Restraints: What do you need to know?

Frequently Asked Questions About Restraints

What is a restraint?

In a medical or care facility context, a restraint is defined as the forcible confinement or control of a subject.

What are the different types of restraint?

Generally, restraints are divided into three different categories: personal, mechanical, and chemical.

What is a personal restraint?

A personal restraint occurs whenever an individual is restrained physically by another person without the use of any devices.  Examples of personal restraints include grabbing an individual by the wrist, enveloping them in a bear hug, or pinning them to the ground.

What is a mechanical restraint?

A mechanical restraint is the restraint of an individual using a device of some sort, such as a papoose board, restraint chair or arm and leg straps attached to a chair or bed.

What is a chemical restraint?

A chemical restraint occurs when a sedative or other medication is administered to an individual in response to a behavior.

Are restraints dangerous?

They can be.  There have been several documented cases nationwide of injuries and even deaths resulting from the use of restraints in institutional settings.  Additionally many experts believe that not only are restraints of no therapeutic value, in many cases the use of restraints can be a traumatic experience for the individual subjected to it.

When is it acceptable to use restraints?

Many experts believe that due to the inherent risks of physical injury and traumatization, restraint should never be an option.  However, the rules put forth by the Centers for Medicaid and Medicare Services, or CMS, state that restraints should be used only as a last resort and never for discipline, staff convenience or as a substitute for other treatment.

How do I know what the restraint policy is at a facility?

The best way to be informed about any aspect of your, or a loved one’s, care is to ask the staff.  If you ask a question that a staff member cannot answer, ask them who would know and then ask that person.

What questions should I ask when considering a facility for my, or a loved one’s, placement?

While there will be many important factors which will be specific to your, or a loved one’s, circumstances, some things you may want to know include:

  • Can the services you require be provided in a home or community-based setting instead of a congregate care facility?
  • What are the staff-to-resident ratios (which will often vary according to time of day)?
  • What training does direct care staff receive?
  • What are the facility’s policies on restraint, and which methods are utilized?
  • What is the frequency of restraint use?
  • How many medical and psychiatric staff does the facility employ, and what is their availability at different times of day? What are their credentials?

Who can help if I feel that I or a loved one is being subjected to unnecessary or excessive restraints in a congregate care facility?

  • Disability Rights Arkansas

1-800-482-1174

http://disabilityrightsar.org/contact/

 

  • Arkansas Office of Long Term Care

501-682-8430

TDD: 501-682-6789

http://humanservices.arkansas.gov/dms/pages/oltchome.aspx

 

  • The Arkansas Long-Term Care Ombudsman Program

501-682-8952

http://www.arombudsman.com/