Consequences of restraint use

Hidden Consequences of Restraint Use in People with Dementia

Although restraints are often used in care settings to prevent harm, research and experience show that they frequently cause harm instead. People who attempt to break free from restraints can suffer severe injuries—such as broken bones, concussions, or even death. Moreover, simply sitting or lying down for too long without movement can weaken the body and mind, leading to a wide range of health problems.

Below are some of the most common and serious complications caused by physical restraints:

1. Dehydration

People who are restrained are often unable to drink water independently. Without adequate hydration, they can quickly become dehydrated, which affects every system in the body.

2. Psychological Distress

Being restrained can be deeply traumatic. Individuals may feel anxious, stressed, frustrated, agitated, lonely, or ashamed. This distress can lead to depression, social withdrawal, or even increased aggression and restlessness—the very behaviors restraints aim to control.

3. Loss of Postural Tone

Remaining in the same position for extended periods causes a loss of “vascular tone”—the ability of blood vessels to constrict properly. When a person changes position, such as from lying to sitting, blood pressure may drop, leading to dizziness, confusion, or fainting.

4. Pneumonia

Prolonged bed rest increases the risk of pneumonia. When a person lies down for too long, fluid can accumulate in the chest, making it easier for infections to develop and spread to the lungs.

5. Decreased Appetite and Malnutrition

A lack of movement often leads to a reduced appetite. Someone who was previously active may lose interest in eating, resulting in malnutrition and weakened immunity.

6. Urinary Tract Infection (UTI)

Restraints can cause or worsen incontinence. Limited mobility, lack of fluids, and an inability to use the bathroom independently all contribute to the development of UTIs.

7. Constipation

Physical activity is crucial for healthy digestion. When someone cannot move freely, the bowels slow down, leading to constipation—made worse by poor hydration and reduced appetite.

8. Incontinence

Restraints can make it impossible for individuals to reach or use the toilet in time, resulting in incontinence. Over time, this can also lead to skin irritation and infection.

9. Decreased Bone and Muscle Strength

When people are confined and unable to move, their bones lose density and muscles lose mass. This physical decline can make walking or even sitting up difficult, increasing the risk of falls and fractures.

10. Swollen Feet

People restrained in a sitting position often develop swollen feet, as fluids accumulate in the lower limbs when movement is restricted.

11. Pressure Sores

Pressure sores, or bedsores, develop when the same part of the body bears weight for too long. Redness is an early warning sign; if ignored, these sores can progress to painful, infected wounds.

12. Contracted Muscles

Without stretching and movement, muscles and tendons can shorten and stiffen—a condition called contracture. This reduces flexibility and can permanently limit mobility.

13. Decreased Functional Skills

The combined effects of these physical and psychological issues lead to a significant decline in a person’s ability to perform daily tasks—such as eating, bathing, or using the bathroom—further reducing independence and quality of life.

Conclusion

Physical restraints may seem like a safety measure, but they often create new risks and diminish dignity. Understanding the consequences of restraint use helps caregivers seek safer, person-centered care alternatives that support both well-being and autonomy.

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