The Use of Physical Restraints in Home Care in the Netherlands

OBJECTIVES To gain more knowledge of the application of physical restraints to restrict, restrain, or prevent movement by elderly people living at home. DESIGN Survey. SETTING Nursing staff in Dutch home care. PARTICIPANTS One hundred fifty-seven nursing staff in home care (registered nurses and certified nursing assistants) from a randomly selected and nationally representative panel returned the questionnaire (response rate 72%). MEASUREMENTS A structured questionnaire on the use of physical restraints. RESULTS Four of every five nursing staff members have applied physical restraints. The use of bed rails, putting the client in a deep chair or using a chair with a table, and locking doors to prevent wandering were most frequently applied, often at the request of the client or his or her family. Protection of the client is the reason most frequently given for these actions. Almost all respondents (94%) know of no alternatives, nor does consensus exist on what is considered to be a physical restraint. CONCLUSION Guidelines are necessary regarding the course of action to be taken when a client is in danger of hurting him- or herself. Further education on and due consideration of the use of physical restraints in home care are also required.