Nursing facilities cut use of restraints

March 27, 2008|Kevin Freking, Associated Press

WASHINGTON - The use of physical restraints on nursing home patients declined nearly 40 percent nationally in recent years as the federal government, states, and the nursing home industry placed greater emphasis on eliminating what once was a common practice.

Overall, about 5.9 percent of 1.5 million long-term patients were physically restrained repeatedly in 2006. That's a drop from 9.7 percent in 2002.

Physical restraints, such as bed rails or wheelchair belts, were once regarded as necessary to improve safety, to keep patients from falling or wandering off, but that mind-set has changed during the past two decades.

States where physical restraints for nursing home patients were most frequently used in 2006 were California, 13.4 percent; Arkansas, 13.2 percent; and Oklahoma, 11.5 percent.

States where restraints were least frequently used were Nebraska, at 1.3 percent; and Iowa, Kansas, and Maine, at 2 percent. The nursing home data were part of an Agency for Healthcare Research and Quality report that compares states on numerous health issues.

Mary Jean Koren, assistant vice president at The Commonwealth Fund, a research group, said that changes to federal law in 1987 made it illegal for nursing homes to use restraints to discipline residents or as a matter of convenience. The restraints can be used only for medical reasons, such as to prevent a resident from tearing out an IV.

"We didn't know better," Koren said. "We didn't understand what it did to people both physically and psychologically."

Those effects typically include depression, pressure sores, and dehydration, she said. Research has also shown that restraints increased the likelihood of injury as the restrained residents lost strength due to inactivity.