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Physical Restraints And Nursing Home Residents

When physical restraints are used on nursing homes residents, it can cause serious injuries or even death. The federal Nursing Home Reform Act, enacted in 1987, prohibits this practice except under specific circumstances. The act gives nursing home residents: “The right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.”

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What Types of Physical Restraints Are Used in Nursing Homes?

Physical restraints are physical or mechanical devices attached to or placed near the elderly person’s body to restrict freedom of movement, which cannot be easily controlled or removed by the patient. Examples of physical restraints used in nursing homes include:

  • Wrist restraints
  • Ankle restraints
  • Hand mitts
  • Vests that tie residents to chairs or beds
  • Restrictive chairs, such as Geri chairs, with lap trays and small wheels limiting mobility
  • Bedrails used to keep residents from getting out of bed
  • Bedsheets tucked tightly to prevent a resident from moving
  • Placing a wheelchair-bound resident against a wall to prevent the person from getting up

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Risks Associated with Physical Restraints

Nursing home residents have suffered serious injuries and health conditions, as well as severe psychological harm, due to physical restraints, such as:

  • Bedsores (decubitus ulcers)
  • Muscle atrophy
  • Bacterial infections
  • Pain and discomfort
  • Social isolation
  • Bruising and injuries from attempts to escape
  • Increased assisted daily living (ADL) dependence
  • Increased confusion and reduced cognitive function
  • Increased risk of falling
  • Deaths due to asphyxia, when a patient attempting to get free is caught in a position that restricts breathing

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When Are Physical Restraints Allowed in Nursing Homes?

Under the federal Nursing Home Reform Act of 1987, physical or chemical restraints may only be imposed on nursing home residents:

  • To ensure the physical safety of the resident or other residents; and
  • Only upon the written order of a physician specifying the circumstances and duration under which restraints are to be used (except in emergencies, until such an order can be reasonably obtained).

For physical restraints to be permitted on a nursing home resident, the facility must have a comprehensive nursing assessment of problem behaviors, a physician’s order before or immediately after instituting restraints, and documentation of the failure of alternatives to restraint.

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How Prevalent Is the Use of Physical Restraints in Nursing Homes?

As stated in a British Journal of Medical Practitioners (BJMP) article, the frequency of restraint use depends on the type of restraint, the setting, and the country. Two decades ago, the prevalence of physical or chemical restraints in long-term care facilities in the U.S. was between 28% and 37%. Consistent with regulations and a push from the Centers for Medicare and Medicaid Services (CMS), use of restraints in nursing homes has steadily declined and is now down to approximately 5%.

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Alternatives to Physical Restraints in Nursing Homes

In 2007, CMS issued a memorandum on its commitment to reducing physical restraint use in nursing homes, except when permitted under federal regulations. The agency has implemented campaigns to help nursing homes learn better ways to handle residents. Alternatives to physical or chemical restraints may include:

  • Closer or more frequent supervision of residents by nursing home staff
  • Comprehensive assessment and modification of environments
  • Individualized rest periods and toileting schedules
  • Increased physical and social activities
  • Keeping personal and call items within reach of the resident
  • Appropriately lowered beds
  • Appropriate seating
  • Physical or occupational therapy
  • Frequent checks of resident rooms and areas

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What to Do If Your Loved One Has Been Injured by Physical Restraints

If your elderly loved one has been injured or suffered a health condition due to physical restraints, it is in your best interests to speak with an experienced attorney as soon as possible. Call our Albuquerque nursing home abuse lawyers at Sorey, Gilliland & Hull, LLP at (903) 212-2822 for dedicated representation. We are tough advocates for victims of nursing home abuse and neglect.

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Sorey, Gilliland & Hull, LLP is a legal practice that provides personal, client-centered legal services that address the specific needs of accident victims and injured parties.


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