Two articles reported on a groundbreaking study from the Journal of the American Medical Association that has proved the use of restrains to be unnecessary in nursing homes.  According to a study, nursing homes that simply increased staff training and provided supportive equipment had a lessened need for the use of restraints.   "Nursing home care does not necessitate the administration of physical restraints, as demonstrated by our own epidemiological research," the authors of the study said. "We found pronounced center variation, with best-practice centers applying very few physical restraints.”

In the study the experimental group received an intervention where they were trained and taught alternative methods to care for fall prone residents other than simply belting them down to their bed or wheelchair. The study proved the alternative intervention to be just as effective at preventing falls and fall related fractures as the use of restraints. 

It is obvious that there are much better alternatives than simply tying down a resident yet, today restraints are still being used on more than 20% of residents in U.S. nursing homes. Why is there still such a high prevalence of restrains when more effective, humane methods have been proved to be just as effective? The additional cost of the intervention could be the reason more nursing homes are not participating. Sadly, many nursing homes are of the mentality that if the method they have works why spend unnecessary funds on an alternative method, even if the new method could greatly improve their residents’ quality of life.

See articles at MSN Health and Nurses.com.  Find Study at JAMA. 2012;307(20):2177-2184. doi:10.1001/jama.2012.4517 orhere.

Kaiser Health News had an article on the failure of doctors to provide recommended interventions for chronic health issues.  "Large numbers of seniors aren’t receiving recommended interventions that could help forestall medical problems and improve their health, according to a new survey from the John A. Hartford Foundation."  Medicare pays doctors about three times their ordinary office visit rate for asking about older adults’ ability to function, evaluating their mood, recommending preventive services, and connecting them with community resources during wellness visits.

Notably, one-third of older adults said doctors didn’t review all their medications, even though problems with prescription and over-the-counter drugs are common among the elderly, leading to over 177,000 emergency room visits every year.  More than two-thirds of the time doctors and nurses didn’t ask older patients whether they’d taken a tumble or provide advice about how to avoid tripping on carpets or slipping on the stairs.  62 percent of seniors said doctors and nurses hadn’t inquired about whether they were sad, depressed or anxious.

The results, which cover a period of 12 months, speak to doctors’ and nurses’ lack of training in geriatric medicine. Providers need to recognize that “care of an 80 year old differs from that of a 50 year old,” said Dr. Rosanne Leipzig, professor of geriatrics at the Mount Sinai School of Medicine in New York.