Restrictive practices are often frowned upon in healthcare. But there come situations where these practices are needed and in fact encouraged, and thus used. In the field of aged care, such practices can sometimes be the only thing preserving a senior patient’s safety and wellbeing.
Restrictive practices: A Definition
A restrictive practice is any practice or intervention that has the effect of restricting the rights or freedom of movement of an aged care consumer. This could range from not being allowed certain services or activities, to restricting usage of medicines.
The Aged Care Act 1997 and the Quality of Care Principles 2014 have been updated to clarify and strengthen approved provider requirements in relation to the use of these practices in aged care. These changes protect senior Australians receiving aged care and services and ensure that providers understand and meet their obligations in this regard.
The revised legislation, taking effect from 1 July 2021:
- replaces the term ‘restraints’ with ‘restrictive practices’;
- defines restrictive practices;
- details the requirements for the use of restrictive practices, including strengthening those in relation to consent, documentation, and monitoring;
- emphasises person-centred care and reinforces the rights of aged care consumers by ensuring that these are only used as a last resort to prevent harm after best practice behaviour supports have been considered, applied and documented;
- require the provider to have a behaviour support plan in place for each consumer who has restrictive practices considered, implemented or used as part of their care;
- introduces restrictive practices compliance notices and the potential for civil penalties if providers do not meet the requirements.
Types of Restrictive Practices
- Chemical Restraint – Chemical restraint is a practice or intervention that is, or that involves, the use of medication or a chemical substance for the primary purpose of influencing a consumer’s behaviour.
- Environmental Restraint – Environmental restraint is a practice or intervention that restricts, or that involves restricting, a consumer’s free access to all parts of the consumer’s environment. This could include restriction from certain activities and spaces.
- Mechanical Restraint – Mechanical restraint is a practice or intervention that is, or that involves, the use of a device to prevent, restrict or subdue a consumer’s movement. Examples of this is are low beds and bed rails.
- Physical Restraint – Physical restraint is a practice or intervention that is or involves the use of physical force to prevent, restrict or subdue movement of a consumer’s body, or part of a consumer’s body. This does not include the use of a hands on technique in a reflexive way to guide or redirect the consumer away from potential harm or injury.
- Seclusion – Seclusion is a practice or intervention that is, or that involves, the solitary confinement of a consumer in a room or a physical space at any hour of the day or night. This practice is the equivalent of a “time out”.
These practices may sound harmful at face value, but they are always only used as last resorts, and only after all other efforts have been exercised beforehand. Restrictive practices are needed to keep the safety of senior consumers at the forefront of service.
As part of a community, how do you feel about the usage of restrictive practices? Are they more harmful, or do you agree that they are in place?
Nina Alvarez is a Content Producer for Healthcare Channel. Her interests include writing, particularly about the healthcare sector and the many ways it can improve to further benefit people from all walks of life.