What is restraint

A device, substance, or procedure that restricts a person’s ability to move as desired. Restraints can be physical, such as lap buddies, geri-belts, posey jackets, and other items that fasten to a chair or bed to prevent the person from rising. Restraints also can be chemical, such as sedatives and antipsychotic medications that reduce a person’s interest in or capacity for movement. Generally, safety features such as bedrails are not considered restraints.

The use of restraints is controversial. No one likes the idea of a loved one’s being “tied up” or otherwise restricted from movement. Restraints are most frequently used when a person has cognitive impairment significant enough to interfere with judgment combined with physical limitations, and unsupervised mobility is likely to result in falls and injuries. State and federal regulations and guidelines strictly define appropriate use of restraints in hospitals and residential care settings such as LONG-TERM CARE FACILITIES and SKILLED nursing facilities (SNFs), and some states outlaw their use altogether.

Many facilities have internal policies and procedures for the use of restraints that are more explicit than state and federal laws and often provide examples as well as explanations for proper application of restraints. When considering a residential facility for a person with Parkinson’s, ask about restraints and ask to see the facility’s written policy documents. Also check whether residents appear to be restrained. Most facilities allow families to request that loved ones not be restrained. An open and frank discussion with the doctor and the facility’s director can help family members to decide whether restraints are necessary to protect a loved one.