The restraint-free approach to behavior problems in the nursing home.

The Omnibus Budget Reconciliation Act of 1987 states that nursing home residents have the right to be free of physical and chemical restraints that are not required to treat the residents' medical symptoms. The article outlines a "restraint proper" approach to treating behavior problems: assess the problem, establish a presumptive diagnosis, consider the risks and benefits of treatment alternatives, select the best treatment for the individual patient, evaluate the effectiveness of treatment and side effects, change treatment as necessary, discontinue treatments when they are no longer needed, and provide documentation.