The ethics of coercive treatment of people with dementia

Abstract

The aim of the present study was to describe how registered nurses in nursing homes ensure legal security, good and safe nursing care and uphold the dignity of nursing home residents with severe dementia without violating residents' integrity. Semi-structured interviews were conducted with 10 charge nurses in a county in central Sweden. The transcribed interviews were examined using manifest and latent content analyses. The manifest analysis identified actual local routines involving coercive treatment and registered nurses' descriptions of complications and alternative measures. The latent analysis resulted in three themes describing nursing strategies: one with coercive treatment, one with coercive treatment under specific circumstances and one to prevent coercive treatment. Interpretations of legal terms regarding coercive treatment and inadequate gerontological nursing training and understaffing seem to preserve the use of coercive treatment.

Competence for older people nursing in care and nursing homes: An integrative review

“…However, it should be noted that RNs are not always able to supervise other nursing staff due to time constraints (Mueller et al., ; Prentice & Black, ), and RNs are not always on duty. This should be taken seriously because insufficient gerontological nursing training and understaffing appears to preserve, for instance, the use of coercive treatment on people with dementia (Lejman, Westerbotn, Pöder, & Wadensten, ). A poor staffing skill mix may contribute to resident transfers from nursing homes to hospitals (Laging, Ford, Bauer, & Nay, ).…”

Respect for Persons in Bioethics: Towards a Human Rights-Based Account

“…Finally, the right to integrity is clearly applicable to human beings that are not capable of autonomous decision making. Sometimes physical restraint is used in care, e.g., in the case of people with dementia, and even though autonomy might then not be an issue, there are still strong reasons to organize care so that the use of physical restraint is minimized, in order to be respectful of the integrity of persons (Lejman et al 2013).…”

Institutionalized elderly people with dementia: an integrative review on nursing care

“…The studies also revealed research demands in the field of elderly-centered care. It is necessary to understand how this approach can help to reduce physical restrictions in the institutionalized elderly (45) , to establish a stronger relationship between elderly-centered care and increased quality of care (44) , and to find ways to ensure the implementation of existing strategies (14) .…”