Friday, May 23, 2008

Use of Restraints in California Nursing Home Highest in United States

Federal Nursing Home Reform Act of 1987
Nursing homes that receive Medicare or Medicaid must comply with the Nursing Home Patients Bill of Rights as provided by the Federal Nursing Home Act of 1987. Among these rights is the right to be free from unreasonable restraints. The Federal Code, under 42 CFR 483.13, subsection (a), states that nursing home residents have “the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms.”

Nursing Home Restraints Since 1987
The use of restraints in nursing homes has declined overall since the passing of the Federal Nursing Home Reform Act of 1987. Their use decreased almost 40% during the period between 2002 through 2006. According to the Federal Agency for Healthcare Research and Quality, only 5.9% of United States nursing home residents were restrained in 2006 compared to 9.7% in 2002. Some states did better than others. Nursing homes in California were among the worst offenders with 13.4% of residents being repeatedly restrained. Fortunately, not all nursing home in California restrain residents at this rate. Most comply with the Federal Law. However, you may not have much time to find a nursing home for a loved one. You may have as little as 24 hours after a hospital stay to find a good facility. The AARP Magazine has compiled a list of ten essential tips one should follow when choosing a nursing home. To view the list, click the following link:

Potential risk of restraint related injury exists even if you are careful when selecting a home. Be sure to visit your loved one and inspect the facility regularly to make sure things are going well and that your loved one's risks are minimized.

Restraint Injuries
Residents of nursing homes are restrained for different reasons. For example, a resident may be restrained to prevent a fall or to prevent injury. Sometimes residents are restrained to keep them from rolling out of bed or to keep them seated in a chair. Often facilities will use restraints because of staffing shortages, staff inexperience, or just plain laziness. Restraints that have been used by different facilities include belt restraints, vest restraints, mittens, and wrist restraints.

Mechanical restraints such as straps, tie-downs, and bed rails are designed to limit mobility. If they are not used correctly, they can cause strangulation and death. Pressure ulcers (bedsores), incontinence, and confusion can also be caused by the misuse of these restraints. Long term use of mechanical restraints has been known to cause emotional distress, loss of strength, and depression. Nursing homes should never use restraints as a cost-cutting measure. They are not a substitute for the proper number of trained staff. Restraints should only be used if a doctor determines that they are necessary.

If loved one has been unreasonably restrained and has suffered injuries, you should contact a lawyer to protect his or her rights. If you have a question or comment, feel free to respond to this posting, but keep in mind your response will not be confidential. You can also call or e-mail me to discuss your matter confidentially. Thanks for reading.