Physical and chemical restraints in acute care: their potential impact on the rehabilitation of older people

Agitation is a major problem for older people and is present in over half of the hospitalizations for people > 65 years of age. In a previous study by the authors, results indicated that nursing actions often did not meet best-practice standards in the care of older, agitated patients. This paper builds on these results by reviewing the literature pertaining to the use of restraints and contributes to the body of knowledge surrounding the impact of the acute-care experience on rehabilitation outcomes. Successful rehabilitation relies on the improvement of functional health outcomes and, for this to happen, physical and emotional well-being are important. The sequelae of restraint use in acute care have the potential to alter peoples' ability to participate fully in a rehabilitation programme, thereby placing their future placement at risk. This paper explores the outcomes of restraint use in the acute-care setting and presents the argument that their effects are likely to be detrimental to rehabilitation outcomes.