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Quality indicator – use of physical restraint

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Physical restraint is deliberately restricting a person’s movement or behaviour. It can be by the use of equipment designed to limit or stop someone from moving, taking away mobility aids or by using physical force.

Some examples of equipment that could be used as physical restraints include bed rails, lap belts, restraining chairs, table overlays, hand mitts and vests.

Why is physical restraint used as a quality indicator?

A restraint-free environment is the recommended standard of care for aged care homes. Research shows that using physical restraints can cause harm.

Aged care homes should carefully consider what physical restraints are used in their homes and look at other ways which may produce better results.

What is the impact of physical restraint?

While the use of physical restraints may be seen as a safety measure for people, it may cause harm. For example it can lead to:

  • pressure injuries
  • incontinence
  • loss of muscle strength
  • falls
  • cuts and bruising
  • pain
  • poor nutrition
  • difficulty moving
  • mood swings including anger, withdrawal and aggression
  • confusion, anxiety and depression
  • loss of trust between older people and their families, and staff
  • distress for family members

Physical restraint also has an impact on your rights and dignity.

What can lead to the use of physical restraint?

People are more likely to be restrained if they have poor health, dementia, physical disabilities, mental health issues or they are at a high risk of falls.

Issues that may lead to harm for you should be included in your care plan so that you receive care without the use of restraint where possible.

How is physical restraint managed?

Aged care homes should regularly review the number of times they use physical restraint and look for other ways of caring for older people.

Health professionals make decisions about when to use physical restraint. You, your family or your representative should be involved in all these decisions.

What can be done to avoid physical restraint?

Things the aged care home can do instead of physical restraint include:

  • reducing the risk of falls and injury by using equipment such as low beds, non-slip mats and hip protectors
  • educating families and staff about behavioural and psychological symptoms
  • increasing the safety of the home, such as secure environments to allow safe wandering, or making sure the home is well lit
  • using exercise and social activities
  • taking care of needs such as poor eyesight and mental health, or problems such as poor balance or unstable blood pressure.

How can I help minimise physical restraint?

It is important that you or your representative are involved as much as possible in developing a care plan.

Tell care givers about any conditions that may affect your care, as well as what you do and don't like, and how you would like to be treated.

Let the staff at your home know as soon as possible about any changes that may impact your care plan. Family members can also be very important in noticing changes that mean a medical problem is starting or getting worse.

Questions you may like to ask an aged care home about physical restraint

You might like to ask the aged care home some of these questions:

  • How do you manage physical restraint?
  • Is physical restraint recommended by health professionals for people like me?
  • Can I or my family ask that a physical restraint is used or say that we do not want a restraint to be used?
  • If a restraint device is being used:
    • can you explain why it is needed?
    • has a thorough assessment been made?
    • have you considered other ways of managing this issue?
    • can you provide me with some information about the other ways of managing this issue?

Last reviewed: 10 December, 2016.