Physical restraints in homes for the elderly: attitudes of management and nursing staff towards their use

C. A. Elsden, E. Vélez Mediavilla, J. Arana Izuel, Mª. I. Chasco Arróniz, Mª. J. Espina Díez

SUMMARY

Introduction: The use of physical restraints, such as straps and cotsides, in Residential Homes for the Elderly raises serious questions as regards ethics, legality and care-giving. The attitudes of management and direct care staff in Residential Homes towards their use are very important for its reduction. Aim: To examine the attitudes of management staff, social workers, and medical and nursing staff towards their use. Methods: A qualitative study with 25 in-depth interviews of staff using 13 multiple open questions; the validity of the transcription of answers was checked using the blind judges technique. Results: All agreed that the use of restraints should be avoided as much as possible. The nursing staffs were those most in favour; management staff mentioned ethical problems. In general their use caused negative feelings although some claimed not to be personally affected or to become accustomed to it. There are protocols or action guidelines; the decision to use restraint is delegated to the medical staff, after considering the resident’s welfare. Some residents feel bad about their use, others more secure. Conclusions: There is a need for relevant legislation, action protocols, staff training and research. The multidisciplinary team should take part in decision-making.

KEY WORDS

Physical restraint, residential facilities, aged, staff attitudes.

Vol. 13 nº1-2002