Coercive Measures on Elderly People while being Hospitalized - Abstract
Since the second half of XX century there is a growing concern about the unregulated practice of restraining elderly people admitted at hospital and not only in geriatric wards. Several articles reviewed coincide in pointing out that coercive measures are not harmless and, therefore it would be convenient to think it out before using them. Rates of morbidity and mortality increases in parallel with the prolonged restrain. “Mobility rather than immobility” sentenced one of the reviewed authors.
We have carried out a case control study on a sample of 279 case patients and 510 case-controls. The analysis shows several factors with significant association (p<0,001): age, sex, type of hospital wards and staff work shift in four big Spanish hospitals.
And we conclude that restraining should not be applied without previous information of the patients. Once patients have been informed, the applications should not be used without their consent. An alternative could be the consent given by his/her tutor or representative.
We recommend that every hospital should developed a protocol regulating who should prescribe any type of restraining; in what condition the measure should be applied; and a register of the measure: when and by who it was prescribed, for how long it was applied and what incidences occurred during the time of application, if any.
A thoughtful debate should be opened on the ethical and legal aspects of the coercive measures.