Objective: To describe the individualized care alternatives used during the process of removing physical restraints in a nursing home.
Design: Descriptive survey.
Setting: A non-profit geriatric long-term care facility.
Subjects: Sixty-three physically restrained residents (mean age = 85.3 years).
Measures: Information regarding the different care alternatives used to replace physical restraints was obtained from the Gerontological Clinical Nurse Specialist implementing the process of removing restraints.
Results: The physical restraints of six of the 63 participants were removed without implementing any care alternative. With the remaining 57 participants, an average of 3.3 different care alternatives were used (range 1-7 care alternatives). Environmental alternatives (such as wheelchair adaptations and alternative seating) were used with 86% of the restrained residents; alterations in nursing care (such as additional supervision and toileting schedules) were used with 77% of the participants. Psychosocial and physiological alternatives, as well as the use of structured activities, were used less frequently. At the end of the study period, five residents remained restrained.
Conclusions: This papers shows the complexity of the process of removing physical restraints in the nursing home. The need of an individualized approach is stressed.