Researchers advocate ‘selective’ restraint

Swedish researchers recommend a reduction in the use of sleeping pills and “selective” restraint to reduce falls in nursing homes.

A group of Swedish researchers say a “selective” use of physical restraints and a reduction in the use of sleeping pills could lead to a significant reduction in falls among elderly nursing home residents.

Journal of Clinical NursingPublished in the Journal of Clinical Nursing, the four-year study entitled ‘Falls and fall risk among nursing home residents’ analysed over 2,000 reported falls in five facilities in relation to fall risk assessment, the use of safety belts, wheelchairs and sleeping pills.

All the residents involved in the study had a physical illness or dementia or both.

The researchers found that people using sleeping pills (especially those with benzodiazepines), anti-depressants and neuroleptics (anti-psychotic drugs) were much more likely to fall.

On the other hand, people in wheelchairs were much less likely to fall. Other measures that were found to reduce the risk of falls were the use of bed rails and belts.

But the authors stressed that when healthcare professionals use restraints, they must also consider the need to maintain independence and that restraints can also lead to other types of injuries.

“It is impossible to prevent every single fall and we cannot rule out the fact that freedom-restricting measures will continue to be used in the care of older people” said the study’s lead author, Edit Fonad from the Karolinska Institutet.

“Our results suggest that freedom-restricting actions cannot eliminate falls totally, but they might be protective when used selectively with fewer sedatives, especially benzodiazepines.”

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