It has been revealed that a special nursing home in Hakodate City, Hokkaido, is suspected of routinely subjecting residents to inappropriate physical restraints, such as by surrounding their beds with fences, and the city is investigating whether this constitutes abuse. We are conducting an investigation, including conducting interviews. On the other hand, the chairman of the corporation that operates the facility said, ``It is true that there was physical restraint, and we regret it, but we have not done anything that would lead to accusations of abuse.''

The facility that has been accused of inappropriate physical restraint is ``Erakuen'', a special nursing home in Hakodate City.



According to NHK interviews with people involved, at this facility residents' beds were surrounded by fences and their lower bodies were wrapped tightly in sheets or towelettes to make them unable to move. about it.



In principle, physical restraint on elderly people in nursing care facilities is prohibited under the Nursing Care Insurance Act, etc., and is permitted only in urgent and unavoidable


cases


. It is also necessary to fully explain and seek understanding.



However, according to multiple sources at this facility, nursing care staff have been physically restraining residents, mainly those with dementia, for many years without gaining the understanding of the residents or their families.



Hakodate City also learned of this information last year and is conducting an investigation, including interviewing the facility to determine if it constitutes abuse.



On the other hand, Tatsuhiko Suga, chairman of the social welfare corporation Esan Keiaikai, which operates the facility, said, ``It is true that physical restraint was used and we deeply regret it, but it was done because the staff believed it was necessary for nursing care. We have not done anything that would cause any criticism to be made.We would like to cooperate with future city investigations in order to improve the facility."

Images inside the facility show residents whose movements are restricted.

Images from inside the facility obtained by NHK show residents who are forced to sit with their legs hanging out from the bed rails and whose movements are restricted.



Other images show her lying on a bed with her lower body wrapped tightly in sheets, unable to move, and her pants pulled down and left in a diaper.



According to the people who provided the images, all of the people in the photos are residents who suffer from dementia and have difficulty resisting or expressing their intentions, and that physical restraints were carried out without the consent of the individuals or their families. It means that it was.

Employee: “Physical restraint has been around for at least 10 years”

This time, a staff member working at the facility responded to an interview with NHK on the condition of anonymity and testified about the actual conditions of physical restraint.



According to this employee, physical restraint without the consent of the residents or their families has been going on for at least 10 years, and most of the nursing staff were involved.



Particularly at the time when the new coronavirus spread, visits were prohibited, so there was no need to worry about family members watching, and physical restraint became commonplace.



The staff member said, ``My colleagues were turning a blind eye to each other.With staff shortages, I had a selfish way of thinking, ``I want people to stay still while I work,'' and I was worried about how the residents would feel. I had no idea if he was there," he testified.



Regarding the physical restraints of mainly residents with dementia, he said, ``No problem was discovered because people don't tell people they have severe dementia.For the care staff, it makes their work easier if they physically restrain them.'' So I left it alone," he said, revealing the truth.

Number of elder abuse cases last year

According to the Ministry of Health, Labor and Welfare's investigation into abuse suffered by the elderly at the hands of nursing home staff, the number of consultations and reports last year was 2,795, an increase of 405 cases from the previous year and the highest ever.



Additionally, 856 of these cases were determined to have involved abuse, an increase of 117 from the previous year and a new record high.



Multiple answers were given for the reasons why abuse occurred.


``Problems related to education, knowledge, caregiving skills, etc.'' were the most common at 56.1%,


followed by


``Problems with staff stress and emotional control'' at 23%. ▽``


Organizations that promote abuse.'' 22.5% said ``corporate culture, poor relationships among staff, management system, etc.''


17.9% said ``lack of ethics or philosophy''


▽ 11.6% said ``busyness related to staffing shortages and staffing issues.''



Regarding the type of abuse, multiple answers were accepted


: 57.6% said physical abuse


, 33% said psychological abuse,


23.2% said neglect of nursing care,


3.9% said economic abuse,


and 3.5% said sexual abuse.

In principle, physical restraint that deprives people of their freedom is prohibited.

In principle, physical restraint that deprives users of their physical freedom, such as tying them to beds in nursing care facilities, is prohibited by ministerial ordinances based on the Nursing Care Insurance Act and the Elderly Welfare Act.



The Ministry of Health, Labor and Welfare states that physical restraint is only permitted in ``unavoidable cases.'' Specifically, ▽ ``


Urgency'' where there is a high possibility that life or body is in danger


▽ There is no other method of nursing care other than physical restraint.

The following three conditions must be met: ``

non-substitutability''


and ▽temporality, which means that the physical restraint is only temporary.

However, when making such decisions,

the facility will consider the matter and then

provide sufficient explanations to the person and their family to seek their understanding.






Expert: “All kinds of negative factors for mind and body”

Professor Toshio Hasegawa of Kyorin University, who is familiar with the issue of physical restraint in nursing homes, said, ``Surrounding the area with a fence to prevent people from getting out of bed is obvious physical restraint, and wrapping the lower body in something like a sheet to bind it. "This is very similar to physical restraint. Such acts have all sorts of negative effects on the mind and body, such as reducing bodily functions and causing a sense of humiliation."



Furthermore, Professor Hasegawa points out that the reason why inappropriate physical restraint and abuse continue to occur in nursing homes and other facilities is the facility's awareness that they are ``taking care of the residents,'' and the ostensible efforts to prevent staffing shortages and injury prevention. It is strictly pointed out that the reason for this is not valid.



He added, ``In order for facilities to avoid being trapped by incorrect thinking, we should increase opportunities to disseminate knowledge such as examples of external cases that provide appropriate care, and the government should continue to appeal to facilities to ``eradicate physical restraint.'' I need to go," he said.