title: [Effects of a physical restraint removal program on older people with dementia in residential care].
abstract: OBJECTIVE
  To analyse the results of removing physical restraints from elderly patients with dementia living in nursing homes. This objective is part of a wider process of change in residential care.
  
  
  METHODS
  Quasi-experimental study conducted in two residences from May 2010 to May 2012. Information was collected at 7 time points and longitudinal analyses were performed. After training staff, the physical restraints in El Puig centre were phased out, while in the Conarda centre, restraints were still applied to elderly people. The main variables studied were: falls, psychotropic medication prescriptions, different indicators of mental impairment, and degree of dependence (Norton, NPI, Mini-mental, Tinetti, Barthel).
  
  
  RESULTS
  In the El Puig centre all the physical restraints were removed. A slight improvement was seen in the number of falls, and their consequences. The ANOVA showed significant improvements in the centre that removed restraints in prescribing psychotropic medications, cognitive impairment, and behavioural changes.
  
  
  CONCLUSIONS
  It is shown that removing physical restraints do not cause negative effects as regards the number of falls, and also positively affects the welfare and independence of elderly people (through changes in behaviour and mental impairment). Furthermore, it is demonstrated that this program must be accompanied by the reduction and control of medicines (withdrawal of the number of psychotropic prescriptions).
authors.affiliation: Departamento de Economía Aplicada, Universitat de València, Valencia, España. Electronic address: Angeles.tortosa@uv.es.
authors.forename: M Ángeles
authors.initials: MÁ
authors.lastname: Tortosa
authors.affiliation: Departamento de Economía Aplicada, Universitat de València, Valencia, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Granell
authors.affiliation: Departamento de Economía Aplicada, Universitat de València, Valencia, España.
authors.forename: Amadeo
authors.initials: A
authors.lastname: Fuenmayor
authors.affiliation: Geroresidencias, La Saleta, Valencia, España.
authors.forename: Mary
authors.initials: M
authors.lastname: Martínez
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D003704:Dementia / Q000451:nursing*; D006801:Humans; D009735:Nursing Homes; D010808:Physical Examination; D012149:Restraint, Physical
keywords: Caídas; Falls; Medication; Nursing homes; Patient-centred outcomes research; Physical restraints; Psicofármacos; Residencias mayores; Resultados atención centrada en persona; Sujeciones físicas