Consenting older residents to use physical restraints in residential care homes: Family members' perspectives on degree of understanding and acceptance

Abstract

Background: Physical restraint continues to be common practice in residential care facilities. Although family members are involved in making decisions about physical restraints, their voices have not extensively been studied.

Aim: To examine family members’ views, level of understanding and acceptance towards the use of physical restraints on their older relatives in residential care homes.

Methodology: A descriptive qualitative study was conducted using one-on-one interviews with family members of their older parents in two homes in Hong Kong. Purposive sampling was used to recruit 13 family members of older residents who used at least one physical restraint.

Findings: Family members could vividly recall the consent procedure to grant permission to apply physical restraint on their older relatives. The process revealed their lack or minimal understanding of what physical restraint was and its intended use, how restraints could be applied, limited choice of restraints, and restraint alternatives. Although family members were given time to ponder about the need for restraint, they tended to accept staffs’ explanation to keep older residents safe. The degree of acceptance to continue using restraint depended on which body parts were restrained, how restraints were used throughout the 24-hour day, signs of injuries, and when to off-restraint when the family visited. Being updated on the resident’s physical condition and protocol to step-up restraints should be disclosed.

Conclusion: Family members who make decisions to restrain their older relatives should receive more education and support. Their voices should be involved in all protocols relating to restraint-use in the homes.