RESTRAINTS: NOT ALWAYS A BAD THING
In many cases, falls in nursing homes and hospitals could be prevented by use of appropriate restraints following careful patient/resident assessment by nurses and physicians. As a result of the federal nursing home statute, OBRA 87, which specifically prohibits use of restraints in long-term care settings without acceptable medical review and assessment, many doctors, hospitals and nursing homes believe that restraints are inappropriate for use under any circumstance. In fact, many of these facilities tout themselves as “restraint-free facilities.” This is not true. In many instances, people who are agitated or not cognitively intact would be well served by the use of a restraint if appropriate and it is determined after an appropriate medical assessment that use of a restraint even on a temporary basis may prevent the person from falling and sustaining a hip fracture, brain bleed or other potentially life ending injuries. While it is certainly correct to say that restraints cannot be used as a form of punishment or as a matter of convenience for a health care provider, in many instances falls, fractures and many deaths could be prevented if restraints were used following careful medical assessment that an individual may be in need of them.