title: Commentary: Barriers to a sustained restraint-free environment.
abstract: A restraint-free culture is becoming a standard practice in the provision of long-term care services for older people, a standard by which licensure and accreditation agencies evaluate providers. Although most health care providers initiate restraint-elimination processes, many fail to achieve the intended result or sustain the practice because of a variety of barriers. Faltering organizations find themselves faced with monumental changes in administrative and supervisory staff, substantial recruitment and retention crises, and inadequate attention to a culture of continuous learning, teamwork, and leadership skill building. This article informs policy makers about the barriers to achieving and sustaining a restraint-free environment and suggests public policy agendas and processes to improve conditions for the aging population.
authors.affiliation: Kendal Outreach, LLC, Kennett Square, Pennsylvania 19382, USA. bgoldman@kendaloutreach.org
authors.forename: Beryl D
authors.initials: BD
authors.lastname: Goldman
mesh_terms: D000368:Aged; D006282:Health Personnel / Q000458:organization & administration; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D009735:Nursing Homes / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011640:Public Policy; D011787:Quality of Health Care / Q000458:organization & administration; D012149:Restraint, Physical / Q000706:statistics & numerical data*