Physical Restraints

A physical restraint is a manual method or a physical or mechanical device that is attached or placed next to a person's body that restricts freedom of movement and can't be controlled or easily removed by the patient. Examples of physical restraints include:

• Hand mitts
• Restrictive chairs, like Gerichairs with lap trays and small wheels that limit mobility
• Vests that tie nursing home residents to their chairs or beds
• Wrist restraints
• Ankle restraints
• Bedrails when used to keep a resident from getting out of bed when desired
• Bed sheets tucked so tightly that a resident can't move
• The placement of a wheelchair-bound resident to a wall that prevents the resident from getting up.

Bedrail Injuries

Remember also that the law requires a doctor to write an order for bedrails when they are used to restrain a nursing home resident. Oftentimes, the use of bedrails isn't questioned and orders are not obtained because people mistakenly believe that the bedrails are either an effective safety device or that they pose no harm.

The most common injury suffered by those enclosed by bedrails occurs when a nursing home resident climbs over the rails and falls to the floor. This type of fall increases the risk of a more significant injury because when people climb over their bedrails and fall, the height of the fall is greater than had they fallen from a bed without rails.

Also, because the use of bedrails increases the likelihood that a nursing home resident will spend more time in bed and, therefore, lose muscle strength and develop gait and balance problems and disorientation and confusion, the chances of falling when attempting to get up after the rails are removed increases.

The combination of bedrail restraints and any other physical restraint attached to the body, like a vest or wrist restraint, can be deadly. The likelihood that a falling resident will become suspended in the restraint when attempting to climb over, under, around, through, or between the rails increases, and possible resulting injuries include:

• Chest compression
• Strangulation
• Suffocation
• Death

Restraint Injury Resources:

• Chemical restraints
• Effects of restraints
• Evaluating physical restraint claims
• Overview
• Prevention tips

Other Nursing Home Abuses:

• Bedsores
• Dehydration
• Elopement
• Falls
• Malnutrition
• Mental Abuse
• Physical Abuse
• Restraints
• Sexual Abuse
• Wandering
• Wrongful Death

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