Containers in the elderly: the problem of subjugation

Containers in the elderlyMore specifically, mechanical stresses such as chemical and pharmacological imply limitation, retention or impediment in people.

The term retained evokes a more favorable meaning than “subjection”. This is why we will then define what mechanical constraints are, how they act and the differences between restraint, restraint and restraint.

We also explained what it entails the new manifesto of the national platform without subjection, The signatory entities are the Spanish Committee of Representatives of People with Disabilities (CERMI) and the Fundación Cures Dignes headed by Dr Ana Urrutia, among others.

    What are the restrictions?

    The constraints are chemical or pharmacological, physical and mechanical retention. There are generally two criteria to classify them according to the theoretical review of the physiotherapist expert in geriatrics Sandra Marquez: “the acceptance of the person to whom it applies” or “the temporary character with which it applies”.

    CCMM Mechanical Containers

    Mechanical containment is any material or mechanical instrument used by preventing a person from moving in order to avoid damaging movements to a person in the environment or at risk of falling.

    However, from the international model of comprehensive and person-centered care (AICP) and from the point of view of interventional social gerontology, this belief is erroneous because mechanical stresses cause damage that is difficult to reverse; use as a restraint to prevent falls is considered bad practice, as the same restraints can also cause ulcers or high-risk falls, in addition to invading self-esteem and conception. self of the person.

    Chemical or pharmacological constraints

    Chemical or pharmacological containment is the use of drugs that primarily have an impact on the central nervous system decreasing the need to walk, to attack verbally.

    These restrictions they generate the inhibition of behaviors considered to be “disruptive” in a residential or domestic environment, So that from the AICP the actions of bad practice are taken into account since they are restrictive, they do not facilitate the functionality and the autonomy of the person and they have serious and complex undesirable effects. As argued by Burgueño (2005) cited by Márquez (2017), it is “the use of drugs (psychotropic or not) to treat a problem for which there is no better treatment”.

    physical constraints

    Physical restraint refers to a space in which contextual materials are used. They are often used in residences and also in homes to reduce the space in which the person can walk.

    It refers to furniture, chairs, tables or any other material in the context in which resides the person who can restrict movement in space.

    Difference between confinement and subjection

    According to Rodríguez (2011) cited by Márquez (2017) and on the basis of his examination within the working group of the Social Services Ethics Committee of the Generalitat de Catalunya, containment is “anything that limits, restrains or prevents a person who transgresses a mental or emotional boundary. On the other hand, according to the author, the term subjugation directly implies restriction equivalent to physical binding.

    Manifesto of the national platform without subjection

    The Manifesto of the National Platform without subjection is exhibited by the Fundación Cures Dignes, Led by the famous geriatrician Ana Urrutia.

    This manifesto has the signature of important entities such as HelpAge International, the Pilars Foundation, Dignitas Vitae, the General Council of Official Medical Associations, the UPD and the LARES Foundation. Its goal is eradicate the practice of physical and chemical restraint among the elderly, people with disabilities and / or mental health problems being its mission to educate society, professionals who dedicate themselves to care and organizations.

    Strategies to eradicate constraints

    In accordance with BBPP’s Good Practices that all Gerontological Resources must exercise in matters of sexuality in the elderly and / or in a situation of dependence or vulnerability, the National Platform without subjection seeks to guarantee comprehensive and person-centered care. fighting for taking action based on geriatrics and gerontology which therefore avoid the use of physical and chemical fixings.

    The strategies are developed by professionals in gerontology and / or geriatrics (psychologists, directors, occupational therapists, etc.) always taking into account the person’s life cycle, as well as his motivations and relatively preserved skills.

    Care plans, what are they?

    The Manifesto of the National Platform Without Subjugation states that “ all entities and organizations that deal with elderly people in a situation of dependency or similar, in the different levels and sectors of care of care (including accommodation centers as well as than home care resources) should be required to offer caregivers the option of opting for “care plans” free from physical and pharmacological conditions.

    Care plans are personalized care plans commonly called in gerontology PIAI (Complete individualized care plan). It should also be taken into account that in the field of Home Care Service, these plans are considered to be in development and likely to be improved.

      Containment and abuse in the elderly

      Any professional, family or personal behavior that violates the rights of the elderly is considered inappropriate, therefore an abuse. We include in this abuse not only the violation of privacy or the psychological violation but also the violation of freedom.

      Containment of the elderly is considered abuse, along with other types such as situations of psychological or physical neglect, physical or verbal assault, abandonment, etc.

      Bibliographical references:

      • Official College of Nurses of Barcelona. Ethics commission. (2006). “Considerations relating to physical and / or mechanical constraints: ethical and legal aspects”.
      • “How to Remove Subjects. A Guide to Removing Physical and Chemical Subjects in Health Care Settings and Homes.” D. President of Fall Prevent, LLC (2005) and Antonio Burgueño, coordinator of the disconnection program for elderly patients and Alzheimer’s at CEOMA.

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