What Is Improper Use of Restraints by Nursing Home Staff?

Restraints may only be used by nursing home staff in extremely limited circumstances. This is to protect both the safety and the dignity of nursing home residents. While there are circumstances in which the use of restraints is permitted under Wisconsin law, the unfortunate reality is that nursing home staff use restraints much more often than they should.

All nursing home residents in Wisconsin are protected by the law. Under the law, nursing home residents are entitled to several protections—and this specifically includes protection against the use of unnecessary restraints by nursing home staff. As stated in Section 50.09(1)(k) of the Wisconsin Statutes: 

“[Nursing home residents have the right to] be free from chemical and physical restraints except as authorized in writing by a physician, physician assistant, or advanced practice nurse prescriber for a specified and limited period of time and documented in the resident’s medical record.” 

While the law goes on to state that, “[p]hysical restraints may be used in an emergency when necessary to protect the resident from injury to himself or herself or others or to property,” it also makes clear that, “authorization for continuing use of the physical restraints [must] be secured from a physician, physician assistant, or advanced practice nurse prescriber within 12 hours.”

Understanding the Restrictions on Physical Restraints in Wisconsin Nursing Homes 

In a document titled, Avoiding Physical Restraints, the Wisconsin Department of Health Services (DHS) discusses both the risks and restrictions related to the use of physical restraints by nursing home staff. It identifies four broad categories of risks related to the unnecessary use of physical restraints by nursing home staff:

• Injuries from Falls – As the Wisconsin DHS explains, while many people assume that physical restraints help to prevent injuries, primarily due to falls, “the opposite is true.” When nursing home residents are restrained, they are “more likely to be seriously injured trying to get out of a restraint than they are from a fall.” 
• Other Physical Health Risks – The Wisconsin DHS lists several other physical health risks linked to the use of physical restraints as well. These include malnutrition, incontinence, urinary tract infections, loss of bone mass and muscle strength, pressure sores, and fractures, among others. 
• Cognitive and Emotional Harm – Along with causing physical trauma, the use of restraints by nursing home staff can also cause severe cognitive and emotional harm. The Wisconsin DHS lists risks including loss of autonomy, dignity, and self-respect; feelings of isolation and dehumanization; feelings of entrapment; and withdrawal, agitation, and depression, among others. 
• Risk of Premature Death – As the Wisconsin DHS correctly indicates, physical restraints can also increase nursing home residents’ risk of premature death. Asphyxiation and strangulation can both be very real concerns, as can complications from other health problems caused by the use of restraints.

Due to these risks, physical restraints may only be used in accordance with Wisconsin law, and only when necessary, “to treat a resident’s medical symptom[s] and help the resident achieve or maintain the highest practicable level of functioning and wellbeing.” If a less-restrictive alternative is available, then this alternative must be used unless and until it is proven ineffective. As identified by the Wisconsin DHS, some examples of common (and often highly effective) alternatives to physical restraints by nursing home staff include:

• Providing additional training to nursing home staff
• Installing non-slip surfaces
• Removing trip hazards or other impediments to mobility 
• Lowering the height of a resident’s bed 
• Providing additional pillows or mattresses 
• Developing mobility or activity programs to promote independence
• Assisting residents with maintaining regular routines

Restraint Use in Nursing Homes

One of the fundamental tenets of the Nursing Home Patients’ Bill of Rights is the right of a long-term care patient to live free from restraints, whether they are physical, chemical, or mechanical. Patients must have the ability to control their own body functions, to the greatest degree possible, unhampered by restraints. While restraints are necessary in some extreme cases, or on a temporary basis during an emergency situation, the overuse of restraints can lead to significant injuries to a nursing home resident, both physically and emotionally.

Unfortunately, many short-staffed nursing or long-term care facilities use restraints for convenience rather than necessity. Physical restraints are objects that physically restrain a resident, such as belts, straps, and side rails on a bed. If a resident is left restrained for a significant period of time, he or she may suffer physical injuries due to an inability to freely move about, such as bruises on their wrists and feet. A prolonged period of physical restraint also can cause psychological or emotional issues in a patient due to neglect, lack of human contact, and inability to move in any meaningful fashion.

Although chemical restraints act much differently than physical restraints, they often have the same effect. By using drugs to restrict a patient’s freedom, nursing home staff may believe that they can more easily care for a large number of residents. However, continual usage of medications to effectively sedate nursing home residents is not in accordance with a resident’s rights to move freely without fear of dizziness, falling, or excessive sleepiness. These drugs are only appropriate when prescribed by a doctor to a specific patient in order to treat a certain medical condition or symptom, not for the convenience of nursing home staff.

All too often, nursing home staff members use restraints on residents improperly, and to the extent that the residents suffer neglect and even injury. While restraints are necessary in certain situations, they should not be used as a means to control unattended patients. At Boller & Vaughan, we focus on protecting the rights of those who have suffered neglectful or abusive actions at the hands of nursing home facilities. We have the skills and knowledge to delve into the facts your case, consider all available options, and advocate on your behalf by bringing any legal claims that you may have against the nursing home in question, or its staff members.

What to Do if You Have Concerns About an Improper Physical Restraint 

If the use of a physical restraint is unnecessary, then it is improper. Except in emergency circumstances, the use of physical restraints also requires a medical recommendation and consent from the resident or the resident’s legal decision-maker. With this in mind, the use of physical restraints by nursing home staff should be extremely rare; and, when restraints are truly necessary, the means used should involve the minimum amount of restraint necessary for the resident’s safety. 

Given that this is the case, if you have concerns about an improper physical restraint in a Wisconsin nursing home, you should not ignore them. Unfortunately, you or your loved one may be a victim of nursing home abuse. If so, you and your family have clear legal rights, and you can—and should—hire a lawyer to assist you right away. 

Speak with a Wisconsin Nursing Home Abuse Lawyer for FREE 

If you would like to speak with a Wisconsin nursing home abuse lawyer in confidence, we invite you to get in touch. Our attorneys have extensive experience helping nursing home abuse victims and their families throughout the state.

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Contact the Boller & Vaughan today online or at (608) 268-0268 for a FREE case evaluation. We proudly serve clients in Madison and throughout Wisconsin.