The use of restraints in aged care facilities is a controversial and difficult topic.

Aged care facilities are permitted to restrain residents and sometimes this is in the best interests and for the safety of the resident, other residents and staff. The effectiveness of new laws to minimise the inappropriate use of restraints are currently being reviewed.

There have been a number of shocking cases in the media and told through the Royal Commission into Aged Care Quality and Safety on abuse of aged care residents including through inappropriate restraints. Our elder law and aged care law team has handled cases for aged care residents and their families to take action against aged care facilities or staff members for inappropriate care, including inappropriate restraint.

How do aged care facilities restrain residents? 

Restraint is a very serious issue. It is defined as a practice, device, or action that interferes with someone’s ability to make a decision or which restricts their free movement.

Residents in aged care facilities are restrained using physical or chemical methods.

Physical methods include using bed rails, lap belts, restraining chairs, table overlays, hand mitts and vests. Physical restraint also includes locking a person in a room or building.

Chemical methods include using medication to change a person’s behaviour. Medications are prescribed if they have a therapeutic benefit. The 2019 Human Rights Watch report, “Fading Away” How Aged Care Facilities in Australia Chemically Restrain Older People with Dementia, affirms the point that “Medications should only be given when they have a therapeutic value. Medication for the purposes of controlling behaviour without a therapeutic purpose is chemical restraint.”

New laws regarding restraint in aged care facilities – Restraints Principles

On 1 July 2019, the Australian Government introduced new laws to minimise the inappropriate use of restraint in residential aged care facilities. Known as the Restraints Principles, these laws, for the first time, put obligations on residential aged care providers regarding the use of restraint. The Restraints Principles are contained in Part 4A of the Quality of Care Principles 2014.

Approved providers must ensure that restraint is only used in response to proper clinical assessment and (for chemical restraint) prescribing by health professionals.  Section 15F of the Principles covers use of physical restraint, and section 15G covers chemical restraint.

States and Territories have differing legislation relating to who can legally give substitute consent for restraint and in which specific situations.

Review of the Restraints Principles

The 2019 legislation requires the Department of Health to review of the new laws.

The review is underway. It will evaluate if, since the introduction the Restraints Principles, there has been a:

• reduction in the inappropriate use of chemical and physical restraint in residential aged care
• change in the levels of awareness, attitudes, skills and behaviours in relation to restraint across the aged care sector since the Restraints Principles were introduced.

The reviewer will research literature and policy documentation, physical and chemical restraint data, and seek input from key stakeholders, aged care residents and their families about their experience of the use of restraint since July 1 2019.

The findings will be submitted to the Department of Health in December 2020. The report will be tabled in Parliament and will be published on the Department’s website.

If you or someone you support experienced restraint at a residential aged care facility since July 1, 2019 you are invited to share your experiences in a confidential telephone interview. To be involved:

• Click here for more information about the interview
• Call AHA on 1300 119 564 (9 am to 5 pm AEST) between Friday 31 July and Monday 31 August 2020 to complete the interview over the phone
• Email restraintreview@ahaconsulting.com.au or call 1300 119 564 (9 am to 5 pm AEST) for more information or to request an interpreter.

If you work for a provider of residential aged care (management or direct-care staff), you are invited to share your views on the Restraint Principles. For further information on the Review and the consultation, click here.

If you would like to contribute to this review, complete this anonymous survey by Friday 14 August 2020.

For further information about the review contact AHA on 1300 788 667 (9 am to 5 pm AEST) or email restraintreview@ahaconsulting.com.au.

What should I do if I think a someone is being inappropriately restrained in an aged care facility?

You should raise the issue with the management of the aged care facility.

If you are dissatisfied with their response, you can also contact the Aged Care Quality and Safety Commission which regulates aged care facilities.

Our caring and expert team of aged care lawyers can assist you in making a complaint and/or help you to take legal action against an aged care facility, medical practitioner or provider of aged care services. The law can be a powerful tool in changing practices and to help ensure your loved or other people do not experience inappropriate care.

Please do not hesitate to call us on (02) 4929 3995 for a confidential discussion so that we can listen to your needs. You may also get in touch via our contact page.