The use of restraints in a nursing home can be a controversial issue due to the possibility that basic medical ethics can be violated. There have been more restrictions on using restraints in recent years.
There have been many instances where different forms of restraints have resulted in harm to a patient. There are also circumstances where restraint use aids in keeping a patient safe.
If you or a family member feels that a form of restraint has been used harmfully, you should speak with the personal injury attorneys. Rosenfeld Injury Lawyers LLC has decades of experience managing personal injury cases.
Our nursing home abuse lawyers are committed to obtaining the settlement you deserve if your loved one was illegally physically restrained by the nursing staff. Call us at (888) 424-5757, and schedule a free initial consultation.
What Is a Restraint?
There was more of a common misconception in the past that restraint use is necessary for the safety of the resident. It is known that restraint use can be overused to the point that it causes pain and harm to a resident.
Many people who work in nursing homes feel that restraints ensure safety for the staff, nurses, and other residents. Doctors and nurses must obtain informed consent from the patient or their power of attorney before using any legally ordered physical restraint.
There are two primary forms of restraint used in nursing homes that the staff members may feel they need to use. The two types are physical restraints and chemical restraints.
Physical Restraints
Physical restraints involve physical or mechanical devices, materials, or equipment attached to restrict a person from making certain movements. Examples of physical restraints include hand mitts, arm restraints, leg restraints, soft ties, and bed rails.
Physical restraints will not allow a person to have normal access to their body. The patient with an attached physical restraint will also not be able to easily remove the device.
Hand mitts are an example of a physical restraint used to aid in the safety of a resident that tends to scratch or pulls on the equipment during treatment. Using a wrist restraint with the hand mitts or attaching them to the bed is a more severe form of physical restraint.
Bed rails are viewed as a benefit because their intended use is to assist a resident in turning around in bed and sitting up. They are considered a form of physical restraint if they restrict a resident from leaving their bed.
Environmental Restraints
There are instances where physical restraints are not used to directly restrict a person’s body. Placing items in a room can also be considered physical, known as environmental restraint.
Often, staff members will place physical items to block a resident from leaving an area out of concern for their safety. If restraints do not allow a person to move around a room or out of an area freely, they are considered environmental restraints.
Positioning objects such as furniture in a way that blocks a person from moving out of a specific area is an example of this form of physical restraint. Unnecessary use of these physical restraints can cause stress and anguish to a resident.
Chemical Restraints
Different medications used to control the state of a patient’s behavior are considered chemical restraints. It is illegal for nursing home staff to use medications as a form of restraint without a medical reason.
Medications not prescribed by the doctor are sometimes used to sedate a person for control.
Effects of the Use of Physical Restraint
While chemical and physical restraints can assist nursing home staff members in maintaining the resident’s physical safety, there are huge risks to consider.
Nurses and staff are trained to understand that physical restraint use can significantly negatively impact the resident’s health and mental state. Restraints may cause increased dependence on the staff, muscle atrophy, and feelings of embarrassment.
Listed below are some of the harmful effects of restraints in nursing homes. It is important to note that there are many more potential risks to the use of physical restraint due to negligence.
Bedsores
One kind of physical restraint is restraining a resident in a wheelchair. Another similar physical restraint is the bed rails that may keep a patient from leaving their bed.
Confining a resident to their wheelchair or bed for prolonged periods can result in injury. This type of physical restraint can cause the bedsores development from the long-term pressure of the skin against a cushion.
If the sores are left untreated, they can break open and become infected. Developing any kind of infection poses a great risk to nursing home residents because they are likely elderly and have a weak immune system.
Muscle Atrophy
When nursing home staff members use physical restraints to keep a resident from readjusting the body without restriction, there is a potential risk that atrophy in the muscles can develop. The use of physical restraints, such as soft ties, can cause this condition and hinder the ability to walk.
Apart from risks posed to a resident’s health, there are also psychological effects associated with the use of physical restraint. Unnecessary restraint of a patient can lead to discomfort, stress, and destructive emotions.
Falls
There are some cases where a resident will resist being physically restrained and become aggressive. The resident’s resistance to a physical restraint may cause them to fall and sustain serious injuries.
Most nursing home residents are elderly with fragile bones. Falling can cause many injuries, including broken bones, sprains, and bruises.
There is a higher risk of falling when a resident attempts to escape restraints. Avoiding this risk altogether is the better option to prevent falls.
Blood Clots
Physical restraint use can also decrease blood circulation in a resident’s body. The nurse may use the top bedsheet as restraint by tucking it under the mattress too tightly.
A decrease in circulation can lead to blood clots. If the blood clots are left untreated, they can lead to other health conditions that require medical attention.
High Blood Pressure
The emotional distress that nursing home residents experience from physical restraints can also lead to high blood pressure. The residents may have other health conditions and be at more risk of having a heart attack because the restraint increased their blood pressure.
Because elderly patients can be fragile, a heart attack can lead to death.
Damaging Effects From Medication
The use of chemical restraint is also risky and can pose serious health risks. Many of the residents are taking multiple prescriptions for their health conditions.
Using medication or psychoactive drugs as a restraint can be dangerous because a drug interaction can lead to complications and other problems. The illegal use of chemical restraints can be considered abuse when used without a physician’s directive.
The chemical restraint should only be used in the case of an emergency with the guidance of a doctor who makes that decision based on medical standards of care. A physician should be the one to order any type of medication for a resident.
A physician can only prescribe a restraint if they know the resident’s medical symptoms and treatment history, and the use meets state and federal law restrictions.
State Laws and Guidelines
In 1986, a study identified the increasing abuse rate in nursing homes. Injuries and deaths caused by the use of restraints were significant.
The Institute of Medicine asked Congress for reforms. In response, lawmakers passed the Nursing Home Reform Act the next year as part of the Omnibus Budget Reconciliation Act of 1987.
Since the passage of the act, Federal law states that it is illegal to use unnecessary restraints.
Facilities that receive Medicare and Medicaid are required to meet the standards that are outlined in the act.
The act sets standards that nursing homes must meet to improve the quality of care for residents. The act highlights the legal rights that nursing home patients have. It also provides guidelines that nursing homes need to follow to ensure the safety of their residents.
These guidelines include maintaining a certain level of staff and nurses, training, and routine examinations of facilities. There are also penalties that each state can give if procedures are not followed according to state laws.
Avoiding the Use of Physical Restraints Among Nursing Home Residents
There are alternatives to using physical restraint that staff are trained to use. The health care team and staff of a nursing facility are advised to use alternative methods, such as developing an individualized care plan.
Specialized care plans tailored to individuals are encouraged to help avoid the need for restraints. Other methods include careful supervision and assessments focused on the individual’s needs.
Ensuring that items such as a call button or water are near to meet a resident’s needs can provide comfort and ensure that any medical problem is addressed right away.
There are also useful tools such as bed alarms that avoid physical restraint. These devices will alert the staff when a resident attempts to get up for any reason.
Staff is also trained to communicate verbally with residents and respectfully handle certain circumstances. Restraints can be avoided when safer methods are put into practice.
Speak With an Attorney
Nursing home residents are already vulnerable due to their health and age. The stress and damages that accompany an injury due to negligence from the use of chemical and physical restraints can negatively impact a resident for a long time.
If you or a family member has been injured due to chemical or physical restraints, you can seek compensation for damages. Contact our attorneys at Rosenfeld Injury Lawyers LLC, at (888) 424-5757 and we will schedule a free consultation.
Our Chicago lawyers are committed to providing the best possible representation. We have the experience to handle personal injury cases and will guide you through the entire process.
All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.
