Physical and Chemical Restraints in Nursing Homes

Though the use of restraints on patients and residents in care facilities might seem outdated, the law does allow nursing homes to still use restraints in certain situations. However, there are strict rules and standards that must be followed when using restraints in nursing homes. If a nursing home does not properly follow state regulations with regard to the use of restraints, they can be held liable for their negligent actions.

Improper use of restraints in nursing homes is a form of abuse. Residents who are subjected to this kind of abuse can suffer physical and emotional damages that can be dangerous for their health and well-being.

If you suspect the nursing home where your loved one resides is abusing the use of restraints, you should take immediate action to report the incident and have the issue resolved. This includes contacting a lawyer who can help you file an official claim or even a lawsuit against the nursing home.

At Crossen Law Firm, our nursing home abuse and neglect lawyers are dedicated to advocating for those suffering in nursing homes. We understand how devastating and traumatic these situations can be and are here to help you and your loved one hold the right parties accountable and ensure you are fairly compensated for the damages suffered.

If you suspect your loved one is the victim of nursing home abuse through the improper use of restraints, contact a skilled nursing home abuse lawyer right away at (317) 401-8626.

What Is the Purpose of Using Physical Restraints?

There are many legitimate reasons why restraints may need to be used in a nursing home. While the term “restraint” is often associated with negative connotations, care facilities will sometimes use physical restraints when it is in the resident’s best interest. Using restraints can prevent residents from hurting themselves or even hurting others.

Situations where restraints might be used can include:

• To prevent a resident with behavior problems from harming themself or harming someone else.
• To prevent a patient from falling out of bed who has a history of falls with a risk of serious injury.
• To help a resident with a neurological or orthopedic condition maintain strict positioning.
• To prevent the dislodgement of a fresh central line in the neck or chest, which may be used for dialysis or UV therapy.
• To restrain a patient who is easily confused, becomes violent, or agitated when it is necessary to give them medications or intravenous fluids.

Examples of Physical Restraints in Nursing Homes

A physical restraint can include a number of implements or devices that are used to restrict movement. In a nursing home, physical restraints can include:

• Lap belts
• Side rails
• Recliners and geri chairs that prevent easy movement
• Concave mattresses that prevent a resident from getting up and falling out of bed
• Trays on chairs that prevent a resident from rising
• Orthotic devices that keep a resident in a certain position or restrict movement
• Vests that restrict movement
• Belts on the wrists, pelvis, or waist that restrict movement

What Is the Protocol for Use of Physical Restraints in Nursing Homes?

While the restraints listed above are allowed, the government still has strict protocols and standards that must be followed when using restraints in a nursing home. If these regulations are not followed, it can be viewed as a violation of resident rights and a form of abuse.

Indiana Code 16.2-3.1-26 lists the following as proper facility practices with regard to the use of restraints:

• Less restrictive measures must first be tried and have proven ineffective before restraints are applied.
• Restraints may only be employed by order of a physician, and the type of restraint must be specified.
• Restraints shall only be employed per required need (PRN) upon authorization of a licensed nurse.
• The nursing home’s policy manual must designate who is authorized to apply restraints.
• Those authorized to apply restraints must have been properly trained.
• If an emergency warrants the need for immediate restraint, restraint may be authorized by a licensed nurse and may be used for no longer than 12 hours. After 12 hours, a physician’s order is required for continued use of the restraints.
• Nursing homes must keep records of when physical restraints are used.
• If a resident is under restraint, they must be checked on by a member of the nursing staff at least once every hour.
• If a resident is restrained, they must be temporarily released from their restraints at least every two hours except when the resident is asleep. When the resident is temporarily released, they should be assisted with their needs (using the bathroom, changing positions, etc.)
• Key lock restraints are not permitted.
• Restraints shall be used in a way so as not to cause physical injury.
• Restraints shall only be used for the protection and safety of the resident or others as required by medical symptoms that warrant the use of the restraint.
• Restraints shall not be used as a form of punishment.
• Restraints shall be used in a way as to minimize discomfort.
• The resident’s legal representative must be notified of the need for restraint at the time of the physician’s order or within 24 hours after an emergency restraint was applied.
• The least restrictive restraint must be used, and the continued use of the restraint must be reviewed at each care plan conference.
• The use of restraints must be reviewed by the interdisciplinary team within one month after the restraint was applied, every 30 days for the first 90 days, and at least quarterly thereafter.

Injuries That Can Result From the Use of Physical Restraints

As stated in the regulations above, physical restraints must be used in a way so as not to cause injury. Unfortunately, it is not uncommon for nursing homes to use restraints improperly, which can easily lead to injury. Some of the most common injuries that occur from the use of restraints include:

• Bruising
• Restricted breathing/breathing difficulties
• Ulcers
• Sores
• Urinary and bowel issues (from being unable to use the bathroom)
• Malnutrition (from being unable to eat)
• Loss of muscle strength and balance
• Decreased cardiovascular endurance

The use of physical restraints in nursing homes can also be psychologically damaging for residents. When a resident is restrained too long and improperly, they can become agitated, depressed, hopeless, scared, and experience increased anxiety.

What are Chemical Restraints?

Chemical restraints are drugs that are used to calm someone. The specific term for these kinds of chemicals is psychoactive drugs. Similar to physical restraints, chemical restraints are often used when someone is a danger to themselves or others. Examples of chemical restraints used in nursing homes include:

• Antipsychotics
• Benzodiazepines (i.e. Valium, Xanax, Ativan)
• Mood stabilizers
• Antidepressants

What is the Purpose of Using Chemical Restraints in Nursing Homes?

Use of chemical restraints in nursing homes can occur for many reasons but are most often used to sedate a resident whose behavior is violent, dangerous, or erratic. They are also used on residents who have dementia or other cognitive or mental disorders that can cause them to act out and become unmanageable when agitated, confused, or scared.

Like physical restraints, chemical restraints may also only be applied under certain circumstances while following government regulations for chemical restraint protocols. Unfortunately, chemical restraints are often abused in nursing home settings and are applied for convenience rather than safety.

A report by Human Rights Watch, for example, shows that chemical restraints are often applied simply to keep residents docile and make the job easier for nurses and other staff. According to the report, nursing homes administer antipsychotic drugs to over 179,000 residents who do not have diagnoses that warrant the use of such drugs.

Dangers of Chemical Restraints

The use of chemical restraints can come with a number of risks. Even when there is an official order provided by a physician for the use of chemical restraints, these methods can still be dangerous.

Some of the most common risks associated with the use of chemical restraints in nursing homes include:

• Increased risk of falling
• Increased risk of stroke
• Difficulty walking
• Issues with balance
• Dizziness
• Delirium
• Increased confusion or agitation
• Gastrointestinal problems
• Memory loss
• Insomnia
• Death

How a Nursing Home Abuse and Neglect Lawyer Can Help

Improper use of restraints in nursing homes can have serious consequences. If you suspect your loved one is being abused by improper use of restraints, you should report the issue immediately to the local authorities, Adult Protective Services, and your local Ombudsman program.

You should also get in contact with a lawyer if you suspect restraint abuse. Proving that restraints are being used inappropriately is not easy. Nursing homes will do whatever it takes to prove they have the legal right to use the restraints. Thus, you will need a lawyer who can help you gather the evidence needed to hold the nursing home accountable.

A lawyer can also help guide you through the entire legal process, help you understand your rights, and ensure your loved one gets the care they need. They can also represent you in court if necessary and can ensure you are awarded the fair settlement you deserve for the damages suffered as a result of the abuse of your loved one.

Crossen Law Firm: Indianapolis Nursing Home Abuse Lawyer

Discussing your case with an experienced Indiana nursing home abuse lawyer can help you during this trying time. At Crossen Law Firm, our team will fight tirelessly on your behalf and the behalf of your loved one to help you get what you are owed. You will not owe us anything unless we win your case.

Make the right call. Call Crossen Law Firm at (317) 401-8626 or contact our firm online.