Can wrist restraints be used legally in SC for a dementia patient who is aggressive?

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My 91 yr old husband with vascular dementia and incontinence has become aggressive (attempts to grab, threats of breaking and biting) when we try to change and clean him. Meds either don't work or totally knock him out (we are working on finding the right ones). In the meantime, for safety, we would like to use restraints for safety.

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Federal laws and regulations talk about restraints on people who are residents of care facilities. Under Federal law, patients have the right to be free from:
"any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.
Restraints may only be imposed—
(I) to ensure the physical safety of the resident or other residents, and
(II) only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used.”
42 U.S.C. § 1395i-3(c)(1)(A)(ii) and 42 U.S.C. § 1396r(c)(1)(A)(ii).

These broad guidelines may be helpful as you search for solutions to the combative behavior. Talk with a social worker at your local ASAP (Aging Services Access Point) and an elder law attorney, to learn about laws and regulations in your state that may protect people in your home care situation.

Continue talking with the physicians to see if you can spot behavioral triggers that can be alleviated. Dr. Helen Kyomen, a geriatric psychiatrist, has written online articles on Agitation in Older Adults, suggesting the questions you can ask when an elder show signs of agitation. Paul Raia, Ph.D. of the Alzheimer’s Association has explained how a behavior plan can be developed to identify triggers for agitation and anxiety in dementia patients.
I don't have the answer for you but we are in a similar situation with my dad and I just want to wish you the very best. God bless you as I know you are in a very difficult and stressful situation.
What book is being plugged here? I saw online articles mentioned, but no book.
I was having the same "fighting" problem with a client in late stage AL in a facility. I asked for another set of hands, & she shared a wonderful tip. The person holding the hands should pull back on the middle finger (away from Palm) & hold onto it until finished. Doing this, they can throw their arms around, but are unable to establish a grip. IT DOES NOT HURT THEM. If the 2nd person is quick, by the time the patient realizes what's happening, it's done...just be quick to grab the finger. Good luck, & God bless you through this journey
I agree with JohnnyJ. ONly medications will reduce the aggression.
Why isn't plugging his book not right if it can provide information to help people?
Right. I just saw the person providing references to online articles professional medical specialists wrote, not their own book.
I saw the plug that is mention - some how it has magically been edited from the post.
An extract from our NHS (bear in mind that the National Health Service is a UK organisation NOT an SC one ) states this:

Leave and return
‘Leave and return’ is a strategy when someone is resisting care. There is a (sic) need to employ good judgment here. If a person (sic) absolutely needs medical intervention, or another essential intervention e.g. a soiled incontinence pad needs changing, physical intervention may be necessary. But in the majority of cases things can wait (washing or shaving, for example). Constant informal risk assessment is needed, along with adequate supervision, and opportunities to discuss and debrief dilemmas and people (sic) being trusted to use their judgment.

I have looked and SC doesn't appear to be overly VISIBLY helpful but I did find one article which we could all do with looking at


DEMENTIA DIALOGUES - Arnold School of Public Health

It will bring up a very useful presentation on combative dementia and may not sort the problem but you may get some tools that you could use to deflect the issue
I assume adult protective services are available in SC like here in MN. I would ask them for advice on this. They have resources to refer you to for help, too. When my friend Beth first became incontinent, I had a local home health agency provide some care and they were able to work effectively until she became resistant to all care. Someone trained in doing this work could help you, too. Of course, you have to pay them, but they have skills and experience that make them worth it. It's hard to imagine wrist restraints working for long once he starts fighting their use.

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