Restraints on elderly people: the problem of restraints

The manifesto of the National Platform without restraints points out the harmful effects of these measures.

Restraint of the elderlyThe term "restraint" has a more favorable meaning than "restraint", and the term "restraint" is used to refer to "restraint of the elderly".

The term restraint has a more favorable meaning than "restraint". For this reason, we will now define what mechanical restraints are, how they affect and the differences between restraint, restraint and restraint.

We also explain what is implied by the new manifesto of the National Platform without Restraintswhose signatories are the Spanish Committee of Representatives of People with Disabilities (CERMI) and the Dignified Care Foundation led by Dr. Ana Urrutia, among others.

What are containments?

Restraints are chemical or pharmacological, physical and mechanical restraints.. There are generally two criteria to classify them according to the theoretical review of the expert Physiotherapist in Geriatrics Sandra Márquez: the "acceptance of the person to whom it is applied" or the "temporary nature with which it is applied".

Mechanical Restraints CCMM

Mechanical restraint is any material or mechanical instrument used to prevent a person from moving in such a way that he or she can be prevent a person from moving in order to prevent movement of harm to a surrounding person or risk of injury. to a surrounding person or risk of falling.

However, from the international model of Integrated and Person-Centered Care (IPCC) and from the perspective of Social Interventionist Gerontology, this belief is erroneous, since mechanical restraints cause damage that is difficult to reverse; using restraints to prevent falls is considered malpractice, since the same restraints can also cause ulcers or high-risk falls, in addition to invading the person's self-esteem and self-concept.

Chemical or pharmacological restraints

Chemical or pharmacological restraint is the use of medications that mainly have repercussions on the Central Nervous System reducing the need to wander, to verbally assault.

Such restraints generate the inhibition of behaviors considered "disruptive" in a residential or domiciliary environment.Therefore, they are considered malpractice actions by the AICP because they are restrictive, do not facilitate the functionality and autonomy of the person and have serious and complex adverse effects. As defended by Burgueño (2005) cited by Márquez (2017) it is the "use of drugs (psychotropic or not) to treat a problem for which there is no better treatment".

Physical restraints

Physical containment refers to a space in which context-restrictive materials are used .. They are often used in residences and also in homes to reduce the space in which the person can wander.

It refers to furniture, chairs, tables or any other material in the context in which the person resides that may restrict his or her movement in the space.

Difference between restraint and securing

According to Rodríguez (2011) cited by Márquez (2017) and based on his review in the Working Group of the Ethics Committee of Social Services of the Generalitat de Catalunya, restraint is "everything that limits, retains or prevents a person from transgressing a physical, psychological or emotional limit''. On the other hand, according to the author, the term restraint implies directly the restriction equivalent to physically binding.

Manifesto of the National Platform without restraints

The Manifesto of the National Platform without Restraints is presented by the Dignified Care Foundationled by the renowned Geriatrician Ana Urrutia.

This manifesto has the signature of important entities such as Helpage International, Fundación Pilares, Dignitas Vitae, the General Council of Medical Associations, UPD and the LARES Foundation. Its objective is to to eradicate the practice of physical and chemical restraints on the elderly, people with disabilities and/or mental health problems. Its mission is to raise awareness in society, care professionals and organizations.

Strategies to eradicate restraints

Aligned with the BBPP Good Practices that every Gerontological Resource should exercise with respect to sexuality in elderly and/or dependent or vulnerable people, the National Platform without restraints seeks to ensure the Comprehensive and Person-Centered Care by fighting for the implementation of strategies based on Geriatrics and Gerontology, thus avoiding the use of restraints. that avoid the use of physical and chemical restraints.

The strategies are developed by professionals of Gerontology and/or Geriatrics (Psychologists, Directors, Occupational Therapists, etc.) always considering the person's Life History, as well as his/her motivations and relatively preserved abilities.

Care Plans, what are they?

The Manifesto of the National Platform without Restraints states that "all entities and organizations that care for elderly people in a situation of dependency or similar, in the different levels and sectors of care (including residential centers as well as home care resources) should be obliged to offer the people they care for the possibility of opting for "care plans" free of physical and pharmacological restraints.

Care plans are individualized care programs. commonly known in gerontology as PIAI (Plan Integral de Atención Individualizado). We must also consider that in Home Care (Home Care Service) these plans are considered to be in development and susceptible to improvement.

Restraint and mistreatment of older people.

Any professional, family or personal behavior that violates the rights of the elderly is considered inappropriate treatment, therefore mistreatment. We include in such mistreatment not only the violation of privacy or psychological violation but also the violation of freedom.

Restraint of the elderly is considered mistreatment, as well as other types of mistreatment such as psychological or physical neglect, physical or verbal aggression, abandonment, etc.