Commentary: Barriers to a Sustained Restraint-Free Environment

ABSTRACT

A restraint-free culture is becoming a standard practice in the provision of long-term care services for older people, a standard by which licensure and accreditation agencies evaluate providers. Although most health care providers initiate restraint-elimination processes, many fail to achieve the intended result or sustain the practice because of a variety of barriers. Faltering organizations find themselves faced with monumental changes in administrative and supervisory staff, substantial recruitment and retention crises, and inadequate attention to a culture of continuous learning, teamwork, and leadership skill building. This article informs policy makers about the barriers to achieving and sustaining a restraint-free environment and suggests public policy agendas and processes to improve conditions for the aging population.

KEYWORDS:

• Restraint-free
• physical restraints
• barriers
• regulation
• approach to care
• quality

Notes

Centers for Medicare and Medicaid Services. (1990). Federal regulations for long-term care facilities. 42 C.F.R. §483.13(a).