Improper Restraints

According to the Nursing Home Patients’ Bill of Rights (NHPBR), which establishes fundamental rights for nursing home residents, a nursing home resident has the right to be free from any restraint – physical, mechanical or chemical which may restrict his/her movement or ability to control his or her bodily functions. Sadly, all too often in the nursing home environment, staff use restraints unnecessarily out of convenience. When restraints are used on these often vulnerable patients, they can become seriously injured and can also suffer emotional damage.

There are two basic types of restraints used in nursing homes: physical restraints and chemical restraints. Physical restraints are designed to restrict the person’s movement. Some of the most commonly used physical restraints include:

Belts or Straps – Often times belts or straps are used to tie or restrain nursing home patients in beds or in chairs. While this practice can be done legally, it is often misused. A gait belt is a fall prevention device used by nursing home staff that is often called a “safety belt”. This device is to be used by applying it around the waist of the resident while they are being assisted with walking. If the resident loses his or her balance, the staff uses the belt to bring the person under control to prevent them from falling. When this type of safety device is not used by a patient with walking problems and that patient falls and injuries themselves, the staff could be held accountable for nursing home neglect.

The National Institute for Occupational Safety and Health (NIOSH) has declared that gait belts are not to be used as transfer or lifting devices as they can cause soft tissue or other injuries to patients. If a nursing home staff misuses a gait belt in this manner that results in a patient becoming seriously injured, the patient and his or her family may be able to file a nursing home abuse claim against the facility.

Posey Vests – The J.T. Posey Company makes belts, jackets and vests which are used to restrain patients to beds or chairs. A Posey vest is used by placing the garment on the patient wherein straps extending from each corner are tied to each side of a bed or together to the back of a chair. This type of physical restraint is designed to prevent a patient from injuring themselves by falling or leaving the bed or chair. Laws in most locations require these vests be put on with the opening at the patient’s front. Abuse takes place when the vest is put on backwards wherein the patient cannot use his or her arms. Many lawsuits have been litigated in which patients have died while being restrained by Posey vests.

Chemical restraints are achieved through the use of psychoactive drugs in order to control a patient’s behavior or to restrict his or her freedom. Nursing homes may use a variety of drugs including Mellaril, Xanax, Benzodiazepine or Lorazepam in order to sedate a patient for the convenience of the staff. These types of medications should never be used unless the reasons and limitations are in written detail in the patient’s care plan.

Signs of Chemical and Physical Restraint

In a nursing home setting, it may be necessary to use chemical restraints in order to protect the health of an individual who has been diagnosed as having a particular type of mental condition. However, it is estimated that up to 21 percent of patients given these drugs do not have mental conditions which require them. The warning signs of chemical restraint include:

  • Drastic changes in the person’s personality and awareness level
  • Tremors, tics or involuntary body movements
  • Excessive tiredness or lethargy and body weakness
  • Anxiety, agitation or the inability to sleep
  • Hallucinations or confusion
  • Dry mouth, blurry vision, constipation, weight loss or gain or other unusual physical changes

The signs of physical restraint include:

  • Unexplained bruising or other suspicious marks on the body
  • The presence of physical restraint devices which may indicate they are being used on your loved one
  • Changes in personality such as anxiety, depression or withdrawal
  • Open wounds or cuts
  • Emotional changes such as being easily upset or agitated

What to Do If You Suspect a Loved One is Being Restrained Improperly

Physical and chemical restraints can be a form of medical treatment if used properly and if documented in the patient’s plan of care. However, the use of these restraints is risky as there are often more negative consequences as a result of their use than there are benefits.

Nursing home patients often do not understand why they are being physically restrained. They can become very anxious, fearful and agitated and will do whatever they can to free them themselves from a physical restraint that can result in them becoming seriously injured. The improper use of both chemical and physical restraint is a form of California nursing home abuse.

You should contact Adult Protective Services if you suspect restraints are being used improperly on your loved one. Your local ombudsman will conduct a thorough investigation to verify or discredit your claim. The improper use of restraints is often the result of under-staffing as it’s more convenient for staff to medicate or restrain a resident than it is to provide them with good care. It is against the law to chemically or physically restrain a nursing home resident when it is done merely for the convenience of staff.

You should contact a California personal injury lawyer as quickly as possible if you suspect that your loved one is the victim of the improper use of chemical or physical restraints. Remember that your loved one is counting on you to oversee his or her care. You would want someone to take action on your behalf if you were a vulnerable individual who was being victimized by nursing home staff.

Our San Francisco personal injury attorneys can help you and your loved one get the justice and compensation you need. We will evaluate your case and then advise you on what steps must be taken in order to prove your claim. Nursing homes are supposed to provide their residents with loving care and should never abuse or neglect residents by misusing chemical or physical restraints.

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