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Restraint and the care home community
In this chapter, we explore what various members of the care home community think about restraint.
Valuing the views of staff, residents and relatives on any issue - but in this case, restraint - is an important part of creating an environment where everyone feels safe and supported.
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Restraint and the care home community
What do residents say about restraint?
We don't know much about what people who have experienced restraint think about restraint as very few studies have looked at this (see SCIE's literature review on restraint, 2009).
One study found that if residents felt they could control the restraint device - for example, a user-controlled bedrail - they were far more likely to be positive about the restraint (see Gallinagh et al, 2001).
Part of SCIE's practice survey on restraint involved asking residents for their views on restraint (2009).
Read below residents views.
"I love going out and given every opportunity I'll go out. I've no trouble at all in mentioning it to the staff, and they sort out an arrangement."
"It is very important to feel safe, but equally important that you keep your independence."
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Restraint and the care home community
What do staff say about restraint?
As part of SCIE's practice survey (2009), we also asked care staff to share their views and experience on restraint.
Find out more about staff views of restraint below.
"It is down to weighing up the risk and whether the benefits outweigh the risks. This would be discussed with the resident and their relative. We have a man who goes unaccompanied to the local pub every other day. This involves crossing a busy road. He is fully aware of the risks, and he has his own unique way of stopping the traffic with his stick!"
"I had an experience a month ago when we had to physically restrain a man because he attacked the activity organiser and one of the residents. We had to physically remove him from the scene because he was really threatening and throwing hot coffee at other residents."
"We had a man with dementia who was dying. He was constantly thrashing about in the bed. It would have been tempting to sedate him and put up the bed rails, but we had someone with him all the time, so at least he got to do what he wanted in the safety of his own room. It took more staff but at least he found some comfort before he died."
"We have a duty of care to our residents with regards to their safety, but this is their home, so yes we do lock the back door as it opens onto a busy road, however, the front door is only locked at night so residents can walk freely into the garden. We do not stop residents going out."
"We have a resident who always says she wants to go out. Rather than crowd her and say 'No you can't go out', we say 'Ok, off you go' but as long as there's a member of staff about five paces behind her. Just to see where she's going, because they don't actually go far."
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Restraint and the care home community
What do relatives say about restraint?
Like staff, relatives will have different ideas about restraint: some may be more comfortable with risk, others may be frightened, and this will affect their views on restraint.
Relatives may be torn between wanting to make sure their loved one is safe and secure, but also being aware of the distress that restraint may cause.
Read what relatives told us about restraint as part of SCIE's practice survey (2009). See below:
"When my mum first came to this home, I did sign a consent form for restraining and also to allow her to have pureed foods, because she can't swallow."
"Restraint is sometimes necessary."
"I hope the staff know to keep the bed rails up. I very rarely find them down now. But because she [mother] is totally dependent, you've got to feed her, you've got to give her fluid. One minute she'll say she doesn't want a drink, the next she drinks the lot up. She doesn't seem to know what she wants. They always say to me here, 'We've got to respect her wishes' but my mother doesn't make good choices anymore."
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