Restraint Rights and Alternatives to Restraints

Resident Rights and Types of Restraints

Residents have the legal right to be free from physical and chemical restraints used for discipline or staff convenience or that are not required to treat medical symptoms. Federal law strictly prohibits the use of restraints for staff convenience or resident discipline. Restraints may be used only when clinically necessary to treat a medical symptom, with appropriate authorization from a health care provider. Restraints are always a last resort; less restrictive alternatives must be considered and tried when appropriate before any restraint is applied.

A restraint requires an order from an authorized health care provider and must be used according to the care plan and facility policy. Nurse aides are never permitted to decide independently to apply a restraint. You must always follow the nurse's instructions and the resident's care plan regarding restraint use. Even if a resident is restless or attempting to climb out of bed, a nurse aide cannot choose to apply a restraint on their own authority.

It is essential to understand the difference between physical and chemical restraints. A physical restraint is a manual method or a device the resident cannot easily remove that restricts the resident's movement or normal access to the body. A chemical restraint is any medication used to control behavior or restrict movement rather than treat medical symptoms. Both types take away a resident's freedom of movement and are subject to strict legal guidelines.

Everyday care items can become physical restraints depending on how they are used. For example, side rails raised on a bed can be considered physical restraints if they prevent a resident from leaving the bed voluntarily. A geriatric chair with a locked tray table attached is considered a physical restraint if the resident cannot remove it. Similarly, tucking bed linens in so tightly that a resident cannot move freely is considered a physical restraint.