Physical restraint deaths in a 13-year national cohort of nursing home residents

Age Ageing. 2017 Jul 1;46(4):688-693. doi: 10.1093/ageing/afw246.


Objective: this paper aims to investigate the nature and extent of physical restraint deaths reported to Coroners in Australia over a 13-year period.

Methods: the study comprised a retrospective cohort study of residents dwelling in accredited nursing homes in Australia whose deaths were reported to the Coroners between 1 July 2000 and 30 June 2013 and was attributed to physical restraint.

Results: five deaths in nursing home residents due to physical restraint were reported in Australia over a 13-year period. The median age of residents was 83 years; all residents had impaired mobility and had restraints applied for falls prevention. Neck compression and entrapment by the restraints was the mechanism of harm in all cases, resulting in restraint asphyxia and mechanical asphyxia, respectively.

Conclusions: this national study confirms that the use of physical restraint does cause fatalities, although rare. Further research is still needed to identify which alternatives strategies to restraint are most effective, and to examine the reporting system for physical restraint-related deaths.

Keywords: Death; Nursing homes; Older people; Physical restraint.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control
  • Aged
  • Aged, 80 and over
  • Asphyxia / diagnosis
  • Asphyxia / etiology
  • Asphyxia / mortality*
  • Australia
  • Cause of Death
  • Comorbidity
  • Coroners and Medical Examiners
  • Female
  • Homes for the Aged*
  • Humans
  • Male
  • Middle Aged
  • Mobility Limitation
  • Nursing Homes*
  • Restraint, Physical / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Time Factors