Avoiding restraints in patients with dementia: understanding, prevention, and management are the keys.
Older adults with dementia are at higher risk than other patients for being placed in restraints, despite numerous negative physical and psychological outcomes associated with their use. Many nurses continue to believe that restraints are necessary to control behavioral symptoms and prevent falls or the disruption of life-sustaining therapies in patients with dementia. Reducing the use of restraints depends on interpreting patient behavior to identify unmet needs; regular assessment for changes in mental or physical status; individualized care focused on communication, consistency, surveillance, and appropriate environments; and a flexible team approach based on dialogue among staff members and respect for patients' needs and rights. For a free online video demonstrating the use of the practice guide, go to: (http://links.lww.com/A231).
Evans
Lois K
LK
Psychiatric Mental Health Advanced Practice Program, University of Pennsylvania School of Nursing, Philadelphia, PA, USA. evans@nursing.upenn.edu
Cotter
Valerie T
VT
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D003142:Communication; D003704:Dementia / Q000517:prevention & control* / Q000523:psychology; D015577:Geriatric Assessment / Q000379:methods*; D005851:Geriatric Nursing / Q000458:organization & administration; D006272:Health Facility Environment; D006801:Humans; D008297:Male; D024802:Nurse's Role; D009730:Nursing Assessment / Q000458:organization & administration*; D009936:Organizational Innovation; D010344:Patient Advocacy; D018802:Patient-Centered Care; D012149:Restraint, Physical / Q000009:adverse effects / Q000523:psychology / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D017751:Safety Management / Q000458:organization & administration