Interdisciplinary Perspectives on Restraint Use in Aged Care

Juanita Breen, Barbara C. Wimmer, Chloé C.H. Smit, Helen Courtney-Pratt, Katherine Lawler, Katharine Salmon, Andrea Price and Lynette R. Goldberg
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Juanita Breen: Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
Barbara C. Wimmer: School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
Chloé C.H. Smit: Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
Helen Courtney-Pratt: Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
Katherine Lawler: Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
Katharine Salmon: Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
Andrea Price: Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
Lynette R. Goldberg: Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia

IJERPH, 2021, vol. 18, issue 21, 1-15

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.

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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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