Restraints have always been an emotive issue. As an NDIS registered provider we can see both sides of the coin, and sometimes restraints are needed in order to ensure the safety of the person in our care. However, historically the use of restraints in some establishments was simply to make things easier on the staff. We disagree with this viewpoint and work hard to reduce the need to rely on or use physical, chemical or environmental restrains instead looking to out-of-the-box thinking to find alternative solutions.
About Restraints
Physical restraints used in many disability services on the Gold Coast include things like the use of bed rails and belts to ensure a person cannot fall out of bed, trays or vests to keep someone in a wheelchair or proximity alarms to stop them from leaving a room. Chemical restraints are drugs given to control behaviour, perhaps sedatives, and again this tends to be for the convenience of the staff, not the best interests of the patient. Reducing the need for restraints is something we work hard on, but there are occasions when temporary restraints are needed to secure a situation. However, overall we are committed to reducing the need.
The Call to Reduce Restraints
Our NDIS support workers are all too aware of the negative aspects of relying on restraints. Patients forced to remain in bed or chairs are prone to pressure sores, bruises and UTIs; they may not be able to access adequate hydration or food, leaving them dehydrated or malnourish and most importantly, this is a loss of dignity and can lead to mental health issues such as depression. Of course, the use of restraints can be well-meant and in the best interests because of the danger of getting out and becoming a danger to themselves; however, we believe there are better, more dignified ways to handle flight risk and other situations that may previously have lead to restraint.
Alternatives to Reduce Restraints
There are many different ways of approaching the challenges presented by some patients and their needs. Firstly having the correct ratio of staff is paramount. Monitoring and supervision are skipped in some settings in order to have more paying clients, but this is an appalling business model and detrimental to the patients. Each patient should be assessed and provided with the correct amount of one-to-one care that meets their needs.
If they are a flight risk, they need to be closely watched, not just casually glanced at a few times an hour. That may mean an extra staff member assigned to them or fewer clients at that session, but it has to be a priority. Different furniture could reduce the need for bed rails and straps; lower beds that carry a lessened risk of falling are one such example.
With more advanced technology, it is possible to track movement without having to create a prison scenario, and of course, a secure building system can ensure freedom within the facility without needing to restrain.