Accidents associated with the use of physical restraints in the elderly with cognitive disorders: a study of three cases

Abstract

Introduction: Physical restraint is normally applied to the elderly with cognitive disorders in the belief that it improves their safety. However, several studies warn about the risk of a serious accident when these people become trapped by the equipment when trying to get up from a bed or chair. It is estimated that in the USA alone, as many as 200 deaths are caused annually by these devices. Material and methods: The circumstances resulting in the deaths of three elderly people with cognitive impairment and an abdominal belt restraint at the time of death were studied. The information was collected from clinical histories and through a semi-structured interview with the professionals in charge of the patients. Results: Among the possible contributing factors to these incidents could be the patients' disorientation and inability to recognize risks, the lack of adequate supervision, incorrect application of the devices, a low staff ratio on some shifts and insufficient staff training. Conclusions: Both the literature review and the cases analyzed show a common pattern. A probable combination of factors could increase the possibility of an accident occurring. © 2009 SEGG.