"Untie the Elderly": Restraint Use Down in Nursing Homes
A physical restraint is any device that inhibits a person's movement or access to their body, such as bedrails. Physical restraints were once widely used in nursing homes to "protect" elderly residents from harm, keep them in their chairs and from wandering the halls. It was a widespread belief that restraints made residents safer. Use of restraints can cause muscles to atrophy and residents can become socially withdrawn. Statistics show that there have been deaths from restraint use. In fact, the Terry Law Firm has handled several cases where residents have died from the improper use of restraints. Here, Elwin McKenzie and Nancy Durgan, two of our clients, talk about their mother, the nursing home they chose for her, and her death by asphyxiation after becoming entrapped between her mattress and the bedrail restraint.
The United States does not ban the use of restraints if there are documented medical reasons to do so. In fact, in 1987, Congress passed a law that granted nursing home residents the right to be free of restraints and bans their use for discipline or ease of care.
Today, fewer care facilities are using restraints. "Untie the Elderly" is a decades-long crusade to stop the use of restraints and is credited for having gotten the message out about the danger of restraints. That movement united patient advocates, nursing homes, government groups, and private foundations in the fight to free elderly people from restraints. In 1991, 21.1% of residents were restrained daily. In 2003, that number dropped to 8.5% and to 5.5% in 2007. Twenty-five states use restraints on 4% or fewer residents. Three states actually topped 10% in restraint use: Arkansas, California, and Oklahoma. Pennsylvania is one of the leaders of the no-restraint movement with a 2.8% restraint rate.
Restraint use can be lessened if nursing home facilities pad their floors to prevent falls or lessen fall severity. Better pain managment can reduce agitation and efforts to increase companionship or provide activities assist residents with dementia. Constant assessment is important also. Simply altering a medication that causes dizziness or offering physical therapy to increase strenght or improve balance can make all the difference. Providing residents with non-skid socks, non-slip chair seats, lowering beds, and providing beds with special lips helps too.
