Restraint is often reached for to protect lines and tubes, but it can worsen agitation and immobility. Established delirium care starts with finding and treating the cause — pain, retention, constipation, hypoxia, infection, drugs — and with simple measures that reduce distress.
Where restraint is considered, it should be the least restrictive option, time-limited and reviewed frequently, with the reason documented.
- Look for pain, urinary retention, constipation, hypoxia and new drugs in any agitated older patient.
- Use glasses, hearing aids, clocks, familiar faces and daytime light to orientate.
- Secure lines discreetly and remove any that are no longer needed.
- If restraint is used, document why, set a review time and remove it as soon as possible.
Why it matters
Restraint is often a habit rather than a decision, and each use deserves a reason and a review time.
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