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24. Restraints

“Every resident has the right not to be restrained, except in the limited circumstances provided for under this Act and subject to the requirements provided for under this Act.”

In other words: You have the right to be free of restraints, except in the few situations where the law says that the home can use them.

A restraint is anything that limits how you move and stops you from doing something you might want to do. Some examples are:

  • medication or drugs,
  • wheelchairs with seatbelts or tray tables,
  • mittens that keep you from scratching yourself,
  • bed rails that keep you from falling out of bed, and
  • locked doors.

There are some types of restraints that homes can never use, for example:

  • roller bars on wheelchairs, commodes, and toilets,
  • restraints that can be released only with a separate device such as a key or magnet, and
  • sheets and other items they can wrap you in to stop you from moving.

Your home’s restraint policy

Your home must have a written policy that says how they will try to avoid using restraints whenever possible. It must say when they will use restraints and explain what the law allows them to do.

The home can use restraints only in a way that follows the law and where there is a serious risk to a resident or someone else. They must try other options first. And they must use the least restraint possible.

The owner must make sure that the policy is followed. They must also make sure that no resident is ever restrained:

  • to punish them,
  • because it makes things easier for the staff, or
  • using physical devices, drugs, barriers or locks, except when the law says these restraints can be used to keep a resident safe.

When restraints can and cannot be used

If you are mentally capable, no one can restrain you, put you in a locked unit, or stop you from leaving the home unless you agree.

And you can change your mind about the restraints. For example, if you agreed to live on a locked unit, staff must let you out if you ask them.

You may want a friend, family member, or advocate help you decide whether restraints can be used on you.

If you are not mentally capable, there are certain times when your substitute decision-maker may be able to decide if you will be restrained.

Restraints and safety

You may need a restraint for your own safety. This type of restraint is sometimes called a Personal Assistive Services Device (PASD). These are devices that help you with your daily activities.

Before a PASD can be used, it must be approved by a doctor, nurse, occupational therapist, or physical therapist.

Whether a device is a restraint or a PASD depends on why it is being used.

For example, if a seatbelt on your wheelchair is being used to stop you from getting out, it is a restraint. But if it is being used to keep you safe from falling, it may be a PASD.

Restraints should not hurt you or make you feel uncomfortable. They must be the least restrictive type possible.

If you are put in restraints, your health‑care providers must check on you frequently. And you must be assessed at regular times by a doctor, nurse practitioner, or a registered nurse.

Your doctor or nurse practitioner must tell you about any plans to use a restraint or PASD on you. And they must explain how it will be used.

You must be told what will happen if you agree to the restraint or PASD and what will happen if you do not agree.

Using restraints in an emergency

In an emergency, the home can sometimes use restraints for a short period of time without getting your consent.

This can happen if there is no other way to stop you or someone else from being seriously harmed. The law calls this the caregiver’s “common law duty”.

The restraints could be physical devices or drugs, or you or someone else could be put in a locked area.

But there are rules that the home must follow when they use restraints, even in an emergency.

Drugs can be used as a restraint only in an emergency if a doctor or registered nurse orders them. Drugs that are part of your regular treatment plan are not restraints.

Leaving the home

Safety measures are not restraints, unless they stop you from leaving when you want to. Safety measures include locks, push button devices, and barriers at stairways, entrances, and exits.

But a locked door might be a restraint if the staff will not give you the security code that opens it.

If you are being restrained or confined against your will, there may be legal steps you can take. See Getting legal help and information to find out where to get legal advice.

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