The use of mechanical or pharmacological restraints has characterized nursing homes in Spain for years. Due in part to the high life expectancy that the country enjoys, a significant percentage of users who access these centers have a high degree of dependency, hence the extension of this practice. However, in recent times, public institutions and the private sector are making efforts in search of alternative models that advocate the elimination of these restraints.
Restraint-free residences are those centers in which the use of handrails or any other physical restraint element that prevents or limits the freedom of movement of patients has ceased. This characteristic represents a step forward in the quality of life of the residents, since it has been verified that the use of these barriers is not capable of preventing falls and causes them greater pain and deteriorates their mood.
The policies to reduce the use of restraints are consistent with the instruction carried out last year by the State Attorney General's Office, which emphasizes that no one should be immobilized through the use of barriers or drugs without a medical prescription, unless there is a danger to the patient. or your environment. This commitment to favoring the dignity and freedom of people banishes some of the dangers associated with them in centers that advocate the reduction of retentions, such as the risk of malnutrition, loss of continence or even the death by strangulation.
The elimination of restraints in residences has positive effects on the physical and mental health of users. The restraints have a counterproductive effect, contrary to the belief by which their use has been extended, since they increase the degree of dependency of the patient and do not reduce the probability of falling. The reduction of these mechanisms decreases the effects linked to the immobilization of the patient, such as ulcers, bedsores and skin trauma, atrophy, contractures or loss of muscle mass. On the psychological level, patients show a lower degree of anxiety, anger or confusion.
The search for an alternative method for each user subjected to restraint is the main challenge faced by professionals in social health centers. That is why it is crucial to raise awareness and train workers on this issue. Policies of non-restraints promote empathy in the relationships between the professional and the user, greater trust on the part of family members and the acquisition of techniques for the treatment of behavioral disorders associated with dementia and other cognitive diseases that are safer and more respectful
