CHICAGO, IL – When an elderly or disabled patient enters a nursing home, they should never be expected to give up their basic human right to decide how their bodies are treated throughout their stay. Unfortunately, many long-term care facilities seem to ignore this. The ongoing issue of coercive restraints used in Illinois nursing homes and assisted living facilities is not only ethically irresponsible but is a violation of a person’s legal right to autonomy, dignity and freedom.
What is Wrongful Restraint?
An unlawful restraint is generally classified as anything that controls a person’s behavior or freedom of movement to force them into submission. Generally speaking, there are two types of restraints found in nursing homes: physical and chemical.
Federal and Illinois state laws forbid the use of physical or chemical restraints such as tethering a patient to a bed or giving them psychoactive drugs in skilled nursing facilities unless it’s a matter of medical necessity, in which case the patient’s consent and a detailed order from a doctor is required. However, many long-term care facilities apply these restraints liberally, irresponsibly and without consent. This is harmful to a patient’s health and well-being and is legally considered a form of elder abuse.
What are the Causes of Wrongful Restraint?
It has become a common misconception that the use of physical or chemical restraints helps promote safety and well-being in a nursing home. This may be true in some cases – such as in an emergency or when preventing a patient from harming themselves or others – but the truth is that they are more often used excessively to keep patients immobilized, sedated and easier to care for, especially when nursing homes are understaffed and don’t have time to keep up with patients needs. A matter of medical necessity is too easily replaced by a matter of convenience and these practices have dangerous consequences if left unchecked.
What are Physical Restraints?
Physical restraints are any physical or mechanical device or material attached or adjacent to a patient’s body that the patient cannot remove easily, which has the effect of restricting the patient’s freedom of movement.
Some common examples of restraints may include using straps to tether a patient’s arms, legs or waist to a high bedrail so the patient is unable to get out of bed. Another example is by tucking their bed sheets excessively so the patient can’t move. Other types of materials and devices typically used in physical restraints include:
- Wrist and ankle cuffs
- Vests
- Hand mitts
- Cloth ties
- Belts
- Special chairs with straps and bars
- Lap cushions
Caregivers often argue that the use of physical restraints promotes patient safety and reduces the risk of falls, but the reality is that physical restraints are more often used to pacify patients and make them easier to handle. Sadly, there are also instances in which physical restraints are used as a form of punishment or retaliation, which not only amplifies a patient’s subordination and dependency on caregivers for mobility but can also take a severe physical and psychological toll over time.
Risks Caused by Physical Restraints
Aside from hindering a patient’s chance of regaining physical mobility, inordinate and neglectful methods of physical restraint can have much more dangerous long-term health problems. Since physically restrained patients are forced to remain stationary over extended periods, they can easily develop severe health issues such as pressure sores, incontinence and constipation. Extended periods of immobility also affect elderly adults psychologically by causing shame, loss of dignity, depression, isolation and agitation.
What are Chemical Restraints?
Chemical restraints are often in the form of a psychoactive drug used to sedate, subdue or control a person’s behavior. Some common types of psychotherapeutic drugs include:
- Antipsychotic Medications such as Haldol, Mellaril, Navane or Risperdal
- Antidepressants like Zoloft, Prozac, Aventyl/Pamelor or Desyrel
- Anti-anxiety Medications including Xanax, Valium, Ativan or Serax
- Sedative and Hypnotic Medication such as Bendaryl, Vistaril, Dalmane or Restoril
- Mood Stabilizing Drugs like Lithane/Lithium, Eskalith or Depakene
Although these drugs are not considered chemical restraints when used to treat diagnosed depression, schizophrenia or bipolar disorder, they are commonly used off-label to chemically subdue patients for the sake of convenience, discipline, coercion or retaliation. In a nursing home setting, they are also oftentimes used to sedate elders who suffer from dementia-related agitation, discomfort or distress.
Studies have shown that the misuse of antipsychotics to restrain dementia patients can increase their level of aggravation since delirium is often triggered by polypharmacy which is when too many drugs are in their system. A well-staffed nursing home should have enough employees to supervise patients and practice behavioral therapies – not pharmacological ones – as the main form of treatment for dementia.
Effects of Chemical Restraints
Even when used properly, powerful psychoactive drugs can have adverse side effects on all types of patients – including young and physically strong ones. Since the elderly have a significantly reduced drug metabolism due to decreased liver function, their ability to biologically transform these medications and facilitate their elimination from the body is naturally lower. This makes it all the more crucial to use these drugs as sparingly as possible on older adults.
When elderly patients are indiscriminately “drugged” for behavioral control, the effects can be extremely harmful or even deadly. Although risks vary by drug, common side effects can include:
- Agitation, aggression, hallucinations, nightmares and insomnia
- Sedation, unresponsiveness, impaired consciousness and excessive sleepiness
- Disordered thinking or memory loss
- Decreased appetite or constipation
- Blood pressure disturbances, including low blood pressure and hypertension
- Muscle and neurological impairments
The extreme sedation associated with psychoactive drugs can also lead to a decline in a person’s ability to perform daily tasks, such as walking, eating, dressing, using the restroom, and bathing. Reduced mobility from drugs inadvertently leads to the same negative effects and injuries caused by physical restraints, including bed sores (pressure ulcers), incontinence, muscle contractures, balance impairment and increased risk of falls.
Taking Action Against Excessive Restraint and Nursing Home Abuse Today
Patient restraint laws state that nursing home residents have a legal right to accept or refuse any type of care or treatment, including physical or chemical restraints. Aside from health risks, misusing restraints is an assault on a person’s dignity and overall quality of life. No one should have to see their loved one tied up against their will or slouching in a wheelchair after a drug-induced coma.
If you feel that you or your loved one has been wrongfully restrained, don’t hesitate to contact one of our nursing home lawyers today. Contact us by calling (312) 384-1920 or by filling out this form to schedule a free consultation about your nursing home abuse case in Illinois.
