Living with dementia

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Restraints

Use of restraints

A restraint is anything that restricts or controls a person's movement or behaviour. There are three main types of restraints:

  • Physical restraints restrict or control movement or behaviour. They may be attached to a person's body or create physical barriers.
  • Chemical restraints are medications used to modify or restrict behaviour, for example, tranquilizers and sedatives.
  • Environmental restraints change or modify a person's surroundings to restrict or control movement, for example, a locked door.

Restraints are sometimes useful. For example, the temporary use of a lap belt can support a person to sit up and participate in a group activity. The short-term use of a medication can decrease disturbing hallucinations. A protected garden can allow for safe wandering.

Using restraints to manage behaviour in the belief that less harm will be done if the person is restrained is inappropriate and debilitating. It can cause the person to lose skills and abilities that are unlikely to return. Loss of independence and low self-esteem can also occur. Relying on restraints discourages caregivers from trying to find the cause of the person's distress that led to using the restraint.

It’s best to use no restraints. However, using restraints for a limited time, with close monitoring can be helpful. Use the following guidelines:

  • Try to avoid or manage the behaviour that led to considering restraint use.
  • Ask your facility or agency about their protocol on the use of physical, chemical and environmental restraints.
  • Try to make the use of restraints, when they are necessary, a useful tool that preserves  the person's dignity.

Resources:

From the Alzheimer Society of Canada:

  1. The Alzheimer Journey Module 4. Understanding Alzheimer Disease: The Link Between Brain and Behaviour.

Other:

  1. Dementia with Dignity. Eastway Communication, Crow's Nest, NSW, 2002.
  2. Everyone Wins! Quality Care Without Restraints [video and workbooks]. Independent Production Fund, New York, NY, 1995.
  3. Understanding Difficult Behaviours: Some Practical Suggestions for Coping with Alzheimer's Disease and Related Illnesses. Anne Robinson, Beth Spencer and Laurie White, Geriatric Center of Michigan, Ypsilanti, Michigan, 1989.


Last Updated: 05/22/14
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