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Why do we use physical restraints in the elderly?

J P H Hamers1, A R Huizing

  • 1Universiteit Maastricht, Department of Health Care Studies, Section of Nursing Science, 6200 MD Maastricht, The Netherlands. jph.hamers@zw.unimaas.nl

Zeitschrift Fur Gerontologie Und Geriatrie
|March 10, 2005
PubMed
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Physical restraints are frequently used for fall prevention in elderly care, despite evidence of harm. Research suggests reducing their use due to adverse effects like falls and pressure sores.

Area of Science:

  • Gerontology
  • Healthcare Management
  • Patient Safety

Background:

  • Physical restraints are commonly used for elderly patients in hospitals and nursing homes.
  • Prevalence rates for restraint use in nursing homes (41-64%) and hospitals (33-68%) between 1999-2004 are significant.
  • Restraint use in home care settings remains largely undocumented.

Purpose of the Study:

  • To review current knowledge on physical restraint use in elderly care.
  • To identify common types of restraints and reasons for their application.
  • To examine predictors, adverse effects, and strategies for reducing restraint use.

Main Methods:

  • Literature review summarizing data on physical restraint prevalence, types, and indications.
  • Analysis of reported predictors for restraint use, including patient and organizational factors.

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  • Compilation of documented adverse effects associated with physical restraint use.

    • Main Results:

    • Bed rails, belts, and specialized chairs are frequently used restraints.
    • Primary reasons for restraint use include fall prevention and safe medical device management.
    • Predictors include poor mobility, cognitive impairment, high dependency, and perceived fall risk.
    • Adverse effects encompass falls, pressure sores, depression, aggression, and mortality.

    Conclusions:

    • Physical restraints are associated with numerous adverse outcomes in the elderly.
    • Evidence suggests restraints are ineffective for fall prevention.
    • Strategies for reducing physical restraint use are necessary and require further research.