Nursing Home Restraints: Sometimes Necessary, but Easily Abused

The Miami Injury Law Firm of Klemick and Gampel focuses a significant part of its practice on the treatment of the elderly at nursing homes. Far too often, nursing homes are overcrowded with patients and understaffed with workers who are underpaid and not trained adequately. This combination can result in our loved ones being mistreated and even abused by those who are being paid to look after their welfare. This is especially true here in the Miami area, where a great many Americans come to spend their retirement. At Klemick and Gampel, we find abuse and neglect of the elderly particularly abhorrent, and we take pride in helping those who have suffered. If you or a loved one has been injured due to neglect or abuse at the hands of nursing home staff, contact the Law Offices of Klemick and Gampel today.

The use of physical restraints in for elderly residents in nursing homes has long been an uncomfortable issue. The use of belts, vests, pelvic ties, specialized chairs or bedside rails is a common enough occurrence in nursing homes, and sometimes their use can seem cruel or unnecessary. But the sad and uncomfortable truth is that there are some circumstances where the uses of restraints are vital to keeping the patient safe. Patients who are suffering from dementia or disorientation, or patients who fail to recognize that their ability to walk has been either diminished or removed entirely sometimes need to be kept in one place.

The other completely valid side of the argument is that these restraints should not be used as punishment against patients, or used for the convenience of the nursing home staff. At Klemick and Gampel, we know all too well the gray area that exists between proper and necessary restraint of nursing home patients and the abuse of restraints by nursing home staff.

Situations in Which Restraints are Necessary

Patients who suffer from Alzheimer’s or other conditions where dementia and forgetfulness is a symptom can sometimes benefit from the responsible use of restraints. If the patient has to be left unsupervised for a short length of time and has shown a history of wandering, the use of restraints can keep the patient from wandering somewhere dangerous. Similarly, there are cases in which a patient is in denial about physical limitations, and keeping this patient in one safe place is the best thing that can be done until he or she comes to grips with their condition. A patient who needs to be restrained and isn’t is susceptible to falls and injuries, and a nursing home staff that either fails to recognize a high risk patient or ignores orders from a doctor are not doing their jobs.

Situations in Which Restraints are Not Necessary

The state of many nursing homes today is less than perfect. Understaffed, underpaid, overworked and inexperienced staff is almost the rule as opposed to the exception. The reason for this sad state of affairs is almost uniformly due to cost saving measures on the part of the nursing homes, and the consequences of this can be dire for the residents.

The use of restraints as punishment or due to sheer laziness on the part of the staff is not only ethically wrong, but also against the law. The Nursing Home Reform Act of 1987 stated, among other things, that:

The resident has the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms (7).

While the Nursing Home Reform Act did not prohibit the use of restraints entirely, it did set up strict guidelines and parameters that must be met before the use of restraints are considered appropriate. This legislation has dramatically lowered restraining incidents since it began to be enforced in 1990. Prior to the NHRA, restraining incidents occurred with an estimated 40% of nursing home residents. The rate of incidents has since dropped to a level of 12%.

While this is good news, it should also be recognized that many nursing homes do not operate with transparency. There is no way to monitor the performance a nursing home staff 24 hours a day. Who is to say that if your loved one was restrained, it happened for justifiable reasons? A nursing home that is understaffed with inexperienced workers could restrain your loved one simply to make the jobs of the staff easier. And restraining a nursing home resident needlessly can result in a myriad of physical and emotional damages, including confusion and disorientation, a loss of dignity, bedsores, and the excessive accumulation of water in tissues.

A nursing home should not be a prison. While restraint use can be justified, they should not be used as a permanent measure. Restraint use should be combined with every conceivable effort to bring the patient to the point where they are not necessary.

If you suspect that your loved ones are suffering from neglect or abuse at a Miami area nursing home, contact the law offices of Klemick and Gampel for a free legal consultation today.