Relationship between physical restraint in nursing homes and their institutional characteristics

OBJECTS: To clarify relationship between physical restrain in nursing home and its institutional characteristics. METHODS: The subjects consisted of all 103 nursing homes in Okayama prefecture which were open in 2002 with a total of 6,829 residents. Data were obtained by questionnaire through the "Welfare ombudsman Okayama" in 2002 and audited by local government in the same year. We then performed multiple regression analysis. The parameter in question was the ratio of residents who were physically restrained to the residents at high risk of needing physically restraint (physically restrained ratio). Independent valuables were institutional characteristics. To increase the accuracy of estimation, we hypothesized that the residents likely to be the physically restrained were elderly with serious dementia who were defined as IV and over in the dementia elderly daily living independence rank. We also performed analysis with the definition of heavy dementia elderly graded as III and over. RESULTS: We obtained data of 72 institutes housing 1,700 elderly with serious dementia, which did not have any missing values. Of these 74% had at least one resident being physically restrained. The average physically restrained ratio was 24.2%. The institutional characteristics which correlated with use of physical restraint were intensive staffing, holding periodical care conference, and having unit care. The results were robust with regard to change in the serious dementia definition. CONCLUSION: The institutional characteristics which correlate with use of physical restraint are intensive staffing, holding periodical care conference, and having unit care.