. The use of physical restraints in older adults receiving home care: a cross-sectional study in a district of northen Italy.
Introduction: Research on restraint use in home care residents cared by non professional caregivers is scarce.
Aim: To evaluate the prevalence of physical restraints among the elderly assisted by the home care services in the District 1 of Bassano del Grappa ULSS7 Pedemontana (Veneto Region, Italy).
Method: This observational cross-sectional survey was conducted by the 28 home care nurses on all subjects receiving at least one home care service by a nurse during the survey period (13 March-15 April 2017). Data were collected on functional and cognitive conditions, restraints, reasons and duration of restraints use, presence of prescription.
Results: Of the 510 included elderly (93.6% of the 545 service users), 175 (34.3%) were restrained; mean age 84.6(±11.3) years; 62.3% were women. The 15.4% (27) of restrained were bed-bound, 24% (42) had a limited mobility, 33.1% (58) were able to walk with or without help, and 27.4% (48) were confused but able to walk. The most used restraint were bed-rails (159 patients, 90.8%): for 120 (68.8%) the only restraint and for 80 (45.7%) only during the night. The main reason for restraints use was the prevention of falls from the bed or the wheelchair (85.7%).
Conclusions: The prevention of falls from the bed or wheelchair was the most common reason for the use a physical restraint; in 1/3 of cases it was decided by family members. The use of restraints was higher in patients with physical or cognitive disability or confused or agitated.