The thought of your loved one being restrained in a nursing home is heartbreaking. Sometimes, physical restraints are necessary to prevent nursing home residents from being a danger to themselves or others. However, other times, a nursing home's use of physical restraint is a form of neglect or abuse.
How Is Physical Restraint Used on Patients?
Physical restraints restrict a nursing home resident's independence or movement. Some examples of nursing home restraints include:
- Bed rails. Properly used, bed rails prevent patients from falling out of bed, but patients with limited mobility may be unable to get out of bed at all if the rails are deliberately raised. Bed rails are considered an easy way to control a "difficult" resident or as an alternative to providing proper treatment or activities for rehabilitation. These patients may suffer fall injuries as they attempt to climb over the rail.
- Belts and cuffs. These restraints are meant to calm patients if they pose a physical risk to themselves or others. They are usually attached to the patient's wrists, legs, or across the waist to secure them into a bed or chair. Since these restraints may cause chafing, pressure sores, or circulation problems, they must not be left on for prolonged periods. However, some nursing home employees will use these restraints as a means to punish uncooperative residents.
- Chemical restraint. Nursing home staff who overmedicate or use unprescribed medications, such as antipsychotics or sedatives, to keep a patient tranquil are restraining patients with chemicals.
Vests, pelvic ties, and specialized chairs may also restrain a nursing home resident. The overuse of physical restraints is cruel and can put the nursing home resident in danger.
Nursing Homes Can Reduce the Need for Physical Restraints
Nursing homes should use reasonable precautions to keep residents safe and prevent the use of unnecessary restraints. For example, nursing homes may:
- Remove trip and fall hazards, such as tables and trays with non-locking wheels
- Provide residents with free use of walkers, canes, wheelchairs, and non-slip stockings
- Adapt residents' environments with proper lighting, ergonomic seating, and non-skid surfaces
- Offer many different physical and recreational activities, including adequate exercise and outdoor time, to help control a resident's behavior
- Carefully assess the needs of each resident, such as hunger, thirst, toilet needs, sleeping habits, and exercise, and adapt care to meet the residents' routines rather than the facility's schedule
- Properly train each staff member on the individualized needs of each resident
- Employ enough staff members to respond to residents' needs on an individual basis
- Provide residents with an opportunity to socialize, including encouraging interactions with volunteers, family, and friends
- Use positioning devices such as foam pillows, padded furniture, and body cushions to keep residents comfortable and safe
- Change the layout of the physical environment so that staff can better observe the residents
- Install bed/chair/door alarms that alert staff when a resident has moved or needs assistance
These actions may decrease the number of residents who require physical restraints or the amount of time individual residents need restraint.
Limited Use of Physical Restraints Is Permitted
According to state and federal laws, nursing home residents have the right to be free from restraints unless restraints are medically necessary. If restraints are medically necessary, the nursing home should require:
- Assessments. The assessment should include a review of the resident's medical history, medications, physical condition, cognitive abilities, and mobility, and a statement about whether all alternatives to the restraint have been explored.
- Prior authorization. Authorization from a physician and permission from either the resident or the resident's representative may be required before non-emergency use of physical restraints.
If physical restraints are medically necessary, nursing home staff should:
- Continuously monitor the resident's physical condition, including skin color, sensation, movement of the extremities, toileting, and food and fluid intake
- Maintain the resident's privacy
- Provide breaks from physical restraint use
- Regularly evaluate whether continued use of restraints is necessary
Proper use of restraints can help avoid serious physical restraint injuries.
Physical Restraint Injuries
When restraints are used in nursing homes, injuries frequently occur. Restraint injuries include:
- Suffocation. Residents may get caught and be unable to change position when they can't breathe.
- Broken bones. A fall can result in broken bones. Any broken bone may be a severe injury for a nursing home resident, including but not limited to, broken hips.
- Bedsores. Left untreated, bedsores can lead to the destruction of tissue, muscle, and bones. Dangerous infections may also occur.
- Head injuries. Residents who hit their heads may suffer traumatic brain injuries.
- Bruises. Restraints and falls caused by restraints can lead to severe bruising.
- Constipation and incontinence. Residents who cannot get to the bathroom may develop these uncomfortable medical conditions.
- Isolation. Without the freedom to move, residents may become isolated.
- Emotional stress. Emotional issues such as depression and anxiety may develop
In the most extreme circumstances, death may occur from physical restraint related injuries.
Use of Physical Restraints May Be Nursing Home Neglect or Abuse
Many residents are victimized by restraints that are used for no other reason than a caregiver avoiding the necessity of hands-on care. Even though the use of physical restraints in nursing homes and other assisted living facilities is not prohibited by law, they are often overused or utilized for the wrong purpose. Kentucky nursing home staff should never use restraints as:
- A means of permanently controlling the patient
- A form of punishment for a patient's "bad" behavior
- A mode of convenience for the staff, even if the facility is understaffed
- A substitute for physical activities or recreation
- An alternative to therapy or other treatment
In short, restraints should never be used for the caregiver's convenience or to punish a resident.
Protect Your Loved One After a Nursing Home Restraint Injury
If you believe your loved one is being subjected to nursing home abuse, you need to speak with an experienced Kentucky nursing home neglect attorney as soon as possible. Contact us online or call our office directly at 888.450.4456 to schedule a free consultation about your loved one's legal rights and potential recovery.