Use of physical restraints with cognitively impaired nursing home residents

The issue of whether restraints should be used in nursing home settings in order to reduce the number of injuries resulting from falls remains controversial on a world-wide basis. In this Dutch study, the care of 265 residents was examined. It was found that restraints were used with 49 per cent of residents, the most frequently encountered being bed rails, belts, and 'geriatric' chairs with a table attached. The most common reason given by nursing staff for the use of restraints was the prevention of falls, followed by a need to control restlessness, and to allow the safe use of medical devices. A novel aspect of this study was that four members of staff volunteered to experience the use of restraints for themselves during a 24- hour period. They reported a complete absence of privacy and freedom of movement, together with physical discomfort. The authors conclude that there is a need to review the use of such restraints in all their aspects.