From the Southwestern Oklahoma Development Authority
There is much controversy about the use of restraints on residents in long-term care facilities. Many feel restraints prevent injuries; others feel they may cause more injuries. Under Federal laws, restraints cannot be used except in extreme cases where the resident or others may be injured.
There are different types of restraints. A physical restraint is any manual method, or any physical / mechanical device, material or equipment, which is attached or adjacent to the resident's body and which the individual cannot remove easily, and that restricts freedom of movement or normal access to the body. These could be leg or arm restraints, hand mitts, soft ties or vests, safety bars, Geri-chairs and sometimes bedrails, if used to prevent getting out of bed voluntarily. Chemical restraints are any medication given to control mood, mental status or behavior.
What is the the purpose of the method, device, or medication? Does it restrict the resident, or help them to perform more independently? Is the bedrail up to help him turn or balance upon rising from bed? Is the drug given at its lowest possible dose, helping to relieve symptoms of depression or combativeness so they can relax and enjoy some socialization with others?
Federal law says that facilities will not use restraints for discipline or convenience, but only for the health or safety of a resident.
The medical or clinical need must be documented in the resident's record and must be ordered by the resident's physician. The resident must be released from physical restraints at least every two hours or repositioned, and the facility should use the least restrictive methods to determine what level will promote the highest possible physical, mental, or psycho-social functioning ability. Facilities are not to restrain residents who come into the home restraint free, unless there is a documented medical need, and less restrictive options have been tried first.
If you have any questions or concerns about restraint use in long-term care facilities, write to Chris Hamilton or Christi Christian, R.N., ombudsman supervisors, at Southwestern Oklahoma Development Authority, at P.O. Box 569, Burns Flat, OK 73624, or by calling, 1-800-627-4882.
Ombudsman Supervisors will be available for information at Wal-Mart in Altus from noon to 5 p.m. Aug. 13. The next training for new ombudsman volunteers will be Aug. 26 and 27 in Altus, at the Southwest Technology Center, 711 West Tamarack, Room 109.
Training will begin at 9 a.m. and end at 3:30 p.m. on both days. Evening or weekend training is available by request.