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Every Resident - Bill of Rights for people who live in Ontario long-term care homes

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13. Restraint

"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 allows restraints to be used.

A restraint is anything that limits your movement and prevents you from doing something you might want to do. Some examples of restraints are:

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

But there are some types of restraints that homes are never allowed to 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, wraps, or other items used to wrap you to prevent you from moving.

If you are mentally capable, no one can restrain you, put you in a locked unit, or prevent you from leaving if you do not agree. You may want a friend, family member, or advocate to help you decide whether you should allow restraints to be used on you.

You can change your mind about the restraints. For example, if you are mentally capable and agreed to live on a locked unit, you can change your mind and must be let out if you ask.

If you are not mentally capable, your substitute decision‑maker may be able to make a decision about restraining you in certain situations.

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.

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 is a PASD.

Restraints should not hurt you or make you uncomfortable. If you are put in restraints, your health-care providers must check on you frequently. And you must be assessed at regular intervals by:

  • a doctor,
  • a registered nurse, or
  • a nurse practitioner.

Your doctor must tell you about any plans to use a restraint on you and explain how it will be used. You must be told what will happen if you agree to the restraint and what will happen if you do not agree.

Using restraints in emergency situations

In an emergency, restraints can sometimes be used for a short period of time without getting 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 have to be followed when restraints are used, even in an emergency.

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

Leaving the home

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

For example, 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 in a long-term care home, there may be legal steps you can take. Get advice from a lawyer.