Restraint in geriatrics: France's backwardness

Encephale. 2023 Nov 18:S0013-7006(23)00175-6. doi: 10.1016/j.encep.2023.08.010. Online ahead of print.ABSTRACTIn the absence of legal provisions, passive physical restraint methods in geriatrics were defined at the start of this century, accompanied by recommendations relating to their use. Despite the frequency of these measures of restraint, there are few French publications on this subject. It seems that this practice varies according to the geriatric establishments and prevails in hospital more than in nursing home. The most widespread method is the dual barrier on the bed, as well as in hospital than in nursing home. To this should be added restraint provided by the premises themselves, intended to secure access to a facility, found in 90% of residences for the dependent elderly, and also medication. Passive physical restraint, mainly implemented to prevent falls, has however clearly shown its deleterious effects, particularly in the USA where it is thought to be responsible for 1/1000 deaths in nursing homes, although when it is absent there appears to be no increased risk of falls. Medication-based restraint is more readily used to sedate in case of disruptive behaviors (agitation, aggressiveness) although no clear data is available to date. Restraint provided by the premises themselves, used preventively in case of wandering and straying, is nevertheless a deprivation of freedom, and seems to concern the majority of geriatric facilities today. In the absence of legisl...
Source: L Encephale - Category: Psychiatry Authors: Source Type: research