Interdisciplinary Perspectives on Restraint Use in Aged Care

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure re...

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Autores principales:	Juanita Breen, Barbara C. Wimmer, Chloé C.H. Smit, Helen Courtney-Pratt, Katherine Lawler, Katharine Salmon, Andrea Price, Lynette R. Goldberg
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	restraint restrictive practice chemical restraint physical restraint psychotropic residential aged care Medicine R
Acceso en línea:	https://doaj.org/article/1be0f523d11d406294cc49ff40076446
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spelling	oai:doaj.org-article:1be0f523d11d406294cc49ff400764462021-11-11T16:10:50ZInterdisciplinary Perspectives on Restraint Use in Aged Care10.3390/ijerph1821110221660-46011661-7827https://doaj.org/article/1be0f523d11d406294cc49ff400764462021-10-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11022https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, physicians, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint; 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but specified that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.Juanita BreenBarbara C. WimmerChloé C.H. SmitHelen Courtney-PrattKatherine LawlerKatharine SalmonAndrea PriceLynette R. GoldbergMDPI AGarticlerestraintrestrictive practicechemical restraintphysical restraintpsychotropicresidential aged careMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11022, p 11022 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	restraint restrictive practice chemical restraint physical restraint psychotropic residential aged care Medicine R
spellingShingle	restraint restrictive practice chemical restraint physical restraint psychotropic residential aged care Medicine R Juanita Breen Barbara C. Wimmer Chloé C.H. Smit Helen Courtney-Pratt Katherine Lawler Katharine Salmon Andrea Price Lynette R. Goldberg Interdisciplinary Perspectives on Restraint Use in Aged Care
description	Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, physicians, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint; 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but specified that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.
format	article
author	Juanita Breen Barbara C. Wimmer Chloé C.H. Smit Helen Courtney-Pratt Katherine Lawler Katharine Salmon Andrea Price Lynette R. Goldberg
author_facet	Juanita Breen Barbara C. Wimmer Chloé C.H. Smit Helen Courtney-Pratt Katherine Lawler Katharine Salmon Andrea Price Lynette R. Goldberg
author_sort	Juanita Breen
title	Interdisciplinary Perspectives on Restraint Use in Aged Care
title_short	Interdisciplinary Perspectives on Restraint Use in Aged Care
title_full	Interdisciplinary Perspectives on Restraint Use in Aged Care
title_fullStr	Interdisciplinary Perspectives on Restraint Use in Aged Care
title_full_unstemmed	Interdisciplinary Perspectives on Restraint Use in Aged Care
title_sort	interdisciplinary perspectives on restraint use in aged care
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1be0f523d11d406294cc49ff40076446
work_keys_str_mv	AT juanitabreen interdisciplinaryperspectivesonrestraintuseinagedcare AT barbaracwimmer interdisciplinaryperspectivesonrestraintuseinagedcare AT chloechsmit interdisciplinaryperspectivesonrestraintuseinagedcare AT helencourtneypratt interdisciplinaryperspectivesonrestraintuseinagedcare AT katherinelawler interdisciplinaryperspectivesonrestraintuseinagedcare AT katharinesalmon interdisciplinaryperspectivesonrestraintuseinagedcare AT andreaprice interdisciplinaryperspectivesonrestraintuseinagedcare AT lynettergoldberg interdisciplinaryperspectivesonrestraintuseinagedcare
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Interdisciplinary Perspectives on Restraint Use in Aged Care

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