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Restraint Use in Dementia and Alzheimer's Disease


Updated: August 8, 2006

Historically, the treatment of dementia and other psychological problems, is overshadowed with devices and techniques that both restricted and restrained the movement of patients. These devices had multiple functions. At best they were used to keep the patient safe from self harm and accidental injury, at worst, to save the institution and the staff from expense and from having to keep returning to one person to deal with their behavior.

Restraints come in many different forms; chairs with lap barriers, wrist restraints, straight jackets, ties to the bed or chairs and even padded cells.

Over time the use of restraints has increasingly been viewed both as undesirable and abusive. Use of restraints became viewed as synonymous with poorly staffed, tired and frusted caregivers attempting some level of control with agitated, demented, self-determined, sometimes violent people, in a system that was understaffed by poorly trained and often indifferent people in under-funded care facilities.

I know these words sound harsh, but I do talk from a position of knowledge.

Researchers and clinicians working with people exhibiting difficult and challenging behaviors know that restraints are rarely the answer to the difficult job of containing and keeping safe people with dementia such as Alzheimer's. Restraints can increase the incidents of physical harm and the psychological effects can easily be imagined.

Imagine You are Restrained and Have Alzheimer's Disease
One of the great maxims of nursing and medical care is that you should imagine yourself in the patient's position to help you evaluate the impact of your treatments. Imagine you want to get up and go to the toilet. You might not know where you are, what your name is, your experiences are confused but your bladder is full. But you cannot get up, you do not want to wet yourself and you know by moving to another area (the bathroom) that you will feel better. Hard to imagine isn't it?

Use of Restraints and Physical Harm
Just some of the physical problems and side effects of improper use of restraints are:
Prolonged immobility can lead to constipation, muscle wastage, balance problems, pressure sores, incontinence, sores infections, smell, increased use of tranquillizers medications, disease, increased mortality.

Use of Restraints and Psychological Harm
Restraints cause fear, frustration, unhappiness, loss of dignity, depression, increased agitation, skill loss, loss of autonomy and is in most cases violating your human rights.

Go to Page 2. Alternatives to the Use of Restraints

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