Physical and pharmacologic restraint of nursing home patients with dementia: impact of specialized units

Article Abstract:

Nursing home patients who are demented (have severe intellectual impairment) are often restrained, either physically (with special chairs, cuffs, or vests) or pharmacologically (with sedating drugs). However, these practices have come under public criticism because of their negative effects on patient mobility, behavior, and health. Specialized dementia care units, typically established in a wing or separate section of a nursing home, employ staff trained to care for demented patients and often try to minimize the use of restraints. To compare the use of physical and pharmacologic restraints in specialized units and in the traditional nursing home setting, 31 dementia units (housing 307 patients) and 32 traditional nursing home units (318 patients) in five states were studied. Data were collected by questionnaires, review of medical records, rating scales completed by nursing staff, and direct observation. The patients in the specialized units were less functionally impaired than those in the traditional units. In dementia units, 18.1 percent of the patients who were not in bed were physically restrained, compared with 51.6 percent of traditional-care patients. The proportions of patients under pharmacologic restraint were similar in the two types of unit (45 percent and 43 percent, for specialized and traditional units, respectively). The factors most important in determining whether a patient would be physically restrained were: ability to transfer himself in and out of bed; ability to walk; impairment of mental status; history of hip fracture; nursing staff to patient ratio; and housing on a dementia unit. Pharmacological restraint was more likely for patients with: histories of physically abusive behavior; age of 85 or more; severe impairment of mental status; family visits once or more often each week; housing in facilities with fewer than 200 residents; and the ability to walk. Although dementia care units house a different sort of population than traditional units, and although fewer restraints do not automatically imply better care, it seems that the use of restraints for demented patients in nursing homes could be reduced. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Surveys, Dementia, Patients, Nursing home care, Restraint of patients, Physical restraint

---

Bone Health in Nursing Home Residents

Article Abstract:

Research is needed to determine the most effective ways to prevent bone fractures in nursing home patients. The US spends almost $4 billion annually on bone fractures in these patients, a figure that will increase as the number of elderly people increases.

Editorial, Bone density

---

Low Bone Mineral Density and Risk of Fracture in White Female Nursing Home Residents

Article Abstract:

Low bone density and ability to function independently are risk factors for bone fractures in white female nursing home patients. Fractures in nursing home patients are a major source of illness and health care utilization.

Similar abstracts:

• Abstracts: Pharmacologic Treatment of Depression During Pregnancy. Paroxetine Treatment of Generalized Social Phobia (Social Anxiety Disorder)
• Abstracts: Pharmacologic Treatment of the Irritable Bowel Syndrome: A Systematic Review of Randomized, Controlled Trials
• Abstracts: Underlying causes and survival in patients with heart failure. Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure
• Abstracts: Physical activity levels in a sample of Oxford school children aged 10-13 years. Mechanisms of changes in basal metabolism during ageing
• Abstracts: Assessing the long-term effect of a surface penetrating sealant. Porcelain esthetics for the 21st century

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.