Page 15 - Reduction of coercive measures

their client, care staff, and the facility as well as allow the resident to achieve quality of life (Frederiks, 2011). In addition, in 2013, a woman died during physical restraint performed by four care staff (Frederiks & Moonen, 2013). In these specific cases, professionals perhaps concluded that restrictions and infringement on self-determination were needed in order to provide care. Support for these professionals, and indirectly for their clients, should therefore assume complex, interwoven factors that probably require a combination of disciplines to disentangle (Frederiks & Moonen, 2013).
What do we know about the use of coercive measures
Coercive measures are part of daily care for people with intellectual disabilities. Various national and international scientific studies and reports confirmed that coercive measures occur in almost all locations in the care of people with intellectual disabilities. Figures resulting from studies that have established the occurrence of coercive measures within a period of up to more than one year ranged from 11% to 78% (Fitton & Jones, 2018), indicating almost completely uncertainty about the real rate. Nevertheless, even when the lower bound of prevalence figures is accepted as reflecting reality, both residents and staff are on a regular basis confronted with the application of coercive measures. It is important to note that published prevalence rates are based on a subset of coercive measures, applied for short periods of time to prevent residents and staff from acute danger, such as physical or mechanical restraint or locked seclusion (Matson & Boisjoli, 2009). Little is currently known about coercive measures that are applied over a longer period of time and about measures that are not directly visible, such as social restrictions (Dörenberg et al., 2018). Prevalence rates based on the broad definition of coercive measures are likely higher than currently known figures. Uncertainty of information on the use of coercive measures affects not only scientific developments but also the activities of the organizations themselves. On the basis of a reliable estimate of the use of coercive measures, strategies can be developed to reduce the use of these measures. Therefore, in order to obtain accurate information on the use of coercive measures, more knowledge is needed on the reliable registration of these coercive measures in daily practice.
General introduction
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