KIRAS Security Research

Initial situation, problems and motivation: Restrictions on freedom in care, i.e. physical and chemical restraints, and nursing facilities for people with disabilities or mental illnesses to prevent endangerment of self and others (third parties) are acts of state use of coercive power and constitute serious infringments of fundamental and human rights. Since 2005, the so-called “Heimaufenthaltsgesetz” (Nursing and Residential Homes Residence Act) regulates and restricts such infringements in institutional housing and nursing care facilities. The legal act aims for the lowest possible level of restraint use. For this purpose, an extrajudicial legal protection and control institution in form of the residents’ representative (“Bewohnervertretung”) was created. Existing data shows a high prevalence of the use of such restraints among residents in care facilities. At the same time, considerable differences between federal states, regions and facilities can be found. Legal provisions are confronted with differing regional and institutional structures and cultures, which account for the practical application of physical and chemical restraints and have an impact on the sustainable promotion of adequate and less invasive alternatives. Scientific studies that deal with the particular Austrian situation and that analyse the interrelationship of legal, institutional and organisational, professional, socio-economic and cultural factors, their effects on the use of physical and chemical restraints as well as their impacts on the living condition and security of the residents are insufficiently available.

Goals and innovative content: In consideration of these research gaps the planned study focuses particularly on the extrajudical factors, which are of crucial importance for the achievable effects of the “HeimAufG” and puts an emphasis on the work of the resident’s representative (“Bewohnervertretung”). Objectives are:

• to gain scientifically substantiated knowledge on how physical and chemical restraints are applied in the specific circumstances of the “HeimAufG” in different types of care institutions; how their use is monitored and how the use of restraints can be reduced by using adequate and less invasive alternatives.
• The results aim at contributing to the highest possible protection of persons concerned by unlawful restraints while at the same time preventing them from severe and substantial endangerments. Assistance will be provided to the concerned institutions to implement high ethical and professional standards; control bodies as laid down in the “HeimAufG”, particularly the residents’ representative (Bewohnervertretung) but also courts, will be enabled to further develop their audit work on evidence-based grounds.

Aimed results and findings

• Research report comprising comprehensive evidence-based findings concerning the application practice of physical and chemical restraints as well as alternatives in nursing homes
• Recommendations for action and implementation for concerned institutions, professionals, audit bodies, judges, host organisations as well as other relevant stakeholders
• Set of measures enabling a sustainable transfer of the findings into practice (workshops of cooperative knowledge creation, training activities etc.)