This film looks at restraint in health and social care from a human rights perspective. It explains how using a person centred approach by putting people at the centre of decisions about their care can minimise the use restraint. The film looks at what restraint is, when it is acceptable to use restraint, using a person centred process to minimise the use of restraint and the importance of health
(Edited publisher abstract)
This film looks at restraint in health and social care from a human rights perspective. It explains how using a person centred approach by putting people at the centre of decisions about their care can minimise the use restraint. The film looks at what restraint is, when it is acceptable to use restraint, using a person centred process to minimise the use of restraint and the importance of health and social care practitioners being able to talk about the subject freely and openly, without taboo. It draws on the Mental Capacity Act and Human Rights Act.
(Edited publisher abstract)
Subject terms:
human rights, restraint, Mental Capacity Act 2005, person-centred care;
This film uses two examples to illustrate how restraint can be minimised. The first example describes the experience of Peter, who is living in a care home and has a urinary tract infection. A common side effect of such infections is confusion, which is made worse by Peter's Alzheimer's disease. The second story is about Florence, a lady in her 80's who had developed a chest infection and had...
(Edited publisher abstract)
This film uses two examples to illustrate how restraint can be minimised. The first example describes the experience of Peter, who is living in a care home and has a urinary tract infection. A common side effect of such infections is confusion, which is made worse by Peter's Alzheimer's disease. The second story is about Florence, a lady in her 80's who had developed a chest infection and had been admitted to hospital suffering delirium. Key messages for practice are: sometimes it is necessary to apply restraint in the person's best interests; the need for restraint has to be reassessed on each and every occasion as people's needs and capacity change; using a person-centred approach and understanding a person's life story is vital; and talking with colleagues, carers families and people who use services can help to minimise restraint.
(Edited publisher abstract)
Subject terms:
restraint, mental capacity, Alzheimers disease, mental health problems;
This briefing examines the use of restraint in care homes and approaches to minimise its use. It presents some of the learning from a review of the literature on the use of restraint in care homes for older people and an exploration of practice. The briefing looks at what might constitute restraint, whether restraint is ever right, the links between risk and restraint and developing knowledge...
(Edited publisher abstract)
This briefing examines the use of restraint in care homes and approaches to minimise its use. It presents some of the learning from a review of the literature on the use of restraint in care homes for older people and an exploration of practice. The briefing looks at what might constitute restraint, whether restraint is ever right, the links between risk and restraint and developing knowledge and skills. Key messages include: many different actions can constitute restraint, ranging from physically holding someone to unintentionally leaving their walking frame out of reach; understanding what restraint is, and the occasions on which it is acceptable, is the first step towards minimising its use – the Mental Capacity Act (2005) provides some clear guidance; using a five-step framework will help with making informed decisions in situations where the use of restraint is being considered – observe, do some detective work, consider the options, implement the plan, monitor and review the plan; supporting residents to take positive risks helps increase their wellbeing as well as reducing reliance on restraint to maintain their safety; talking openly about restraint with residents, relatives and staff will help promote good practice; using the physical environment to promote a sense of wellbeing can help avoid some of the situations that result in the use of restraint; care staff need opportunities to develop their skills and knowledge, and to share learning about how to respond to the challenges they face.
[Published: October 2009; Updated April 2021]
(Edited publisher abstract)
Subject terms:
older people, physical restraint, restraint, care homes;
Purpose: This paper aims to consider the experiences of people with intellectual disabilities in relation to the COVID-19 pandemic and subsequent lockdown restrictions. Design/methodology/approach: This commentary reflects on the issues raised by Morris et al., and in the wider literature. Findings: Although there have been some benefits to lockdown for people with intellectual disabilities, mainly they have experienced isolation, increased mental health and well-being challenges, difficulty in accessing services, support and adequate adapted information. Originality/value: This commentary argues that it is important to continue to capture the experiences of people with intellectual disabilities now and over time to assess the long-term consequences of the pandemic and to design services which are respondent to their needs.
(Edited publisher abstract)
Purpose: This paper aims to consider the experiences of people with intellectual disabilities in relation to the COVID-19 pandemic and subsequent lockdown restrictions. Design/methodology/approach: This commentary reflects on the issues raised by Morris et al., and in the wider literature. Findings: Although there have been some benefits to lockdown for people with intellectual disabilities, mainly they have experienced isolation, increased mental health and well-being challenges, difficulty in accessing services, support and adequate adapted information. Originality/value: This commentary argues that it is important to continue to capture the experiences of people with intellectual disabilities now and over time to assess the long-term consequences of the pandemic and to design services which are respondent to their needs.
(Edited publisher abstract)
Subject terms:
Covid-19, social isolation, learning disabilities, restraint;
This framework is intended to promote measures that will lead to the reduction of restrictive practices. Restrictive practices include: physical restraint; chemical restraint; environmental restraint; mechanical restraint; seclusion or enforced isolation; long term segregation; coercion. The framework also seeks to ensure that where restrictive practices are used, as a last resort, to prevent
(Edited publisher abstract)
This framework is intended to promote measures that will lead to the reduction of restrictive practices. Restrictive practices include: physical restraint; chemical restraint; environmental restraint; mechanical restraint; seclusion or enforced isolation; long term segregation; coercion. The framework also seeks to ensure that where restrictive practices are used, as a last resort, to prevent harm to the individual or others, that this is informed by person centred planning, within the context of the service setting and in a way which safeguards the individual, those whom they interact with, and those who provide services to them. This document covers: the human rights framework for the reduction of restrictive practices; approaches to support effective person centred practice; restrictive practices; working to reduce restrictive practices.
(Edited publisher abstract)
Subject terms:
restraint, physical restraint, compulsory detention, government policy;
International Journal of Nursing Studies, 117, 2021, p.103856.
Publisher:
Elsevier
Background: Use of physical and chemical restraints are common in residential aged care facilities worldwide. Restraint use can pose harm to residents even causing deaths. Objective: To synthesize the prevalence and variability in physical and chemical restraint use, and examine factors that may contribute to this variability of prevalence rates. Methods: Six health science databases were...
(Edited publisher abstract)
Background: Use of physical and chemical restraints are common in residential aged care facilities worldwide. Restraint use can pose harm to residents even causing deaths. Objective: To synthesize the prevalence and variability in physical and chemical restraint use, and examine factors that may contribute to this variability of prevalence rates. Methods: Six health science databases were searched from inception up to 21st January 2020. Quantitative studies investigating restraint use in residential aged care facilities that reported data from year 2000 onwards were included. Meta-analyses of binomial data using a random effect model were performed to pool proportions of physical or chemical restraints with 95% confidence intervals. Univariable meta-regression analyses were used to assess factors that may contribute to the variability in physical and chemical restraint prevalence. Multiple meta-regression analyses were performed where possible to construct models of factors contributing to these variations. Results: Eighty-five papers were included. The pooled proportion of physical and chemical restraint use in residential aged care facilities were 33% and 32% respectively. Bedrails (44%) and benzodiazepines (42%) were the most prevalent forms of physical and chemical restraint respectively. Studies from North America (lower prevalence) [coefficient (95% CI): -0.15 (-0.27, -0.03)], measurement approaches using direct observation (higher prevalence) [0.17 (0.02, 0.33)] and a combination of multiple measurement approaches (higher prevalence) [0.17 (0.05, 0.29)] explained 25.5% of variability in the prevalence of physical restraint. Multiple meta-regression analyses were not performed to identify factors that may explain the observed variability in chemical restraint prevalence due to the small number of studies with data available. Conclusion: Variability in prevalence of physical restraint could be explained partly by different measurement approaches and geographical regions. Valid and reliable measurement approaches across different regions is required to understand cultural differences due to geographical region effects on the prevalence of physical restraint use.
(Edited publisher abstract)
Subject terms:
restraint, physical restraint, care homes, older people;
Journal of Social Welfare and Family Law, 42(2), 2020, pp.133-153.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
This paper assesses the design and use of protection orders for domestic violence in England and Wales. It draws on data from 400 police classified domestic violence incidents and 65 interviews with victims/survivors, as well as new analysis of government justice data from England and Wales, to address a gap in literature on protection orders.The paper identifies an increasing civil-criminal ‘hybridisation’ of protection orders in England and Wales, and argues that a dual regime has developed, with orders issued by police and/or in criminal proceedings increasingly privileged (and enforced) over victim-led civil orders. Whilst protection orders are being used – as intended – flexibly to protect domestic violence victims, the way they are applied in practice risks downgrading domestic violence in criminal justice terms. The conclusions are especially timely in light of current Government proposals to rationalise protection orders by introducing a single overarching Domestic Abuse Protection Order in England and Wales.
(Publisher abstract)
This paper assesses the design and use of protection orders for domestic violence in England and Wales. It draws on data from 400 police classified domestic violence incidents and 65 interviews with victims/survivors, as well as new analysis of government justice data from England and Wales, to address a gap in literature on protection orders.The paper identifies an increasing civil-criminal ‘hybridisation’ of protection orders in England and Wales, and argues that a dual regime has developed, with orders issued by police and/or in criminal proceedings increasingly privileged (and enforced) over victim-led civil orders. Whilst protection orders are being used – as intended – flexibly to protect domestic violence victims, the way they are applied in practice risks downgrading domestic violence in criminal justice terms. The conclusions are especially timely in light of current Government proposals to rationalise protection orders by introducing a single overarching Domestic Abuse Protection Order in England and Wales.
(Publisher abstract)
Purpose: In the Netherlands, as in England, concerns exist about the extent of and frequency with which freedom-restricting measures are applied. The view is that use of these measures needs to decrease. The purpose of this paper is to outline new legislation that is expected to come into force in the Netherlands in 2020. Design/methodology/approach: This paper provides a description of legislation entering into force on 1 January 2020. Findings: Many of the new legislation’s practical implications remain unclear, including the definition of involuntary care. Research limitations/implications: The new legislation will start being monitored directly after coming into force, and only then the authors will make out what works well and what does not. Practical implications: Introducing new legislation on coercion is not sufficient. Careful implementation of the legislation is important, including the way it defines involuntary care. Originality/value: In 2020, the Netherlands is introducing new legislation on involuntary care for people with an intellectual disability. This includes a definition of involuntary care.
(Edited publisher abstract)
Purpose: In the Netherlands, as in England, concerns exist about the extent of and frequency with which freedom-restricting measures are applied. The view is that use of these measures needs to decrease. The purpose of this paper is to outline new legislation that is expected to come into force in the Netherlands in 2020. Design/methodology/approach: This paper provides a description of legislation entering into force on 1 January 2020. Findings: Many of the new legislation’s practical implications remain unclear, including the definition of involuntary care. Research limitations/implications: The new legislation will start being monitored directly after coming into force, and only then the authors will make out what works well and what does not. Practical implications: Introducing new legislation on coercion is not sufficient. Careful implementation of the legislation is important, including the way it defines involuntary care. Originality/value: In 2020, the Netherlands is introducing new legislation on involuntary care for people with an intellectual disability. This includes a definition of involuntary care.
(Edited publisher abstract)
Journal of Applied Research in Intellectual Disabilities, 28(2), 2015, pp.61-80.
Publisher:
Wiley
Background: The second in a two-part series, this article focuses on experiences with restraint intervention for challenging behaviour among people with intellectual disabilities.
Methods: A mixed methods research synthesis involving statistical meta-analysis and qualitative meta-synthesis techniques was applied to synthesize 76 retrieved articles. This second article reports on the qualitative...
(Edited publisher abstract)
Background: The second in a two-part series, this article focuses on experiences with restraint intervention for challenging behaviour among people with intellectual disabilities.
Methods: A mixed methods research synthesis involving statistical meta-analysis and qualitative meta-synthesis techniques was applied to synthesize 76 retrieved articles. This second article reports on the qualitative meta-synthesis of 17 articles on experiences with restraint intervention for challenging behaviour among people with intellectual disabilities.
Results: The 17 included articles report on important variables relating to the persons receiving restraint intervention, to the persons giving restraint intervention and to their interactions and relationship, as well as variables situated at the meso- and macro-level.
Conclusions: The developed model can assist in reflecting on and improving of current restraint intervention practices among people with intellectual disabilities.
(Edited publisher abstract)
Subject terms:
challenging behaviour, learning disabilities, user views, restraint;
A summary of good practice guidance which identifies key actions that will better meet people’s needs and enhance their quality of life, reducing the need for restrictive interventions. It also sets out mechanisms to ensure accountability for making these improvements, including effective governance, transparency and monitoring. Relevant for all those working in health and social care settings: commissioners of services, executive directors, frontline staff and all those who care for and support people known to be at risk of being exposed to restrictive interventions.
(Edited publisher abstract)
A summary of good practice guidance which identifies key actions that will better meet people’s needs and enhance their quality of life, reducing the need for restrictive interventions. It also sets out mechanisms to ensure accountability for making these improvements, including effective governance, transparency and monitoring. Relevant for all those working in health and social care settings: commissioners of services, executive directors, frontline staff and all those who care for and support people known to be at risk of being exposed to restrictive interventions.
(Edited publisher abstract)
Subject terms:
challenging behaviour, government policy, restraint, physical restraint;