Types of Nursing Home Restraints

Restraining nursing home patients should only be done when absolutely necessary. Older restrained patients are eight times more likely to die than an unrestrained patient, according to Carol Taylor in "Fundamentals of Nursing." A patient should never be restrained as a matter of convenience and restraint should be used as a last resort. Most nursing homes have very strict policies regarding their use of restraints, which must be ordered by a doctor.

Chemical Restraints

• Using medication to sedate patients or make them more cooperative is a form of chemical restraint. This type of restraint is most often use to calm out of control patients when they pose a physical risk to themselves or others. Any drug that is not part of the patient's normal medicine regimen is considered a restraint when used for the purpose of stopping an undesirable behavior. Ativan, Versed and Haldol are commonly used.

Belts and Cuffs

• Belt and cuff restraints can be used on the arms, legs and across the waist. They are commonly attached to the base of the bed. Soft cuff restraints are preferred over the harder leather restraints and are usually sufficient for elderly patients. These restraints should be used for no longer than four hours. To prevent sores, precautions should be taken to ensure the restraints are not rubbing against the skin, especially when using leather.

Chairs

• A chair with a tray, commonly called a Geri Chair, can be considered a restraint. If the tray goes across the front of the patient and is not easily removed it may be difficult for them to stand up or get out of the chair without assistance. The trays may also cause falls if the patients tries to climb over them. Even without a tray a patient with limited mobility may have difficulty getting out of the chair.

Bed Rails

• Raised bed rails are also considered a form of restraint because they can make it difficult or impossible for a patient to get out of their bed. Patients may also attempt to climb over the rail and suffer falling injuries. However, in some circumstances, bed rails can be beneficial because patients can use them for support in turning and sitting. Doctors will commonly order one side raised for this reason. Bed rails are not considered a restraint when the patient requests that they be raised.

Other Forms of Restraint

• Anything that restricts a patient's movement is a form of restraint. Special vests can be used to limit a patient's movement or hold them in a bed or chair. Gauze can be used to create wrist or ankle restraints. Facing a patient in a wheelchair against the wall may prevent them from getting up. Even tucking the bed covers in tightly around a patient can be considered a restraint.