Physical and Chemical Restraints in Nursing Homes

What Are Nursing Home Restraints?

Physical and chemical restraints in nursing homes are methods used to restrict a resident’s movement or behavior. These restraints may be physical devices like belts or bed rails, or medications given to sedate a resident.

Because they can cause serious physical and emotional harm, restraints are highly regulated and may only be used when medically necessary.

Using restraints for staff convenience or as a form of punishment is against federal law and may be considered nursing home abuse.

If your loved one was restrained in a nursing home without medical justification and suffered harm as a result, your family may be able to take legal action against the facility.

Did You Know

A jury awarded $42.5 million in a California nursing home lawsuit after a resident died from daily, unauthorized use of the sedative Ativan® as a chemical restraint.

Our trusted legal partners have recovered over $314 million in nursing home abuse cases nationwide, and they may be able to help your family as well.

Get a free consultation to see if we can connect you with a skilled nursing home restraint abuse attorney who can fight for justice on your behalf.

Why Do They Use Physical and Chemical Restraints in Nursing Homes?

Nursing homes may use restraints when a resident poses a risk of harming themselves or others. Federal rules make clear that restraints should only be used when medically necessary, after less restrictive alternatives have failed, and always under a doctor’s order.

Staff members are encouraged to rely on safer methods, including:

Activity programs
Closer supervision
Environmental changes

Still, in rare cases, a restraint may be used to prevent serious nursing home injuries or manage dangerous behavior.

Improper use sometimes occurs when facilities face problems like inadequate staffing, poor training, or a lack of oversight. When restraints are used for staff convenience rather than medical necessity, it can be considered neglect or abuse.

Types of Physical and Chemical Restraints in Nursing Homes

There are two main types of restraints used in long-term care facilities: physical restraints and chemical restraints. Both carry serious risks and are highly regulated under federal law. Learn more about physical and chemical restraints in nursing homes below.

Physical Restraints in Nursing Homes

These are devices that restrict a resident’s movement or limit their ability to access their own body. These restraints may be used when a resident is considered at risk of falling, wandering, or harming themselves.

Common physical restraints in nursing homes include:

Arm restraints
Bed rails
Hand mitts
Lap trays
Waist belts or vests

The use of physical restraints is discouraged whenever possible, since they can cause physical injuries, loss of mobility, and emotional harm.

Chemical Restraints In Nursing Homes

These are medications given to control a resident’s behavior or movement when it is not medically necessary to treat a health condition.

In some cases, staff may rely on chemical restraints to manage wandering or elopement risk in residents with dementia. However, using drugs in this way can put residents at greater danger by masking symptoms instead of providing proper supervision or safety measures.

Common chemical restraints in nursing homes include:

Antipsychotic drugs (control aggression or psychosis, like Haldol®)
Benzodiazepines (sedatives for anxiety or agitation, like Ativan)
Dissociative anesthetics (dull awareness or cause sedation, like ketamine)
Mood stabilizers (calm mood swings or aggression, like Depakote®)

Because these medications can cause serious side effects, staff are required to document medical necessity and use them only as a last resort.

Complications of Physical Restraints In Nursing Homes

Physical restraints can cause more harm than protection. Even when intended to prevent injury, they often create new dangers for residents.

Complications of physical restraints in nursing homes may include:

Decreased mobility, which can increase fall risk
Emotional distress, including shame or hopelessness
Increased risk of strangulation or suffocation
Long-term psychological harm and poor mental health
Physical injuries, like broken bones or difficulty breathing

Because these outcomes can blur the line between medical necessity and abuse, facilities are urged to avoid physical restraints whenever possible.

Side Effects of Chemical Restraints In Nursing Homes

Chemical restraints, usually in the form of sedating medications, also carry serious risks. Their use is closely monitored under federal law because of the potential for life-threatening side effects.

Side effects of chemical restraints in nursing homes may include:

Agitation or behavioral changes
Cognitive impairment and memory loss
Confusion and reduced awareness
Depression
Higher likelihood of falling
Incontinence
Increased risk of death

These dangers highlight why chemical restraints are meant to be a last resort and never for nursing home staff convenience.

Can Restraints in Nursing Homes Lead to Abuse or Neglect?

Yes, restraints can cross the line into nursing home neglect or abuse when they are used without medical necessity, as punishment, or for staff convenience. Abuse may also occur if a resident is left in restraints for longer than needed, putting their health and dignity at risk.

Watch for these common signs of restraint-related abuse or neglect in nursing homes:

Agitation or sudden aggression
Bedsores from prolonged immobility
Bruising or scarring
Changes in behavior without a medical cause
Marks on wrists or ankles
Social withdrawal
Unexplained injuries or other medical problems

These warning signs of abuse should never be ignored. If you suspect your loved one has been harmed by improper restraint use, report it immediately and seek legal guidance to protect their rights.

Worried About Nursing Home Abuse or Neglect?

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1. Spot Red Flags Before It’s Too Late
Look for bedsores, confusion, weight loss, fear, or silence.
2. Reach Out to Our Team, Day or Night
Speak with a trained advocate who listens and understands.
3. Our Legal Partners File Your Lawsuit
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Laws on Physical and Chemical Restraints in Nursing Homes

The use of physical and chemical restraints in nursing homes is strictly regulated under federal law. These protections exist to safeguard residents’ dignity, independence, and quality of life.

The Nursing Home Reform Act of 1987 established that restraints may never be used for staff convenience or as a form of discipline. Instead, they can only be applied when medically necessary to treat a resident’s specific symptoms, and only with proper documentation and oversight.

The Centers for Medicare & Medicaid Services (CMS) continues to enforce these standards. Updates, including guidance issued in 2008 and later, further clarified residents’ rights to be free from unnecessary restraints and psychotropic drugs.

Families and residents are encouraged to review these rights so they can recognize and report violations if improper restraint use occurs.

If your loved one was harmed, you may be able to seek justice. Get your free case review now.

Taking Action for Nursing Home Restraint Abuse

If you suspect your loved one has been harmed by improper restraint use, it is important to act quickly. Reporting abuse not only protects your family member but may also prevent other residents from suffering the same mistreatment.

Contact these resources after suspected nursing home restraint abuse:

Long-term care ombudsman: These advocates help residents resolve complaints and investigate issues within nursing homes and assisted living facilities.
Adult Protective Services (APS): Contact APS to report suspected abuse, neglect, or exploitation of vulnerable older adults.
Law enforcement: File a police report to ensure responsible parties are investigated and may face criminal charges.
Nursing home abuse lawyer: An attorney can explain your legal rights, help gather evidence, and pursue financial compensation through a lawsuit if harm occurred.

By reaching out to these resources, families can protect their loved one’s safety and hold negligent facilities accountable.

Get Legal Help for Nursing Home Abuse

If you or a loved one was unlawfully restrained in a nursing home and suffered harm, your family may be entitled to pursue legal action and compensation.

The Nursing Home Abuse Center is committed to protecting the rights of older adults and holding negligent facilities accountable.

Our trusted partners have recovered over $314 million for victims of nursing home abuse nationwide.

Call us at (855) 264-6310 right now or get a free case review to see if we can help your family pursue justice.

Physical and Chemical Restraints in Nursing Homes FAQs

Is it legal to use restraints in nursing homes?

Yes, the use of physical and chemical restraints in nursing homes is legal but strictly limited. Federal law requires facilities to show that restraints are medically necessary to treat specific symptoms.

Use of restraints can never be for staff convenience, to discipline nursing home residents, or as a substitute for proper care. If your loved one was harmed after being restrained in a nursing home, call us right now at (855) 264-6310 to see if we can help you seek justice.

Can you sue for restraint use in nursing homes?

Yes, families may have grounds for a lawsuit if physical and chemical restraints in nursing homes were used without medical justification and caused harm.

Improper restraint use may qualify as abuse or neglect. An experienced lawyer can help you understand your legal options.

Get a free case review right now to see if we can connect you.

What are the rules for using restraints in nursing homes?

Rules for physical and chemical restraints in nursing homes are set by the Nursing Home Reform Act and enforced by the Centers for Medicare & Medicaid Services (CMS).

Restraints must follow these requirements:

A physician must order them to address a medical need
The method chosen should be the least restrictive option available
Each use has to be documented in the resident’s care plan
Restraints cannot be used for punishment, discipline, or staff convenience

These safeguards are designed to protect residents’ rights and ensure restraints are only applied when absolutely necessary.

Are chemical restraints used on residents with dementia?

Yes, chemical restraints in nursing homes are sometimes given to residents with dementia to control aggression or agitation, but they carry serious risks.

Antipsychotics have an FDA black box warning for increased risk of death in elderly dementia patients. Because of this danger, federal law limits their use to documented medical necessity, never for staff convenience.

Are bed alarms considered restraints in nursing homes?

Bed and chair alarms may be considered restraints in nursing homes if they restrict a resident’s freedom of movement.

For example, an alarm that startles or discourages a resident from getting out of bed on their own may limit independence. Facilities must show a medical need and use safer alternatives whenever possible.