Restraint Use in Older Adults Receiving Home Care.

OBJECTIVES

To determine the prevalence, types, frequency, and duration of restraint use in older adults receiving home nursing care and to determine factors involved in the decision-making process for restraint use and application.

DESIGN

Cross-sectional survey of restraint use in older adults receiving home care completed by primary care nurses.

SETTING

Homes of older adults receiving care from a home nursing organization in Belgium.

PARTICIPANTS

Randomized sample of older adults receiving home care (N = 6,397; mean age 80.6; 66.8% female).

MEASUREMENTS

For each participant, nurses completed an investigator-constructed and -validated questionnaire collecting information demographic, clinical, and behavioral characteristics and aspects of restraint use. A broad definition of restraint was used that includes a range of restrictive actions.

RESULTS

Restraints were used in 24.7% of the participants, mostly on a daily basis (85%) and often for a long period (54.5%, 24 h/d). The most common reason for restraint use was safety (50.2%). Other reasons were that the individual wanted to remain at home longer, which necessitated the use of restraints (18.2%) and to provide respite for the informal caregiver (8.6%). The latter played an important role in the decision and application process. The physician was less involved in the process. In 64.5% of cases, there was no evaluation after restraint use was initiated.

CONCLUSION

Use of restraints is common in older adults receiving home care nursing in Belgium. These results contribute to a better understanding of the complexity of use of restraints in home care, a situation that may be even more complex than in nursing homes and acute hospital settings.