Page 63 - Reduction of coercive measures

and errors. Furthermore, it is noticed that it is important to maintain a clear definition and that care takers know the benefits of the procedure before they initiate applications (Blamires et al., 2016; Bartlett, 2014).
Research has shown that applying a single definition of involuntary care, as provided for in the legislation, is not sufficient to ensure reliable reporting of involuntary care. Schippers et al. (2018; Chapter 2 of this dissertation) demonstrate that it is nevertheless possible for a great deal of involuntary care to be reliably reported. As possible explanations for the current discrepancy they suggest that there is currently too little understanding or appreciation of the right to self-determination in day-to-day practice, and that actions can often unconsciously be performed as a matter of routine, with the result that providers fail to report a significant amount of care that is provided involuntarily. It was also found that synonyms used in day-to-day practice, including “rest moments” or “room time”, could trivialise the invasiveness of measures, while what was actually happening was in fact seclusion. By using language in this way, care providers may be unaware that the care they are providing is involuntary. Furthermore, around half of the measures that care providers recognise as constituting involuntary care are actually internally reported. That means that others are not being reported, albeit that some measures in this second category may be recorded in the care plan as agreements with clients. Research by Dörenberg et al. (2018) found that care providers agreed almost unanimously that physical restrictions (restraint and seclusion) should be seen as the most drastic forms of involuntary care. Providers would seem to be aware that these measures should be avoided wherever possible, and that if they are applied, this should be in accordance with agreed procedures. In the case of other measures, however, the question of whether care should be regarded as involuntary is subject to more discussion. According to Matson and Boisjoli (2009), involuntary care is not a binary construct, and environmental factors always play a role in assessing it. The way in which environmental factors affect the interpretation remains unclear (Schippers et al., 2018; Chapter 2 of this dissertation). What is clear, however, is that these factors have direct consequences for the way in which information is internally
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