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Assistive technology as an alternative to physical restraints in psychogeriatric nursing homes.

Zwijsen, S., Boekhorst, S. te, Hertogh, C., Francke, A. Assistive technology as an alternative to physical restraints in psychogeriatric nursing homes. Journal of Clinical Nursing: 2010, 19(suppl. 1), p. 100. Abstract. 4th European Nursing Congress 'Older Persons. The Future of Care', 4-5 oktober 2010, Rotterdam.
Introduction: Assistive technology is proposed as an alternative to physical restraints in nursing home care for people with dementia. The number of nursing homes implementing assistive technology is steadily rising. However, research on usability is lacking. Objectives: This mixed methods study explored the usability of assistive technology as an alternative to traditional restraint use in nursing home care for people with dementia. Methods: Residents, proxies and professional caregivers of seven nursing homes were involved in the study. Three of these nursing homes had a policy to promote assistive technology use in their care for people with dementia and already used much assistive technology. The other four nursing homes did not have such a policy, but often used some form of assistive technology. Interviews and focus group discussions were held to examine respondents’ view on assistive technology. Nine of those interviews were held with key figures in the organisation, seven interviews were with proxies of nursing home residents. Eight focus group discussions with nursing home staff were conducted. Professional caregivers also completed a questionnaire assessing their own view on assistive technology, job satisfaction and moral distress. Results: The term restraint is ambiguous to caregivers; their view on the restraining qualities of a method or intervention differs from the legal definition. This discrepancy creates difficulties when implementing policy to reduce physical restraint use. Also, assistive technology seems to be used supplementary to existing measures rather than as an alternative. Technical shortcomings and organisational difficulties are other impeding factors when aiming at substituting physical restraints with assistive technology. Conclusion: Assistive technology wasn’t used as an alternative to restraints. A better supported and more usable description of restraints and a better considered policy on the use of assistive technology could lead to the use of assistive technology as an alternative to restraints instead of just supplementary to existing measures. (aut. ref.)