Rights, Risk and Restraint-Free Care of Older People: Person-Centred Approaches in Health and Social Care

by David Oliver, Gabriele Meyer, Kate Irving, Carmel Hughes, Rhidian Hughes

Overview

The restraint of older people is a pressing issue for health and social care practice. This book provides health and social care professionals with an authoritative reading resource on the ethics and use of restraint.

The book provides an overview of the different forms of restraint, the conditions under which they are used, and their implications for the health and wellbeing of older people. Practical approaches to minimising are then explored, underlining the importance of person-centred care. Innovative programmes and approaches to reducing the use of restraint from around the world are described and assessed, and case studies are drawn upon to highlight practice challenges and their effective resolutions. The perspectives of older people and their carers and families, as well as of professionals, commissioners and regulators of health and social care, are also taken into account. The contributors are drawn from an international range of health and social care settings, as well as from the academic world.

This in-depth volume will help health and social care professionals better understand the complex issues that surround the use of restraint, support practice that puts older people at the centre of decision-making about their care, and enable services to provide safer and more appropriate care.

Product Details

ISBN-13:	9781843109587
Publisher:	Kingsley, Jessica Publishers
Publication date:	12/15/2009
Edition description:	New Edition
Pages:	224
Product dimensions:	5.90(w) x 8.90(h) x 0.60(d)

About the Author

Jane Q. Williams qualified as an Occupational Therapist in 1986 and has a Master’s degree in Advanced Occupational Therapy. She practised as an OT and then a supervisor for ten years predominantly in community settings. Jane then worked for 4 years as Learning and Development Advisor and Manager, designing and implementing approaches to learning for the staff of Devon County Council Social Services. Since December 2007, she has worked as a free-lance music facilitator and music teacher.

Heather Wilkinson is Co-Director of the Centre for Research on Families and Relationships and Research Director for the School of Health in Social Science at the University of Edinburgh.

Table of Contents

List of Acronyms and Abbreviations 11

Foreword Baroness Greengross 13

Preface Rhidian Hughes 16

Chapter 1 Introduction Rhidian Hughes 18

Part I Types of Restraint, Patterns and Trends 29

Chapter 2 Physical Restraint and Medical Interventions David Evans 30

Chapter 3 Covert Medication and Chemical Restraint Carmel M. Hughes Kate L. Lapane 41

Part II Perspectives across Health and Social Care 55

Chapter 4 Pennsylvania's Non-Restraint Approach to Psychiatric Care and Services Gregory M. Smith Donna M. Ashbridge Aidan Altenor Robert H. Davis 56

Chapter 5 Restraint: The US Nursing Home Perspective Beryl D. Goldman Joan Ferlo Todd Janet Davis Karen Russell 63

Chapter 6 Ethical Dilemmas in Maintaining Enteral Feeding: The Use of Hand-Control Mittens Jane Williams 71

Chapter 7 Do We Need Drugs? Strategies to Reduce the Over-Prescription of Drugs in Care Homes Supporting People with Dementia Sheena Wyllie 78

Chapter 8 The Therapy of Companionship Jim Ellis 84

Chapter 9 Health and Safety Perspectives Stephen Clarke 89

Chapter 10 Human Rights Perspectives Rhidian Hughes 97

Part III Issues and Innovations 105

Chapter 11 Clinical-Ethical Considerations on the Use of Physical Restraint Chris Gastmans 106

Chapter 12 Changing Restraint Use: Discourses on Restraint Kate Irving 120

Chapter 13 Therapeutic Approaches and De-Escalation Techniques Suparna Madan Pat Roive 133

Chapter 14 Wander-Walking and People with Dementia Jan Dewing Kent Heather Wilkinson 148

Chapter 15 Preventing Falls and Avoiding Restraint Samuel R. Nyman David Oliver 167

Chapter 16 Using Evidence-Based Knowledge to Avoid Physical Restraint Sascha Köpke Gabriele Meyer Anja Gerlach Antonie Haut 178

Chapter 17 Reducing Restraint - The Benefits of Education and Training Ingelin Testad Dag Aarsland 193

Select Bibliography Rhidian Hughes 207

Afterword Barbara Pointon 210

About the Contributors 213

Subject Index 219

Author Index 222

Editorial Reviews

This thought-provoking book challenges us all to re-examine our personal attitudes when caring for older people. At its heart lies a desire to improve relationships, quality of life and holistic well-being.

Barbara Pointon

Alternatives to restraint and new programs for reducing the use of restraint are described in chapters that outline all the issues involved in providing safe environments for elders. Very highly recommended!... It shows how a simple four-step method can be applied to the typical ADD/ADHD child to teach even the most disorganized, hyperactive child how to make their bed, get ready for school, and get organized. These step-by-step strategies offer routines that aren't boring and ARE positive, keyed to realistic demands and rules governed by fun and individualism.

The Midwest Book Review

the volume's contributors profusely shower a considerable swath of the research field of restraint of older people with the intellectually nourishing rain of informative discourse, discerning criticism, and a plethora of expert opinions and suggestions. The efforts of the contributors may help nurture further research investigation of this issue ridden field.

The long list of persons who may learn much from this highly instructive volume includes: patient advocates, psychiatrists, neuropsychiatrists, geriatric psychiatrists, forensic psychiatrists, psychologists, clinical psychologists, psychoanalysts, psychotherapists, cognitive therapists, behavioral therapists, neurologists, neurosurgeons, nurses, psychiatric nurses, rehabilitation nurses, emergency room nurses, gerontologists, geriatric medicine specialists, long term care specialists, physical medicine and rehabilitation specialists, medicolegal specialists, hospice workers, nursing home personnel, hospital administrators, social workers, social scientists, sociologists, medical ethicists, philosophers, public health professionals, occupational therapists, physical therapists, vocational therapists, physiotherapists, recreation therapists, orthopedic surgeons, emergency room physicians, primary care physicians, pharmacists, pharmacologists, civil liberties lawyers, healthcare lawyers, criminal justice professionals, judges, health regulators, health policy makers, legislators, and risk managers.

metapsychology Online Reviews

There are still too many care homes where residents are not free to move around. They are "restrained" by door locks and key pads or by being belted into wheelchairs, or simply told to "sit down". Most of it arises because the culture of the home remains controlling and risk-averse. Rights, Risks and Restraint-Free Care will help managers and staff to think through the risks and ethics of restraint and find ways to free residents from the institutional bonds that make them prisoners in what is supposed to be their "home". There are some excellent case studies (many from other countries) which are ideally suited for use in training sessions.

Caring Times

I hope this book will be widely read. It encourages us to question our motives if ever we are faced with difficult situations when caring for people to whom it is sometimes very difficult to relate, but people who nevertheless need our care and understanding at the most vulnerable period of their lives as they draw to a close.

Baroness Greengross