It was one of the most controversial points of the agreement for accreditation and quality of centers and services of the System for Autonomy and Dependency Care (SAAD) approved last year in the Territorial Council of Social Services. This is the use of both physical and pharmacological restraints, which are used indiscriminately and widely in numerous residences for the elderly and dependents (up to 50% of inmates, according to the Community of Madrid).
All the autonomies agree that they violate the basic principle of any person, that of freedom, but the problem is that eliminating those ties that immobilize residents means expanding the ratio of professionals who work in these spaces, especially at night . And it is that in many residential centers three auxiliaries take care of up to 200 residents on the night shift. “And now, that one is on vacation, we are two. If they are not tied up, it is impossible to guarantee that they do not fall," explains an assistant who works the night shift at a private residence in the Community of Madrid, who asks not to identify herself or the center so "they don't throw me out." .
But tying a person, in addition to violating their rights and being considered by geriatricians a type of abuse, also has its consequences. As El País reported yesterday, a woman died of suffocation in the Las Peñuelas residence, in the Madrid district of Arganzuela, with her restraint that kept her tied to her bed. At around 3:20 a.m., according to this account, an assistant, in her rounds, verified that the woman had moved so much that her head had reached the middle of the bed and her abdominal support was close. from her neck. She was reinstated and continued her work by visiting other dormitories. Three hours later they returned and saw her body out of place again. This time, they found that the restraint had squeezed his neck. She was no longer breathing.
It is not the first case that is known. A year ago, an inmate of a residence in the Madrid town of Villa del Prado was hanged by the straps that kept her attached to the bed. The event also occurred at night.
“The restraints are a failure of the system. They are tied up because there are not enough staff to care for them. Like putting diapers on them so they can do their needs in them before the impossibility of being able to change them. For the resident who is aware, it is authentic torture, ”says Miguel Vázquez, president of the Platform for the Dignity of the Elderly in Residences (Pladigmare).
They are not the only ones who say so. A few weeks ago, the Spanish Society of Geriatrics and Gerontology (SEGG) presented the report Care without restraints 2023, calling for a legislative change that facilitates the removal of physical, mechanical or chemical restraints in nursing homes and that "clearly" foresees the situations " exceptional" in which it is possible to use them, establishing the legal requirements of "adequate" use in time and form.
The SEGG asks for something to which the communities committed themselves, to eliminate the restraints in three years (now two). And only use them in exceptional cases, highly reasoned and even informing the Prosecutor's Office. For now, they are still there.
