Restraints pose additional risk when COVID is present

The national dementia support service has warned the use of chemical and physical restraints is particularly dangerous for residents with dementia experiencing respiratory illness.

The national dementia support service has warned the use of chemical and physical restraints is particularly dangerous for residents with dementia experiencing respiratory illness.

Dementia Support Australia, the commonwealth funded service operated by HammondCare to help aged care providers and families support people with dementia, is urging facilities to explore alternatives to restraints.

DSA provides the Dementia Behaviour Management Advisory Service and the Severe Behaviour Response Teams, which give advice and short-term case management interventions for people experiencing dementia-related behaviours and symptoms.

DSA director Associate Professor Colm Cunningham said ongoing COVID-19 restrictions and the resulting isolation created a stressful environment for residents with dementia, which may lead to an increase in behaviours and psychological symptoms.

Some providers may face the complex issue of how to assist a person with dementia to self-isolate in the event of infection, he said.

Associate Professor Colm Cunningham

“The need to keep everyone safe and supported is challenging for residential care services during the COVID-19 restrictions,” Associate Professor Cunningham said.

“But we never recommend chemical restraint for people with dementia, especially in the current situation.

“COVID-19 is primarily a respiratory disease and the use of medications that might cause respiratory depression or render a person immobile is likely to lead to an adverse outcome for that resident.”

Physical restraints to enforce immobility when applied to a person with a potential serious respiratory infection may also lead to adverse outcomes,” Associate Professor Cunningham said.

“Physical restraint is always a last resort and even in the case of infection and the need for isolation there are a range of options to consider first.”

If residents infected with COVID-19 are unable to voluntarily isolate, DSA is recommending one-on-one care.

Where that is not possible, DSA may be able to arrange funding for additional support to assist the resident.

DSA launches helpsheets

DSA has issued advice to all residential aged care services on how best to support residents with dementia during COVID-19 lockdowns via a new helpsheet Restrictive practices: understanding and managing behaviours in a time of pandemic.

The helpsheet warns normal infection procedure controls should be followed when caring for a person with dementia and a suspected active COVID-19 infection.

“In this situation, certain types of behaviour such as aggression and wandering may post greater risks for the resident, other residents, staff and visitors,” it says.

If particular behaviour does not place anyone at increased risk of infection, then there is no infection management reason to restrain a person in any way, the advice says.

Residents facing restricted visitors, cancelled excursions and other activities may seek to gain access to outdoors more regularly, according to the helpsheet.

Care home managers should provide opportunities to access outdoor areas at specific times during the lockdown period, it says.

Access the helpsheet here.

DSA has consultants in 34 offices across Australia available to offer support, advice and intervention 24 hours a day to any aged service experiencing difficulties.

Contact DSA on 1800 699 799 or visit

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Tags: behaviour-management, colm-cunningham, covid-19, dementia-support-australia,

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