Aim of the work is promoting an appropriate use of physical restraint in nursing
homes. A bottom-up approach to the problem, with specific guidelines worked
out at regional level is considered proper. The various aspects should be faced by
the multidisciplinary equipe: each professional (physician, nurse, non qualified assistance
person, physiotherapist, etc.) should known the problem (types of restraint
means, indication and contra-indication, sequences) and be able to make a multidimensional
evaluation of the necessities of the elder, putting them inside working
groups. The physician should be in continuous contact with the others members of
the team to verify the possibility of alternative strategies (ie enviromental changes,
use of innovative nursing models): only in the absence of alternatives will prescribe
a restraint mean, having informed consent from the elder. Family members will
have no power to decide for the elder, unless in case of a specific judicial decision.
