Prevalence of patients subjected to constraint in Norwegian nursing homes

Abstract

The use of constraint is a problem in Norwegian nursing homes. Studies are needed to learn more about why constraint is used, and if there is patient or ward characteristics that can explain the use of constraint.

Diagnostic accuracy of three types of fall risk methods for predicting falls in nursing homes

“…Our study population was similar in its age and gender to that of Norwegian nursing home residents in general (47,48). However, any generalizations to other nursing homes generally must be made with caution, because of our study setting, and because the nursing homes were not a random sample from all nursing homes in Norway.…”

Use of constraints and their correlates in Norwegian nursing homes

“…In two Norwegian studies it has been demonstrated that other forms of constraints are also frequently used (Kirkevold et al, 2003;Kirkevold and Engedal, 2004). It has been argued that autonomy is an important ethical principle, vital to successful ageing (Clark, 1988).…”

The ethics of coercive treatment of people with dementia

“…In such situations, their autonomy was overruled, despite the fact that there was no danger to life or health. As previous studies have shown, 4,7,12,15,16,19,28 RNs using coercive measures had convinced themselves that residents' problematic behaviour was due to lack of insight, and therefore, constraints were seen as appropriate. It seems as though legal rights were understood as actions to prevent falls or harm, and not as actions to support autonomy and non-coercive dementia care.…”

“…13 Various types of coercive measures, such as mechanical and non-mechanical restraint, compulsion to take part in nursing and medical treatments or activities of daily life (ADLs), seem to be common practice in institutional care in most Western countries. 7,[14][15][16][17][18][19] Coercive measures have been associated with severe adverse effects. 12,14,17,18 Despite coercive measures' harmful effect on quality of life, use of them is probably primarily based on lack of education and unawareness of alternative measures.…”

“…5,6 Understanding when established constraints are to be perceived as an enforced physical violation or detention, and reflecting over existing norms and attitudes in care of older people, requires legal knowledge, competent staff, committed leadership and multi-professional teamwork. 1,[7][8][9][10][11] Historical background Swedish studies 1,5 have revealed how coercive treatment regulations in municipal dementia care were used incorrectly. Physical restraints were used to a greater extent than permitted by legislation, and the decision to use such restraints had been made by professional healthcare staff other than physicians.…”