Reducing The Use of Restraint For People With Dementia

James Hourihan, Author

The management of challenging behaviours associated with cognitive disorders, such as dementia, requires a nuanced approach to uphold the dignity and well-being of those affected. 

However, studies reveal that the use of restrictive techniques in hospital and social care settings can lead to “dehumanising” outcomes for dementia patients, causing high levels of anxiety and further deterioration – making it all the more essential to apply positive behaviour strategies and help workers safely support people in crisis.

What Is Restraint? 

Restraint refers to any device or activity used to hinder a person’s freedom of movement. These come in many forms from physical restraints and mechanical restraints such as bed rails, chairs with straps, wheelchair lap belts and vests, to chemical restraints like drugs or sedatives used to modify or restrict behaviour. 

Why Is Restraint Used? 

These restrictive methods may be used to protect staff from injury, and prevent someone from harming themselves or others. For example, if a person with dementia attempts to wander out of a facility without supervision, physical restraints may be used in order to prevent them from leaving and possibly harming themselves. 

While it can be a necessary measure in times of crisis, an over-reliance on restraint and the lack of sufficient training for less restrictive interventions (eg: distraction techniques, increased supervision or offering choices) has caused staff in some care settings to accept restrictive interventions as standard practice. 

The Risks of Restraint Used for People with Dementia 

Hence, it is important to remember that restraint should only be used as a last resort and carries several risks which may compromise patient safety and welfare during their dementia care journey. 

Physical Injury & Immobility 

One of the most common risks associated with using restraint is physical injury or immobility. When used in a long-term care setting, prolonged interventions can lead to falls, dehydration, skin breakdowns, circulatory problems, infections and even death in certain cases.

Mental & Emotional Distress 

The individual may become more confused or agitated than before when restrained due to a perceived loss of freedom. This gives cause to feelings of helplessness and vulnerability to express themselves, as well as an increased risk of developing psychosis-like symptoms, such as delusions or delirium if prolonged interventions are used – exacerbating their condition further.

Decreased Quality Of Life 

Another potential risk associated with using restraint is decreased quality of life. Being restrained often leads to boredom and isolation since it limits a person’s ability to communicate their needs effectively, socialise with others, or engage in meaningful activities like hobbies or exercising.

Inappropriate Use 

Finally, if staff do not receive proper training about when and how to appropriately use restraint, they may make decisions that put those individuals in serious harm, rather than actively help them. Additionally, lawsuits could be actioned if an individual’s civil rights are breached. 

Improve Dementia Care With Timian 

Everyone deserves the right to quality care regardless of whether they suffer from dementia or not; therefore it is essential that health and social care workers take proactive steps towards reducing the use of restraint whenever possible. 

At Timian, we help staff develop positive behaviour management strategies tailored specifically towards each individual’s needs with a strong focus on communication and de-escalation skills. 

Call 0800 987 4075 or fill in the form on our website here and our team will be happy to assist you. 

James Hourihan MSc Econ | FRSA | MIOD


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