Day: October 29, 2025

In the past, physical restraints were often seen as a necessary part of dementia care. Caregivers and healthcare staff believed that using restraints would help keep people safe—especially those at risk of falling, wandering, or becoming agitated. The intention behind their use was often good: to protect the person with dementia and those around them.

Why Restraints Were Commonly Used

Restraints were traditionally applied in situations where a person with dementia might:

• Be at risk of falling

• Strike out at others

• Wander or move unsafely

• Take food from other people’s plates

• Enter other residents’ rooms or take their belongings

• Get out of bed during the night

• Appear confused, restless, or agitated

• Require lifesaving medical treatment

These actions were often misunderstood as challenging behaviors that needed to be controlled. In reality, they were expressions of unmet needs, confusion, or distress.

The Hidden Harm of Restraints

Although restraints were meant to prevent harm, research has shown that they often do the opposite. Physical restraints can lead to serious injuries, emotional trauma, and, in some cases, even death. They may increase confusion, fear, and agitation in people with dementia, making behaviors more difficult to manage instead of improving them.

Simply put, the use of restraints causes more harm than good.

Knowing the Person Is Key

When caregivers and families take time to know the person behind the behavior, they can identify what might be causing distress or confusion. This person-centered approach allows for creative, compassionate solutions that keep everyone safe—without compromising dignity or freedom.

Get 10% off on CARES® training and learn proven ways to reduce restraint use while promoting dignity and independence in dementia care.
Use code Halloween10 by November 15, 2025.

In dementia care, our primary goal is always to promote safety without compromising dignity or independence. One area that continues to evolve is how we think about and manage restraints. While once considered protective, restraints—whether physical or chemical—can actually increase the risk of harm and distress. Understanding what constitutes a restraint and why minimizing their use is essential can help caregivers provide better, more person-centered care.

What Is a Restraint?

A restraint is anything that controls or limits a person’s movement, behavior, or access to their body. There are two main types of restraints: physical and chemical.

1. Physical Restraints

Physical restraints are objects or devices that restrict a person’s ability to move freely or access certain parts of their body. Examples include:

• Belts, vests, or wrist ties

• Lap trays or restrictive clothing that the person cannot remove easily

• Chairs designed to prevent standing or movement

• Bed or chair alarms that frighten people into staying still

While these restraints might appear to prevent falls or injuries, they often do more harm than good. They can cause fear, agitation, or even serious accidents when a person with dementia tries to escape them.

2. Chemical Restraints

A chemical restraint involves using medication—usually antipsychotics—to control dementia-related behavior or make care tasks easier for staff. These medications can sedate a person, reducing movement and responsiveness.

However, such medications should never be used simply to calm a person or manage behavior related to dementia unless absolutely necessary for safety reasons. The Centers for Medicare and Medicaid Services (CMS) has required nursing homes to reduce the use of antipsychotics for people with dementia since 2012.
There are times when these medications are appropriate—for example, when a person has a serious mental illness or poses a danger to themselves or others. In those cases, physicians must clearly document why the medication is being prescribed and for how long.

Misconceptions About Restraints

For many years, restraints were believed to promote safety, especially in preventing falls. However, evidence shows that they can actually increase the risk of injury or trauma.

For instance, bed rails were originally designed to keep people from falling out of bed. But for someone with dementia, a bed rail can become a source of danger. A person who doesn’t understand its purpose may try to climb over it, leading to a more severe fall or even entrapment. Without the bed rail, the fall might have been less harmful—or avoided altogether.

In short, restraints can create the illusion of safety while introducing new and serious risks.

Moving Towards a Restraint-Free Approach

The ultimate goal in dementia care is to eliminate the need for restraints by understanding each person as an individual. Compassion, observation, and communication are key. When we connect deeply with the person and respond to their needs—rather than control their behavior—we create a safer, more respectful care environment for everyone.

Get 10% off on CARES® training and learn proven ways to reduce restraint use while promoting dignity and independence in dementia care.
Use code Halloween10 by November 15, 2025.

When caring for individuals living with dementia, “wandering” is one of the most common behaviors caregivers encounter. But rather than seeing it as a problem to eliminate, it’s important to understand wandering as a meaningful activity that happens for a reason. By reframing our perspective, we can create safer, more positive experiences for both the individual and the care community.

Why Wandering Happens

Like all dementia-related behaviors, wandering doesn’t occur without cause. A person may walk around because they’re following a routine, searching for something familiar, or simply enjoying movement. Your role as a caregiver is to pay attention, recognize patterns, and learn what each person is trying to express through their actions.

When Wandering is Positive

Wandering isn’t always something to stop. In fact, when done safely, walking around can be a healthy practice that promotes exercise, reduces restlessness, and provides a sense of purpose. For many individuals with dementia, movement brings comfort and helps them feel engaged with their environment.

When Wandering Becomes Risky

Wandering can become harmful if it leads someone into unsafe areas, outside of the care setting, or into another person’s private space. These risks highlight why it’s so important to understand each person’s habits and to provide safe spaces where exploration can happen without harm.

The Importance of Knowing the Person

The best way to support safe and positive wandering is to know the individual well—his or her routines, habits, and preferences. This knowledge allows caregivers to anticipate needs, prevent unnecessary risks, and make wandering a safe and enriching activity.

Shifting the Language

Language matters. Instead of labeling someone as a “wanderer,” use positive, respectful terms such as “exploring” or “walking around.” This small shift reinforces dignity and helps everyone focus on the person, not the behavior.

Final Thoughts

Wandering is not a behavior to fear, but an opportunity to better understand and connect with people living with dementia. By recognizing the reasons behind it, ensuring safety, and using respectful language, caregivers can turn wandering into a positive part of daily life.

Get 10% off on CARES® training and discover how to turn dementia wandering into safe, meaningful exploration using the CARES® Approach. Use code Halloween10 by November 15, 2025.