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Restraints in LTC homes

It's been a while since my last post, and it hasn't been because I haven't got anything to say, but I've been a bit busy lately. I've heard from some of the readers that they have some issues that I haven't dealt with yet but would like to know if I have any ideas for their issues and if I know anything about how to deal with them. I definitely don't know all of the answers, but I am doing my best to stay on top of the issues and stay up to speed with the Ministry and the goings on in health care, particularly as they relate to elder law. The blog is still fresh, and we really do hope to get to a lot of the issues, but in the meantime, let us know what you'd like to hear about, and if we can we'll write about it.

The Issue:

What I want to talk about now has been something I've thought of recently, and was glad to read this month in the Toronto Star, that there is movement towards a solution. It is nevertheless quite frightening. The article highlights an investigation by the Star's David Buser, Jesse McLean and Andrew Bailey. The trio investigated the wide spread use of off-label prescribing of anti-psychotic medications to residents in Long Term Care Homes. The article is available to read here.


Chemical Restraints:

In the LTC industry, there are rules and regulations when it comes to restraining an individual resident. The restraint can include anything from a table top chair to a combination lock on a unit. It can also include drugs.

What is tragic, but not necessarily surprising - is the prevalence of this practice across Ontario's 300 or so LTC residences. It is important that a patient and their substitute decision makers (SDMs) receive all of the facts about a chemical restraint, not just why it is needed, but also what can happen to an individual who takes them.


As was noted by the Star, the LTC system is under considerable strain. The problem is only going to grow given the aging demographic in the province. Chemical Restraints should not be used as an alternative to appropriate staffing solutions, but the LTC system is drastically understaffed. There are too few qualified staff members per resident, and because of the incredible amount of tasks that are required by the Ministry to be performed, catalogued and noted in a shift, many staff become overwhelmed. Turnover is high, and frontline staff are often put in risky situations. Fear of reprisal is high and the time constraints on them mean that they need solutions. One such solution is chemical restraint.

Table Top

Another is the table top, which was not highlighted in the article but deserves equal attention. Next time you are at a LTC home, especially if you happen to pass through to a Dementia unit, be sure to take a head count of the number of residents who are in chairs with tables. It's not because they love playing solitaire. The brakes aren't on their chairs for their safety.

They are restrained.

ACE's Jane Meadus and Brendan Gray have authored an excellent commentary on the issue dealing primarily with informed consent and what it is, the paper is available here.

If you believe that a LTC home or other institution is infringing upon your rights or the rights of a loved one, and you would like to talk about it with a lawyer, please do so. We are happy to listen and assist if we are able.

Remember, everyone's situation is unique. The blogs posted on this site are informational. They are not intended to be taken as legal advice for your situation. It is always a good idea to seek professional legal advice before making any decisions related to your particular case.

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