Physical or Chemical Restraints
Physical and chemical restraints have legitimate uses in the medical and psychiatric field, but are very rarely necessary in a clinical setting. However, they are used much more frequently in nursing homes, and often for totally unacceptable reasons relating to the convenience of the staff rather than the welfare of the patients. In fact, one of the signs of nursing home abuse is the frequent or unexplained use of medication or restraints on patients.
Physical restraints in nursing homes include the use of devices such as vests, straps, belts, and limb ties associated with the patient’s clothing, or use of devices such as wheelchair bars or reclining chairs: essentially anything that can be used to limit or eliminate a patient’s freedom of movement against their will.
Chemical restraints refer to a number of different classes of legitimate medications, often anti-anxiety drugs or sedatives that are used for the purposes of reducing a patient’s ability to move. These medications can be used in therapeutic ways, but often are prescribed unnecessarily, or in far higher dosages than are necessary with the intent of making patients easier for the staff to manage.
Federal law strictly regulates the usage of drugs having these effects: they must be documented in a patient’s medical file, and it is illegal for them to be used for reasons only relating to staff convenience, the discipline of patients, or any other non-therapeutic purpose. Chemical restraints may only be used with a written order by a physician that states the duration and circumstances that may be involved for their use. Medications of a nature or strength such that they can render a patient immobile or less mobile are extremely potent, and many of them can have serious side-effects. The FDA has never in fact authorized a medication specifically for use as a chemical restraint, thus the use of any medication for this purpose falls into the gray area of “off label use”. Some classes of medications that are commonly used for the purposes of restraining patients include:
- Antipsychotic medications such as haloperidol, olanzapine, risperidone, and droperidol. These types of drugs are among the most common misused for restraint purposes because they all have a heavily sedating effect. They are also known to have severe side effects, including in some cases causing potentially lethal cardiac issues.
- Benzodiazepines such as lorazepam and midazolam. These medications are usually used in the treatment of various psychiatric conditions, as well as muscle tension and seizure disorders. Like the various antipsychotic medications they have a highly sedating effect, which is one of the reasons they are used to treat agitation. Many of them are addictive, some of them highly so, and are used by recreational drug users.
- Dissociative anesthetics, which are types of hallucinogens that function by detaching a patient from their surroundings by disrupting the transfer of nerve impulses in the brain. Dissociative anesthetics are the least commonly used class of medications for restraint purposes quite simply because they are incredibly strong and require careful monitoring.
If a patient in a nursing home is injured while under physical or chemical restraint the facility and its medical staff likely will be liable for their injuries. If you feel that a loved one was injured while under restraint in a nursing home or other extended care facility in the state of Illinois, it is in their best interests that you contact a nursing home lawyer online or call us at 877-374-1417 or 312-332-2872 as soon as possible to schedule a free consultation to discuss your situation and learn about your options.