Clinical review outlines a decision framework and alternatives for chemical and physical restraints in older inpatients, highlighting strategies to operationalize the least restraint principle.
Restraint use remains common (and often overused) in older adults. In the Canadian healthcare system, 1 in 4 medical inpatients are physically or chemically restrained. Given the limited benefit and serious harms associated with restraint use, the decision to restrain a patient or not demands strong ethical and clinical justification. This review operationalizes the least restraint principle, synthesizes restraint practice recommendations, and provides a framework to support clinicians in determining the appropriate use of restraints and finding potential alternatives to their use.
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Riar et al. (2026) studied this question.
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