Restraint of adults with intellectual disabilities: A critical review of the prevalence and characteristics associated with its use

Fitton, Lucy

doi:10.1177/1744629518778695

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…This manuscript is especially valuable for professional caregivers such as nurses and GPs who focus on providing person‐centred dementia care. Involuntary treatment is not only common in home care for PwD, it occurs in other settings, including hospitals (Kalula & Petros, 2016 ; Lay, Nordt, & Rossler, 2011 ) or nursing homes (Gjerberg et al., 2013 ; Gulpers et al., 2011 ; Wagner et al., 2007 ) and in other people in need of care too, including mental health care (O'Brien & Golding, 2003 ; Pelto‐Piri, Kjellin, Lindvall, & Engstrom, 2016 ) and care for people with intellectual disabilities (Fitton & Jones, 2018 ). These studies often refer to coercive measures, resistiveness to care or restraints to describe care against the client's will and/or to which the client resists.…”

Section: Relevance To Clinical Practicementioning

confidence: 99%

Involuntary treatment in dementia care at home: Results from the Netherlands and Belgium

Mengelers

Moermans

Bleijlevens

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To gain insight into the request, use and associated factors of involuntary treatment in people with dementia (PwD) receiving professional home care in the Netherlands and Belgium. Background Most of the PwD remain living at home as long as possible. Due to complex care needs, this can result in an increased risk for care provided against the wishes of the client and/or to which the client resists, referred to as involuntary treatment. Design Secondary data analyses of two cross‐sectional surveys. Methods Dementia case managers and district nurses filled in a questionnaire for each PwD in their caseload. This study included data of 627 PwD receiving professional home care in the Netherlands and 217 in Belgium. The same methodology (questionnaire and variables) was used in both samples. Descriptive statistics and multi‐level logistic regression analyses were used to analyse the data. The study adhered to the STROBE checklist. Results More than half of the PwD (50.7%) living at home received involuntary treatment (Belgium 68.2% and the Netherlands 44.7%). Nonconsensual care (82.7%) was the most common, followed by psychotropic medication (40.7%) and physical restraints (18.5%). Involuntary treatment use was associated with living alone, greater ADL dependency, lower cognitive ability, higher family caregiver burden and receiving home care in Belgium versus the Netherlands. Involuntary treatment was most often requested by family caregivers. Conclusions Involuntary treatment is often used in PwD, which is in line with previous findings indicating dementia as a risk factor for involuntary treatment use. More research is needed to gain insight into variations in prevalence across other countries, which factors influence these differences and what countries can learn from each other regarding prevention of involuntary treatment. Relevance to clinical practice To provide person‐centred care, it is important to study ways to prevent involuntary treatment in PwD and to stimulate dialogue between professional and family caregivers for alternative interventions.

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Section: Relevance To Clinical Practicementioning

confidence: 99%

Involuntary treatment in dementia care at home: Results from the Netherlands and Belgium

Mengelers

Moermans

Bleijlevens

et al. 2020

Journal of Clinical Nursing

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“…The presence of challenging behaviours contributes to the use of coercive practices in services for people with ID (Fitton & Jones, 2018;McGill et al, 2009;Sturmey, 2018;Webber et al, 2019) including seclusion, denied access to personal belongings, physical and chemical restraints (Dörenberg et al, 2018). The use of such practices might put the person at great risk.…”

Section: Lack Of Reports On the Use Of Coercive Measuresmentioning

confidence: 99%

Passing laws is not enough to change staff practice: The case of legally mandated “incident” reporting in Sweden

Björne

Deveau

Nylander

2021

Journal of Intellectual & Developmental Disability

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Background: It is mandatory for staff in Swedish community services for people with intellectual disabilities to report incidents of error or malpractice. Aim: The aim is to study if incident reports contribute to developing quality in services for people with intellectual disabilities who present with challenging behaviours. Method: 159 reports on incidents from group homes and daily activities services were accessed and analysed using narrative thematic analysis. Results: Most reports concerned altercations between service users. Analysis focused mainly on the immediate incident and attributes of service users. Amendments were not (obviously) aligned with causes, and neither sufficiently addressed structural shortcomings. Restrictive measures were described, but changes in practices were not mentioned. Reports including Selfinjurious behaviour (SIB) were conspicuously absent. Conclusion: Reports are handled in a seemingly perfunctory manner, without any development. Quality development relying on staff reports and front-line managers' investigations requires support based on values rather than on the legal framework.

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“…Despite questions about the effectiveness of involuntary care and restrictive measures in providing safe and good‐quality care for people with intellectual disabilities (IDs) (Heyvaert et al . 2014, 2015), involuntary care is still common (Fitton & Jones 2020; Schippers et al . 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Despite questions about the effectiveness of involuntary care and restrictive measures in providing safe and good-quality care for people with intellectual disabilities (IDs) (Heyvaert et al 2014(Heyvaert et al , 2015, involuntary care is still common (Fitton & Jones 2020;Schippers et al 2018). The Convention on the Rights of Persons with Intellectual Disabilities (United Nations 2006) states that people who receive care and support in long-term care facilities have the right to make their own choices about the care they receive.…”

Section: Introductionmentioning

confidence: 99%

Impact of the Care and Coercion Act on recorded involuntary care in intellectual disability care: a time‐series analysis

Bakkum

Bisschops

Lagerweij

et al. 2022

J intellect Disabil Res

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BackgroundOn 1 January 2020, the Care and Coercion Act came into effect in the Netherlands, subjecting involuntary care to more strict regulations and monitoring. This study tested changes in recordings of involuntary care during the transitional year of 2020 and after full implementation in 2021, which coincided with the first severe test of the new regulations, when COVID‐19 lockdown measures were taken on 16 March 2020.MethodsData consisted of weekly counts of involuntary care from 1 January 2017 to 31 December 2021, taken from the care data of more than 3000 clients with intellectual disabilities and challenging behaviour of 's Heeren Loo, a large long‐term care organisation in the Netherlands. An interrupted time series design was used to compare the period under the former law with the period under the new law and to the period during and after implementation, taking into account the impact of the COVID‐19 lockdown measures on recordings of involuntary care.ResultsUnder the new act in Week 1 of 2020, a statistically significant drop occurred in involuntary care counts, after which these counts gradually decreased. The start of 2021, the year in which the act was fully implemented, showed an initial increase in counts of involuntary care, followed by a decrease (all Ps < .001). The introduction of the COVID‐19 lockdown measures did not statistically affect the weekly counts of involuntary care.ConclusionsThe decrease in registered involuntary care after the Care and Coercion Act came into effect is a first indication of the efficacy of this new law that requires careful multidisciplinary consultations around the right of clients to respect their self‐determination. Follow‐up research should examine whether the impact of the new law aligns with clients' experiences of self‐determination.

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Restraint of adults with intellectual disabilities: A critical review of the prevalence and characteristics associated with its use

Abstract: The review highlights a need for more consistent means of defining and measuring restraint and its associated characteristics. Future research into this area may also want to focus on the context of restraint such as whether it is the least restrictive option used.

Cited by 8 publications

References 26 publications

Involuntary treatment in dementia care at home: Results from the Netherlands and Belgium

Involuntary treatment in dementia care at home: Results from the Netherlands and Belgium

Passing laws is not enough to change staff practice: The case of legally mandated “incident” reporting in Sweden

Impact of the Care and Coercion Act on recorded involuntary care in intellectual disability care: a time‐series analysis

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