Difference between revisions of "Use of Restraints in Long-Term Care"

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Use of Restraints in Long-Term Care (view source)

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==Use of Restraints==
''The Residential Care Regulation'' define a restraint as any chemical, electronic, mechanical, physical or other means of controlling or restricting a care facility resident’s freedom of movement. This includes accommodating the person in a secure unit (for example, a locked wing of the facility).
The law does not specifically define chemical restraint, but other sources have described chemical restraint as the use of a medication to restrict a person’s movement, reduce a behaviour, or sedate a person beyond any therapeutic purpose. For more information about the use of chemical restraints, see the 2020 [https://www.bcli.org/consent-to-chemical-restraints-in-long-term-care/#:~:text=Consent%20to%20Restraints&text=Restraints%20can%20only%20be%20used,be%20used%20(s%2073) BC Law Institute blog] by Sara Pon.
The ''Residential Care Regulation'' sets out the general requirements for how and when restraints can be used in long-term care:
* Restraints can only be used if they are needed to protect the adult or others from imminent harm, and not for discipline or the convenience of staff.<ref>''Residential Care Regulation,'' BC Reg 96/2009, s 74, online: &lt;canlii.ca/t/89ln&gt;.</ref>
* Restraints must be as minimal as possible.
* Other options must have been tried before restraints can be used.
* The adult being restrained must be monitored to protect their “safety and physical and emotional dignity”<ref>''Residential Care Regulation,'' BC Reg 96/2009, s 73, online: &lt;canlii.ca/t/89ln&gt;.</ref>
These requirements must be met in every instance that restraints are used. In addition, the ''Residential Care Regulation'' sets out specific requirements for both emergency and non-emergency use of restraints.
If restraints are used in a non-emergency situation, the regulation requires prior consent from the resident or, if they are incapable of making decisions about restraint use, from their substitute decision-maker.<ref>''Residential Care Regulation,'' BC Reg 96/2009, s 74, online: &lt;canlii.ca/t/89ln&gt;.
</ref> The resident’s physician or nurse practitioner must also agree. The resident or their substitute decision-maker and the health practitioner must both consent in writing. Note that the Public Guardian and Trustee cannot provide substitute consent for the use of restraints.<ref>''Residential Care Regulation,'' BC Reg 96/2009, ss 74-75, online: &lt;canlii.ca/t/89ln&gt;.
</ref>
If restraints are used in an emergency, the regulation states:
* Prior agreement is not required if the adult or others are at imminent risk of harm.<ref>''Residential Care Regulation,'' BC Reg 96/2009, s 74, online: &lt;canlii.ca/t/89ln&gt;.</ref>
* The use of restraints must be documented in the care plan; and
* After the restraint has been used, the facility must share information and advice regarding the restraint use, in a manner that fits the person’s skills and abilities, with:
** the resident,
** anyone who witnessed the restraint use, and
** any employees involved in the restraint use.<ref>''Residential Care Regulation,'' BC Reg 96/2009, s 73, online: &lt;canlii.ca/t/89ln&gt;.</ref>
During restraint use, regular reassessments are required:
* The need for the restraint must be reassessed within the first 24 hours of using it.
* If the restraint is used in an emergency and continues for more than 24 hours, the adult or their substitute decision-maker and the adult’s doctor or nurse practitioner must agree to it.
* If the restraint is used with prior consent, reassessment must occur based on what is listed in the care plan or when the adult or substitute decision-maker has specified, whichever is earlier.<ref>''Residential Care Regulation,'' BC Reg 96/2009, s 75, online: &lt;canlii.ca/t/89ln&gt;.</ref>
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==References==
==References==
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