Canadian nursing homes use restraints on a third of their residents

Statistics were gathered from five countries about the use of physical restraints and anti-psychotic medication, drugs whose use on senior citizens has become increasingly controversial.

Prof. Hirdes said that the use of physical or chemical restraints can be reduced in part by dealing with the patients' underlying problems, such as bad eyesight or hearing or bothersome living conditions.

The study found that Canadian nursing homes use anti-psychotics with about 27% of residents. This falls in the middle of the five countries surveyed.

Anti-psychotic drugs are known to have adverse effects, including increased risk of falls, cardiovascular problems and death.

The study also found that Canada is one of the highest users of restraints for the elderly, despite years of evidence that such measures have many negative side effects.

"Use of restraints -- often on patients with dementia or other cognitive impairment -- is considered by experts to be a sign of poor-quality care, and leads to harms ranging from loss of mobility to pressure ulcers and increased agitation." said John Hirdes, a gerontology professor at the University of Waterloo.

According to the study, physical restraints are used in Canadian nursing homes on almost a third of residents (31.4%). Sadly for Canada, that is the highest number in the study. The other countries surveyed were Switzerland (6%), the United States (9%), Hong Kong (20%) and Finland (28%).

Canada has made some improvement over the past decade; in 1999 the figures were above 40%. However, the current figures are still too high. According to experts, ideally, the rate of restraint use should be below 5%. There is room for improvement.

However, a spokesman for the long-term-care industry said that the study misleadingly inflated the Canadian figures. The study included statistics from some chronic care hospitals, and they have less regulation and younger patients than nursing homes. Both of these factors could lead to greater use of restraints.

In Ontario, new legislation is imposing strict rules on nursing homes to limit restraint use. Also, there is going to be a Web site that allows consumers to compare quality of care, and other factors, between facilities.

Source: Blackwell, Tom. "Canada highest user of restraints on elderly." National Post.