Special feature: Implications of physical restraint and restraint reduction of older persons

Physical restraint of older persons remains a common practice in many US health care facilities. Roughly 30% of older acute and rehabilitation inpatients and long-term residents will be physically restrained at some point. This article describes the use and misuse of physical restraints, physical and psychologic implications, and alternative strategies. Restraints are generally shown to adversely affect treatment, decrease functional outcomes, and increase health care costs. Indiscriminate use of physical restraint is incompatible with professional health care. It is recommended that all health care facilities adopt restraint-free or restraint reduction programs and that physical restraint management include the entire caregiving team.