The use of restraints in nursing homes is tightly regulated, allowing them only in specific situations. Restraints can be extremely dangerous and have been known to cause severe physical and emotional trauma to residents,
Federal guidelines say nursing homes should use restraints only when medically necessary and for the shortest possible time. Restraints must be used under supervision and cannot be used for convenience or to control a resident.
What Are Restraints and How Are They Used In Nursing Homes?
There are two main types of restraints used in nursing homes: physical and chemical. Physical restraints are things like bedrails used to prevent movement; wheelchair restraints; straps, belts, or vests; and tying a resident to a bed or chair.
Chemical restraints can be sedative medications used to control a resident’s behavior; overmedication to keep a resident subdued; and antipsychotics or tranquilizers given without medical necessity.
Although there are situations that require staff to use restraints, the Centers for Medicare & Medicaid Services says they cannot be used as a form of discipline or for the staff’s convenience.
Signs and Symptoms of Improper Restraint Use In Nursing Homes
In many instances, residents may not be able to communicate the abuse properly to family or other staff. That’s why it’s critically important that family members can spot the different signs of restraint abuse.
Physical warning signs include: bruising or abrasions on wrists, ankles, or torso; difficulty breathing or shallow respirations; sudden loss of mobility or muscle strength; swelling or numbness in the restrained areas; and pressure sores where restraints were applied.
Behavioral and emotional signs include: panic when placed in bed or a chair; fearfulness, anxiety, or agitation; repetitive movements like rocking or self-soothing; sudden withdrawal or depression; and confusion or increased cognitive decline.
Warning signs of chemical restraints include: sudden personality changes; loss of coordination or increased falls; unusual drowsiness or sedation; decreased ability to communicate; and slurred speech or slowed breathing.
Injuries and Complications Caused by Restraints In Nursing Homes
Improper use of restraints can cause a range of injuries to residents, including death. Some injuries aren’t always visible, leaving the resident to suffer in silence. Regulators and authorities on the topic say restraints often increase the risk of injury rather than reducing it.
Physical injuries include:
- Cuts, bruises, and skin breakdown.
- Nerve damage from prolonged pressure.
- Joint injuries or dislocations.
- Muscle atrophy (loss of strength from immobility).
- Circulation problems.
Serious medical complications include:
- Strangulation or suffocation.
- Respiratory depression (especially with chemical restraints).
- Blood clots (deep vein thrombosis).
- Pressure ulcers (bedsores).
- Aspiration pneumonia.
- Cardiac stress or irregular heart rhythms.
Psychological injuries include:
- Severe anxiety or panic.
- Loss of dignity and autonomy.
- Depression and emotional trauma.
- Accelerated cognitive decline.
Life-threatening outcomes include:
- Positional asphyxia (unable to breathe due to positioning).
- Over-sedation leading to respiratory failure.
- Fatal falls when attempting to escape restraints.
- Death.
Restraints (Nursing Home Abuse and Neglect) FAQs
Are restraints ever allowed in nursing homes?
Yes, but their use is only allowed in specific situations. Federal regulations allow restraints to be used when medically necessary to protect the resident or others and only after less restrictive methods have failed.
Restraints should be used for the shortest possible time and monitored closely. Restraints may not be used as discipline or for the convenience of staff.
Why are restraints considered dangerous?
Both physical and chemical restraints carry risks that put residents in danger. Serious complications like blood clots, muscle loss, and bedsores can be caused by restraints that restrict breathing, circulation, and movement. In the most serious cases, restraints can cause suffocation or even death.
What are the most serious injuries caused by restraints?
Among the more severe consequences are fatal falls, positional asphyxia, respiratory depression, and strangulation. Long-term use of restraints may cause a resident to suffer muscle atrophy, psychological trauma, or pressure ulcers, all of which can be life-threatening for elderly residents.
How can I tell if my loved one is being chemically restrained?
Keeping a close eye on your loved one goes a long way in spotting the warning signs. Look for sudden sedation, a reduced ability to communicate, personality changes, and unusual drowsiness. If the resident is overly calm ot unresponsive without a medical reason, it can be a signal that they’ve been overmedicated. Familiarizing yourself with the medication records can also help identify potential problems.
Are bed rails considered restraints?
In some cases, yes. Bed rails are considered restraints when they restrict the resident’s ability to move freely or get out of their bed. Improper use of bed rails has been linked to death, entrapment, suffocation, and other injuries.
What should I do if I suspect improper restraint use?
Do not wait to take action! Begin by documenting your concerns with photos and diligent notes. Every detail helps when building a case involving restraints. Make sure to obtain medical records and ask the nursing home for a detailed explanation of why restraints were used on your loved one.
Seek medical treatment for the resident as soon as possible to prevent further injury. In some cases, it may be necessary to contact Florida’s oversight agencies.
Why should I contact Weisser Law if I suspect nursing home abuse or neglect?
Cases involving nursing home abuse and neglect are often more complex than you may think and require precision in building your case. That’s where the team at Weisser Law becomes vital.
Nursing homes and their insurance providers will act fast and without restraint to protect themselves and weaken the credibility of your claims. Important medical records, staff logs, internal reports, and other critical evidence can be lost or altered if no one intervenes.
Weisser Law has decades of experience investigating these cases, spotting the warning signs of abuse, understanding how facilities will try to cover up their actions, and ultimately proving that our clients were harmed. Weisser Law consults the right experts to identify exactly how, where, and when nursing homes failed to meet their legal obligations.
Our focus is on building strong, evidence-driven cases that hold accountable the people and facilities that harmed our clients and their families.
Just as important, there’s no financial risk to getting answers about your circumstances. Your consultation is always free, and you pay nothing upfront — we only get paid if we win.