rails, lap trays, and lap belts, only 9% are so burdened in the United States, and just 6% in Switzerland. Although the rate has fallen in Canada from 40% in 1999 and we are moving in the right direction, the usage is still much too high.
Evidence shows that restraints do not prevent falls. In fact, compared to residents who are not restrained, residents in a restraint will suffer from more severe injuries in the event of a fall. Worse, residents are at serious risk of injury and even death from being tangled in a restraint.
Although most nursing homes justify their use to prevent falls, which certainly appears to in the best interest of residents, the opposite is actually true. Restraints have been shown to lead to strangulation, pressure ulcers, decreased mobility, depression, agitation, loss of dignity, incontinence, and constipation.
Many facilities will face resistance from both staff and family members when they move to a ‘least restraint policy’, in which a restraint is used only when the resident is dangerous to himself or others and all other interventions have been unsuccessful. Knowing this, nursing homes must carefully plan for the transition to restraint usage and involve all stakeholders in the process. The nursing home must provide inservices (small educational meetings) to staff, family members, and residents to enlighten them about the myths and realities of restraint use. During these inservices, the home should make you aware of the risks and negative effects of restraint use and should allow you to see the success stories in the home – residents who have had their restraint removed with no resulting falls.
In light of these recent media reports, administrators should be happy to share their statistics about falls and restraint use with residents and their families. As we educate the public about the overuse of restraints in Canada, perhaps we will move closer to American and Swiss success rates and offer seniors more of the freedom and dignity that they deserve in their old age.
Christine Taylor
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