Abstract

This article reviews literature evaluating the perceptions of nursing staff on the use of physical restraints (PR) in care of persons with dementia. We extrapolate on persisting struggles in decision-making, and put forth a model to improve this process, in order to effectively reduce PR use. We analyzed studies published between the years 2000–2017 that focused on staff perceptions on the use of physical restraints in institutionalized dementia care. Journal articles were found using the University of Waterloo, University of Western Ontario, and Wilfred Laurier University library databases by conducting online searches incorporating the key terms “physical restraints,” “dementia,” “nurses,” “perceptions,” “feelings,” and “experiences.” This review includes studies that reported on nurses’ struggles in decision-making regarding the use of PR among persons with dementia residing in long-term care (LTC) homes or acute-care hospital settings. Nurses are often conflicted about using PR among persons with dementia, yet feel that they have no other options due to a number of perceived barriers embedded in institutionalized care. Nurses are seeking more direction in the decision-making process regarding the use of restraints among this population, in order to feel that they are providing the best quality of care to these individuals. A sequential approach, or algorithm, to identifying and managing the risks associated with clinical indicators for restraints should be added to the cognitive-rational model of decision-making in the use of PR among this population.