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Interdisciplinary perspectives on restraint use in aged care

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Breen, J ORCID: 0000-0002-9932-9513, Wimmer, BC ORCID: 0000-0003-3166-7126, Smit, CCH, Courtney-Pratt, H ORCID: 0000-0002-6812-3360, Lawler, K ORCID: 0000-0002-1484-1113, Salmon, K, Price, A ORCID: 0000-0002-3460-2267 and Goldberg, LR ORCID: 0000-0002-8217-317X 2021 , 'Interdisciplinary perspectives on restraint use in aged care' , International Journal of Environmental Research and Public Health, vol. 18, no. 21 , pp. 1-15 , doi: 10.3390/ijerph182111022.

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Abstract

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, physicians, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint; 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but specified that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care

Item Type: Article
Authors/Creators:Breen, J and Wimmer, BC and Smit, CCH and Courtney-Pratt, H and Lawler, K and Salmon, K and Price, A and Goldberg, LR
Keywords: restraint, restrictive practice, chemical restraint, physical restraint, psychotropic, residential aged care, long term aged care, community aged care, nursing home, home care, day care, qualitative
Journal or Publication Title: International Journal of Environmental Research and Public Health
Publisher: MDPI AG
ISSN: 1661-7827
DOI / ID Number: 10.3390/ijerph182111022
Copyright Information:

Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons 4.0 International (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/).

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