Elder abuse inquiry probes restraints, mandatory reporting of alleged assaults

The use of restraint in aged care and the lack of regulation around it is among the issues the Australian Law Reform Commission is exploring in its elder abuse inquiry, an issues paper released today shows.

The use of restraint in aged care and the lack of regulation around it is among the issues the Australian Law Reform Commission is exploring in its elder abuse inquiry, an issues paper released today shows.

The commission said that concerns existed over the use of “restrictive practices in aged care” – which included physical, chemical and environmental restraint to control a resident’s behaviour – and over the processes for obtaining consent to their use when a person’s decision-making capacity was impaired.

“Such practices may be an interference with a person’s rights. They may also constitute abuse and, in some circumstances, a crime,” the issues paper said.

While there was a national framework for reducing and eliminating the use of restrictive practices in the disability service sector, the use of restrictive practices was not explicitly regulated in aged care, although guidance had been provided to support restraint-free environments in aged care, the commission noted.

The paper sought feedback on what ways the use of restrictive practices in aged care should be regulated to improve safeguards against elder abuse.

The commission’s inquiry into the laws and frameworks to safeguard older Australians from abuse is focusing on a range of areas including financial institutions, superannuation, social security, criminal law, aged care and health.

It has been consulting around Australia but the issues paper, released today to coincide with World Elder Abuse Awareness Day, is the first opportunity for broad public input.

The paper also sets out in detail the key issues the commission is examining, and calls for information from stakeholders, experts and the public. The commission also said it was keen to collect case studies from people who had experienced or witnessed elder abuse.

On aged care, the paper also asked what changes should be made to the mandatory reporting of alleged assaults in facilities, to the aged care complaints mechanism, the sanctions regime and to the role of aged care advocacy services and the community visitors scheme.

The effectiveness of mandatory reporting of assaults has been a longstanding debate within the sector, and the department has not undertaken a review of the policy since it was first introduced in 2007.

The paper also asked what evidence existed of elder abuse committed in aged care – across residential, home and flexible care settings – and what further role aged care assessment programs could play in identifying and responding to people at risk of abuse.

The issues paper is available to read here. The commission said it would be providing information about its elder abuse work in 20 Community languages, which is available here.

The inquiry is due to report in May 2017.

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Tags: Australian Law Reform Commission, elder-abuse, mandatory-reporting, restraint, slider, World Elder Abuse Awareness Day,

6 thoughts on “Elder abuse inquiry probes restraints, mandatory reporting of alleged assaults

  1. Excellent news and long overdue. The prevalent use of restraint throughout residential aged care is indicative of an inability to apply a more strategic approach.

    As with so many outdated practices, the threat of litigation may provide the only incentive for change.

  2. I recently placed my elderly mother into a nursing home. Among other things she suffers from dementia. Whenever nature calls, she instinctively attempts to get up, whether from her bed or a chair, resulting in a fall every time. It is impossible to monitor her 24/7, hence she’s had 6 nasty falls within 6 months. 3 of them severe and life-threatening. Broken spine and broken vertebrae in her neck (twice), broken hip, and a fractured knee. She has had to wear a back and neck brace for the past 5 months resulting in her inability to eat properly, causing loss of weight and much discomfort trying to sleep with all that apparatus on her body. I had requested some form of restraint, such as a seat belt on her chair to prevent her getting up, causing her to call for a nurse when nature calls. NO! they said. Restraints are prohibited. I was quite shocked to hear this because it is my belief that had she had some form of restraint whilst sitting in her chair, or a bed rail (like they have in hospitals without question), she would not have had all, those terrible falls. But they argued, including a physio nurse from RMH “restraits are cruel” “how could you do that to your mother”? “restraints may cause harm”, “she could injure herself”. Little did they understand my love for my mother and that I was trying to protect her more by thinking of ways to prevent further falls, which are a certainty to keep happening, against a probability to harm herself with a restraint. I would rather risk harm from a restraint on a chair, than have her continually fall flat on her face. Yes, she had another fall today, this time just a broken nose, a lump om her forehead the size of an apple and bruised arm. I believe certain cases warrant the use of some form of restraints, and NO, in those soecial cases, I do not believe it is cruel or abusive.
    I ask myself the question: Will the next fall without a restraint be her last?

  3. Sadly, It may well be.

    Perhaps you could ask the facility to purchase a low bed; it wont stop her attempts but at least her problem will be trying to get up rather than falling down.

    Why is she so agitated? Does she need a more stimulating environment? Is there any untreated pathological reason for her agitation? There are a range of avenues to pursue so request a full review and/or a DBMAS consult.

    It’s difficult to see our folks deteriorate like this but it’s downright inhumane to have her spend her remaining days harnessed like an animal, confused as to why she’s being tied up and held captive…’for her own good’ or just to make you feel better? It’s tough, but these situations require us to adopt a different paradigm than we’ve been used to.

    Be careful with hospital comparisons. Hospitals have high staffing ratios and the majority of their patients don’t have dementia. They also have horrendous fall rates among their elderly admissions. You’ll find that bed rails are responsible for some ugly injuries and if they do make it over, it’s just further to fall.

    All the best

  4. bed rails create a higher barrier to limb over, A bed that can get as close to the ground must be a better option. Aged care homes are not hospitals and the comparison is like apples and oranges.
    Perhaps scheduled trips to the toilet might assist.

  5. My husband was restrained in a nursing home and I saw it in hospitals as well. They urgently need more trained staff in homes. I have very disturbing memories of staff incapable of tending to the residents .

  6. I just want to say that nursing homes are often following the regulations and expectations of no restraint policy and that’s why no lap belts, bed rails etc are advocated or encouraged. On the other hand if these things are required for the therapeutic or on safety basis with approved authorisations, assessment and well informed pro and cons are still put in use as per the clients choice and preferences. There is always a balance check between use of these things just as restraints or therapeutic requirement ,so the persons/NOKs decisions are respected.

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