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Study Finds Low Activity
Levels Among Nursing Home Residents Regardless of Restraint
Provided by The Gerontological Society of America
The use of physical restraints in U.S. nursing homes
has dropped dramatically since the 1990 implementation
of federal regulations severely limiting the use of
such devices. However, a new study reports there is
little evidence that this freedom has led to increases
in residents' activity levels or in rehabilitation programs
that improve the problems that can result from restraint
use.
The researchers involved in this study conducted their
work on behalf of the Borun Center for Gerontological
Research, a joint venture between the UCLA School of
Medicine and the Jewish Home for the Aging of Greater
Los Angeles. The results were published in the April
issue of The Gerontologist (Vol. 44, No. 2).
Today an estimated 12 percent of nursing home residents
are physically restrained, down from 40 percent in 1990.
Although the danger of being injured by a restraining
device has diminished, the clinical significance of
restraint reduction is still questionable, the researchers
say.
"Federal regulations to achieve restraint reduction
were conceived largely as a means toward an end - the
end being increased movement and physical activity among
residents. Although we've made significant progress
on the means, it doesn't seem to have gotten us much
closer to the end. Perhaps we would reach that goal
faster if we directly measured residents' physical activity
levels," stated lead author John F. Schnelle, PhD,
director of the Borun Center.
Nursing homes with a high rate of physical restraint
use employ more restrictive care processes than facilities
that use restraints less often. But this study - the
first to independently evaluate the validity of a nursing
home "prevalence of restraint" quality measure
- also suggests that most long-stay residents spend
a potentially unhealthful amount of time in bed.
"Based on our observations, we estimate that the
typical resident in a high-restraint home spends between
19 and 20 hours in bed each day. That estimate drops
in low-restraint homes, but by only an hour a day,"
said Schnelle. "The conclusion we draw is that
all residents seem to be spending too much time in bed
and not enough time engaged in activities that enhance
mobility, gait, and balance."
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The Gerontologist is a refereed publication of
The Gerontological Society
of America, the national organization of professionals
in the field of aging.
The article abstract is available online at http://gerontologist.gerontologyjournals.org/cgi/content/abstract/44/2/245.
Posted on April 19,
2004
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