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In nursing homes, restraint use may be abuse

Your mother has had balance issues for a while, and her dementia is gradually getting worse. However, you expect that the help she receives in the nursing home will overcome some of the difficulties so she can enjoy the best life possible for her condition.

Unfortunately, not every facility trains staff in the best way to preserve residents' free will and dignity. In some places, the use of restraints takes the place of quality care.

Are restraints ever necessary?

If there is a risk that your mother may harm herself or someone else if the nursing home staff does not restrain her, they may not have another option. Restraints may take the form of a device or equipment attached directly to your mother or nearby, to keep her and others safe. 

Medicare.gov explains that a safety device is not truly a restraint if she can remove it on her own. For example, a bed rail that staff puts up but your mother can lower to get out of bed herself does not meet the description of a restraint. Unless it keeps her from moving on her own or accessing her own body in some way, it is not a restraint.

Results of restraints

According to Advancing Excellence in America's Nursing Homes, a national campaign with the goal of improving life for nursing home residents, in most cases, not only are restraints not necessary, they can actually cause harm. Their use may result in conditions such as:

  • Weak muscles
  • Pressure sores
  • Poor circulation
  • Constipation and incontinence
  • Loss of bone density

Alternatives to restraints

Your mother's confusion, unstable emotions and weakness may seem like they constitute risks to herself and others. There are, however, proven techniques for preventing harm, and all nursing home staff should receive training in using these. For example, they should understand how to recognize agitation or other restless behaviors and determine what the triggers are. Triggers may include pain or infection, or agitation could be a symptom of her dementia.

Your mother should have a care plan that includes her behavior patterns and the calming methods staff can use to intervene and neutralize the risk to her and others. Engaging her in an activity, offering her a snack or simply holding her hand and chatting for a moment may be all that is needed if there is no underlying medical issue.

If you notice that your mother has unusual bruises on her wrists or ankles, or you see other signs that may indicate abuse through the use of restraints, you should notify the authorities. You may also want to speak to an attorney who has experience in holding nursing homes accountable for injuries they inflict through neglect and abuse.

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