It was one of the most controversial points of the Agreement on Accreditation and Quality of Centers and Services of the SAAD (System for Autonomy and Dependency Care) approved last year by the Territorial Council of Social Services. It is about the use of both physical and pharmacological restraints, which are used in an indiscriminate and generalized manner in numerous residences for the elderly and dependent (with up to 50% of the 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 removing these ligaments that immobilize residents means expanding the ratio of professionals who work in these spaces, especially at night. And, in fact, in many residential centers three assistants are in charge of up to 200 residents during the night shift. "And now, that one is on vacation, there are two of us. If you don't tie them, it's impossible to guarantee that they won't fall", explains an assistant who works the night shift in a private residence in the Community of Madrid, who asks not to be identified or to identify the center "because I don't get out".
But tying up a person, in addition to violating their rights and being considered by geriatricians as a form 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 the restraint that kept her tied to the bed. Around 3.20 in the morning, according to this story, an assistant, on her rounds, found that the woman had moved so much that her head had reached the middle of the bed and the abdominal support was close to her neck . They reinstated her and continued the work visiting other dormitories. Three hours later they returned and saw the body dislocated again. This time, they found that the ligament had pressed on his neck. He wasn't breathing anymore.
It is not the first known case. A year ago, an inmate at a residence in the Madrid town of Villa del Prado, in Madrid, died hanging from the straps that kept her attached to the bed. The events also happened at night.
"Subjugations are a failure of the system. They tie them up because there are not enough staff to attend to them. As with the fact of putting diapers on them so that they can relieve themselves in the face of the impossibility of being able to change them. For the resident who is aware of it, it is real torture", points out Miguel Vázquez, president of the Platform for the Dignity of the Elderly in Homes (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 subjects in 2023, in which it calls for a legislative change that facilitates the removal of physical, mechanical or chemical subjects in homes for the elderly and that foresees "clearly" the "exceptional" situations in which it is possible to use them, establishing the legal requirements for "appropriate" use in time and manner.
The SEGG is asking for something that the autonomous communities committed to: to eliminate the subjections within three years (now two). And only use them in exceptional cases, very well-reasoned and reporting them, even, when the case arises, to the Prosecutor's Office. For now, they are still there.
