Nursing homes must highlight pros and cons of restraints

When I placed my frail elderly mother, who has dementia, in a nursing home recently, the person-in-charge wanted me to sign a consent form for the use of various forms of restraints.

The rationale given was that it was for her safety and would prevent the risk of falls.

I refused to sign the form, and was advised that the nursing home may not accept my mother if I did not.

I was fortunate enough to have read Associate Professor Philip Yap Lin Kiat's article (Let's stop tying down old people; July 19), and so negotiated with the nursing home for an "observe and see" approach to managing my mother's condition.

The objective of restraints is to protect the patient from harm.

However, research suggests that the negative outcomes outweigh the benefits of using them.

The Journal of Medical Ethics has reported that patients who are restrained can suffer respiratory complications, urinary incontinence and constipation.

They have increased dependence in activities of daily living, impaired muscle strength, decreased cardiovascular endurance and feelings of depression and apathy.

In many cases, the discomfort and anxiety of a restrained older person is only increased, resulting in a heightened risk of bruises, injury and even death.

As a son, I would not wish to subject my mother to such an experience.

I suggest that nursing homes highlight not only the benefits of restraints but also the possible negative outcomes, so patients and their next-of-kin are aware and can give proper informed consent.

They should also provide alternative care plans, like that provided by Khoo Teck Puat Hospital's Care for the Acute Mentally Infirm Elder unit (Dementia patients do better without restraints; Aug 13).

I support the use of technology, such as pressure sensors around beds, to monitor patients.

More non-nursing staff can also be trained to help alleviate the manpower problem at nursing homes.

I hope the Ministry of Health can provide subsidies or grants to nursing homes for these purposes.

Singapore is a Smart Nation, and we should adopt the use of technology for smarter healthcare.

Francis Chan Kum Chew

A version of this article appeared in the print edition of The Straits Times on August 17, 2017, with the headline 'Nursing homes must highlight pros and cons of restraints'. Print Edition | Subscribe