What Are Restraints and Why Are They Used in Nursing Homes?

Restraints in nursing homes are measures used to limit a resident’s physical movement. They are typically used for the well-being of at-risk patients, such as those with Alzheimer’s or dementia. Patients who are at risk of harming themselves or others may also be restrained, such as if they are at risk of falling, pulling out medical devices, or displaying violent outbursts.

Pennsylvania Restraint Laws

The use of restraints in nursing homes is controversial, but regulations have been enacted at the state and federal levels.

Federal law prohibits the unnecessary use of physical or chemical restraints outside of emergencies. Facility staff can only use physical restraints to protect the resident from hurting themselves or others, not as a form of punishment.

28 Pa. Code § 211.8 provides further regulation:

  • When ordered, restraints will be used to “safely and adequately respond to individual resident needs in accordance with the resident’s comprehensive assessment and comprehensive care plan”
  • Physical restraints must be removed for at least 10 minutes every two hours during normal waking hours
  • During normal waking hours, the patient will be moved at least every 2 hours

Types of Restraints

There are two main types of restraints that can be used in Pennsylvania nursing homes: physical and chemical.


Physical restraints restrict a patient’s movement to keep them from moving freely about. They include devices such as:

  • Bed rails
  • Lap belts
  • Hand mitts
  • Vests


Chemical restraints involve the use of medication to sedate or calm a patient with drugs such as:

  • Tranquilizers
  • Antipsychotics
  • Anxiolytics

Negative Effects of Restraint Use on Nursing Home Patients

Though heavily regulated, misuse of restraints in nursing homes still occurs and can have severe negative consequences on residents:

Physical Injuries

Improperly applying restraints and leaving them too tight or unmonitored can cause pressure on the skin and lead to reduced circulation and bedsores which can become infected if left untreated.

Fall-prevention restraints such as bedrails can also cause injury or death if a resident becomes trapped and can’t free themselves. Patients who are restrained for too long with limited movement can become weaker over time, leading to a greater future risk of injuries like falls and fractures.

Psychological Damage

Restraints can make patients feel helpless and frustrated, which can contribute to depression and anxiety. Prolonged restraint can create intense feelings of isolation and despair, leading to social withdrawal which could cause them to lash out in frustration.

Alternatives to Restraint Use

Several methods have been proposed for reducing the use of restraints in nursing homes and the associated risk of injury.

Environmental Modifications

Nursing homes can make changes to the facility to make it a safer space with fewer restrictions by:

  • Providing grab bars and other walking aids
  • Raising toilet seats
  • Lowering beds
  • Installing non-slip flooring, adequate lighting, and clear pathways

Behavioral Interventions

In addition to facility improvements, nursing home staff can be trained in communicating with challenging patients and de-escalating situations without the use of restraints by redirecting or distracting them.

Preventative Measures

Staff can also work proactively to reduce the use of restraints by ensuring residents are hydrated, getting regular exercise, and rewarded for positive behaviors and improvements.

Management should make sure their facilities are well-staffed to provide better patient monitoring and timely intervention, especially with at-risk patients.

Who Is Liable for Restraint Injuries?

If your loved one was hurt in a nursing home due to the misuse of restraints, several parties could be liable:

  • Staff members– A caregiver (for example, a nurse) might have applied restraints incorrectly, failed to monitor a restrained resident, or used restraints for inappropriate reasons.
  • The nursing home– The nursing home might have failed to properly assess the resident’s needs before using restraints or employed insufficient or unqualified staff.
  • Nursing home management– Managing personnel may have failed to implement proper training protocols or uphold safety standards.

Your nursing home abuse lawyer will determine all the parties who could be liable in your case and work to hold them accountable for the harm they caused.

Recovering Compensation for Injuries after Restraint Misuse

We’ll make sure all the losses you suffered due to restraint misuse are considered in your nursing home abuse claim. You could recover economic and non-economic damages such as:

  • Past and future medical bills
  • Permanent impairment
  • Long-term care expenses
  • Pain and suffering
  • Mental anguish

Wrongful Death

If your loved one passed away after being improperly restrained in their nursing home, you could have a claim under Pennsylvania’s wrongful death law. Surviving spouses or heirs could recover compensation for their family member’s funeral expenses, loss of companionship, and the loss of financial support they would have provided (for example, if the decedent was in rehab and planned to return to work).

Hurt by Restraint Use in a PA Nursing Home? Call Atlee Hall Today

Atlee Hall understands how traumatizing a physical restraint injury can be for a nursing home resident. If a facility misused restraints and hurt your loved one, contact us immediately. We have decades of experience fighting for injury victims and their families in Pennsylvania, and we can provide the aggressive advocacy you need to recover compensation for the harm you’ve suffered.

Contact us today or call (717) 393-9596 for a free initial consultation.