Page 77 - Reduction of coercive measures

The present study explored a set of resident and staff factors that have been suggested to explain the use of coercive measures and subsets of coercive measures in a large, diverse residential care organization. Coercive measures are broadly defined as every measure that is restrictive in a specific situation and includes a wide range of measures (Frederiks et al., 2017). Because factors may be specific to different care practices, two subsets of coercive measures were tested. The first subset referred to measures applied during acute, directly dangerous incidents. Examples of measures included in the first subset are locked seclusion and physical and mechanical restraint. The second subset referred to measures applied to prevent a resident from indirect danger or serious disadvantage. Most of these measures concerned limitations of participation in daily life activities.
Broadly speaking, studies of the use of coercive measures usually examined resident characteristics and sometimes characteristics of the care that is provided (Fitton & Jones, 2018). Concerning factors related to residents, their challenging behavior (CB) has been found associated with the use of coercive measures (Allen, Lowe, Brophy, & Moore, 2009; Didden, Duker, & Korzilius, 1997; Heyvaert, Saenen, Maes, & Onghena, 2014; Matson & Boisjoli 2009; Sturmey, 2009). Challenging behavior refers to “behavior of such an intensity, frequency or duration that the physical safety of the person is likely to be placed in serious jeopardy, or behavior which is likely to seriously limit or deny access to and use of ordinary facilities” (Emerson, 2001, p 3.). Using coercive measures as a response to CB may occur within the bounds of law and regulations, which state that coercive measures may be used as a last resort to prevent people with ID from harm. Physical and mechanical restraints and environmental restraints, for example locked doors, are often used to guarantee safety (Heyvaert et al., 2014). However, not all studies have found an association between CB and coercive measures (Lundström et al., 2011). This variation in outcome may be due to variations in definition and measurement of CB, coercive measures, as well as having alternative methods available to reduce the risk of harm (McGill, Murphy, & Kelly-Pike, 2009; Scheirs et al., 2012), but these explanations await empirical testing.
Associate factors of coercive measures
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