Restraints in Dementia Care

A Nurse’s Guide to Minimizing Their Use


Restraints in Dementia Care

Your best tool to optimize patient care by minimizing restraint use

Frontline nurses face fraught decisions every day about whether and how to use restraints in dementia care. They need to consider many complicated issues: legislation governing the use of restraints, the policies of health-care facilities, the expectations of families, and—most importantly—the well-being, dignity, and safety of patients and care providers.

Frontline nurses need the right support to navigate decisions about restraint use.

Dr. Atul Sunny Luthra and his colleagues have developed an algorithm to provide that support. Their work comes from focus-group consultations with frontline staff, a review of current literature on restraint use, and a clear summary of key legislation. The algorithm’s systematic approach ensures restraints are a last-resort measure, and puts the right steps in place when restraints are necessary.

This short guide includes:A review of nurses’ perspectives on restraint use.Alternatives to restraints in patient management and assessment of clinical indicators for restraint use.Procedures to ensure informed consent when restraints are necessary.A reference on appropriate and inappropriate restraint use in everyday clinical situations.

Table of Contents

Table of Contents
Restraints in Dementia Care 1
Acknowledgements 4
Introduction 5
1 Five clinical scenarios Perspectives on restraint use from frontline staff at Homewood Health Centre 7
2 Nurses perceptions of restraint use A literature review 17
3 Clinical indicators for restraint use A literature review 26
4 The law and restraint use 38
5 Obtaining informed consent for restraint use 45
6 A decision making algorithm for restraint use in dementia care 57
7 A reference on appropriate restraint use 65
References 81
About the authors 87