When can a nursing facility restrain a resident?  Typically, when we think of restraining a person we think of the negative implications.  You are taking away a person’s freedom by restraining them.  Prisoners, for instance, are restrained.  My father, someone might think, should never be restrained, particularly when he is paying the nursing home in which he resides $10,000 a month.

There are federal and state laws prohibiting a nursing facility from restraining residents, except in certain circumstances.  The federal law states the following:

(ii)Free from restraints.  The right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms. Restraints may only be imposed—

(I) to ensure the physical safety of the resident or other residents, and

(II)only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used

In the past, nursing facilities would restrain residents simply as a matter of convenience.  The facility would tie the patient down just so the staff didn’t have to be bothered with his ranting and raving.

In some circumstances, nursing facilities continue to over-medicate residents in order to keep them sedate.  This type of practice violates the federal law’s prohibition against chemical restraints, but a few nursing facilities are alleged to engage in this practice even today.

In recent months, the health of my parents has not been good.  My mom had to enter a nursing facility as a long-term resident, and my dad recently fell and bumped his head.  As a result of his head trauma, fluid began to build up in his head, which is called a subdural hematoma.

As a result of his injury, small homes were drilled into his head to permit the fluid to drain off his brain.  Since the surgery, which took place about three weeks ago, he has been in a semi-conscious state.  He required the insertion of a PEG tube, which is a feeding tube.

My dad was admitted to a nursing facility in the rehabilitation section.  Like many residents in his mental state with PEG tubes, my father pulled his feeding tube out, twice.  Each time he pulled the tube out, he had to be taken back to the hospital to have the tube reinserted.  Each time this occurred, he suffered additional trauma and further setbacks in his care.

My sister asked his nurse why his hands aren’t restrained.  In the hospital, the staff places restraints on his hands and arms that prevented my father from tearing the various tubes from his body.  While it didn’t look nice, the family understood that the restraints had to be put in place.

Many people who are recovering from injuries require these type of restraints.  When you are in a semi-conscious state, you don’t understand that the tubes in your body are there to help you.  All you understand is that the tubes are uncomfortable and foreign, so you try and pull the tubes out.

The nurse whom my sister asked about the restraints said the nursing facility in which my father was receiving rehabilitation was a “restraint-free facility.”  Personally, I don’t know what that is.  I understand where the concept comes from, from the law quoted above.  But I don’t understand why a medical facility would say they are a restraint-free facility.

It’s something that sounds nice, that sounds very politically-correct, but healthcare, like much of life, shouldn’t be governed by political correctness.  It’s a very good thing, for instance, that nursing facilities are prohibited by law from restraining their residents simply as a matter of convenience, but sometimes patients need to be restrained, for their own good.

As you can see, the law clearly recognizes this distinction, permitting facilities to restrain residents if the restraint is for the resident’s own good.  I think some facilities may be so concerned about appearing to care for residents that they are forgetting how to actually care for residents.

Nursing home residents have important legal protections. Knowing those rights helps families advocate for safe and appropriate care.