The short answer
A physical restraint is anything attached to or near a resident's body that the resident cannot easily remove and that limits movement or access to the body, such as a vest, lap belt, tray table or tucked sheets, and sometimes bed rails or a chair the resident cannot get out of. A chemical restraint is a drug used for discipline or staff convenience rather than to treat a medical symptom. Residents have the right to be free from both, except when required to treat a medical symptom.
Physical restraints
Whether something is a restraint depends on its effect on the resident, not its name. Common examples:
- Vests, belts and wrist ties
- Lap trays or tables the resident cannot remove
- Chairs that tilt back or are placed so the resident cannot get up
- Sheets tucked so tightly the resident cannot move
- Bed rails that keep a resident from getting out of bed voluntarily
Chemical restraints
A medication becomes a chemical restraint when it is used to make a resident easier to manage rather than to treat a diagnosed condition. Antipsychotics and sedatives given to calm "behaviors" are the most common concern. See antipsychotics in nursing homes.
When restraints are allowed
Only when needed to treat a specific medical symptom, after less restrictive alternatives have been tried, for the shortest time possible, with the resident's or representative's informed consent and regular reassessment. Staff convenience and short staffing are never valid reasons.
Why restraints are dangerous
Restraints do not reliably prevent falls. They can cause strangulation and entrapment, pressure injuries, muscle loss, incontinence, agitation and depression.
What families can do
- Ask what medical symptom the restraint is treating and what alternatives were tried.
- Ask to see the order, the assessment and the consent.
- Raise it at the care plan meeting, and file a grievance or Department of Health complaint if the restraint continues without justification.
The rules behind this
- 42 C.F.R. § 483.10(e)(1) (right to be free from restraints)
- 42 C.F.R. § 483.12(a)(2)
- 10 NYCRR Part 415
Related questions
This guide provides general information, not medical or legal advice. Rules change; confirm current requirements with the facility, the New York State Department of Health or a professional. Attorney Advertising.