Page 17 - Reduction of coercive measures

does not provide a definition of coercive measures, but lists a number of concrete care practices as coercive measures, such as physical and mechanical restraint and seclusion. Under the influence of societal and political debate, field parties and regulators have advocated a broader view of coercive care (Romijn & Frederiks, 2012). The Care and Coercion Act is based on the term ‘involuntary care’, which refers to all forms of care that is resisted by the resident or a representative. In addition to the criterion of resistance by the resident or representative, the act formulates nine categories of involuntary care as a guideline for registration. However, it is unclear to what extent this gives direction to a uniform registration. Even when people agree on which practices constitute involuntary care, the judgment in individual cases is likely to depend on multiple characteristics in the context in which care is provided rather than a simple absence or presence (Matson & Boisjoli, 2009). Research results show that experts subscribe to the importance of standardized reporting of coercive measures. However, the definition and the nine categories as set by the legislator are insufficient to ensure uniform, consistent, and reliable registration of involuntary care, and therefore of coercive measures. An expert meeting was held which concluded that many considerations to determine coercive measures remain unclear, which is in line with ongoing international debate (Cairns et al 2011; Carpenter, Langan, Patsios, & Jepson, 2014). Although opinions of experts varied, they unanimously stated that residents’ resistance to care must in any case be recorded. They also concluded that the administration of fluids, food, or medication and application of physical restraint, separation or seclusion should always be recorded, regardless of resistance by the client. These findings demonstrate the need for more concrete and clear definitions of involuntary care in legislation, to protect the legal position of residents.
Associations between resident and support staff related factors and the use of coercive measures.
Chapter four addressed the lack of comprehensive and integrated insight in the use of coercive measures and associated factors in long term care organizations (Fitton & Jones, 2018). Past research has
Summary and general discussion
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