Physical restraint use on people with dementia: a review of the literature.

OBJECTIVE To provide a critical review of contemporary literature published between 1992 and 2003 on the use of physical restraints on residents with dementia in long-term care. DESIGN Forty-two manuscripts related to dementia (cognitive impairment) and physical restraint in long-term care settings were examined. RESULTS Four dominant themes were identified in the literature: relationship between restraint use and cognitive decline; falls/related injuries and associated mortality; reduction/removal/alternatives to use; and, nurses' attitudes to restraints. It appears that despite nurses' desire to use physical restraint for protection there is no scientific evidence that physical restraint actually protects residents against injuries. A discussion of the methodological issues arising in the literature and recommendations for further research and implications for nursing practice are outlined. CONCLUSION To curb the practice of restraint use the concentrated assistance of Australia federal and state governments and peak geriatric and dementia organisations may be required.