Physical Restraint Initiation in Nursing Homes and Subsequent Resident Health

Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associa...

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Bibliographic Details
Published in:The Gerontologist 2008-08, Vol.48 (4), p.442-452
Main Authors: Engberg, John, Castle, Nicholas G., McCaffrey, Daniel
Format: Article
Language:English
Subjects:
Accidental Falls
Activities of Daily Living
Activities of Daily Living - psychology
Behavior Problems
Coercion
Cognition
Cognitive Functioning
Correlation
Daily Living Skills
Data Analysis
Depression - psychology
Female
Gerontology
Health
Health Behavior
Health Problems
Health Status
Humans
Individual Characteristics
Male
Medications
Mental Health
Nursing Homes
Older Adults
Older people
Outcomes
Patients
Pennsylvania
Physical Activity Level
Physical Health
Physical restraint
Physical restraints
Problems
Regression Analysis
Restraint, Physical - adverse effects
Retrospective Studies
Risk Factors
Statistical Significance
Studies
Treatment Methods
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Summary:Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental health. Design and Methods: We used all nursing homes (N = 740) in Pennsylvania in 2001, with 12,820 residents. We used the Minimum Data Set data; Online Survey, Certification and Reporting data; and the Area Resource File as data sources. We restricted our sample to newly admitted nursing home residents who were not restrained in the first two quarters of their residency. We examined which facility and individual characteristics during those first two quarters were associated with restraint initiation during the third quarter. We then examined the association of third-quarter restraint initiation with fourth-quarter health outcomes, using regressions that controlled for first- and second-quarter health status as well as other resident, facility, and market characteristics. The physical health outcomes examined consisted of falls, walking dependence, activities of daily living (ADLs), pressure ulcers, and contractures. Mental health outcomes examined consisted of cognitive performance, depression, and behavior problems. Results: The initiation of restraint use was associated with a previous fall (p
ISSN:0016-9013
1758-5341
DOI:10.1093/geront/48.4.442