Abstract
OBJECTIVES: We aimed to identify factors associated with the use of physical restraints in geriatric care facilities housing older adults with dementia during the COVID-19 pandemic in Japan. METHODS: A cross-sectional anonymous online survey was conducted from January to February 2023 in special nursing homes (SNHs) for older adults with moderate to severe dementia and group homes (GHs) for those with mild to moderate dementia. The survey gathered information on facility characteristics, the presence of residents with dementia infected during COVID-19 clusters, and the use of physical restraints. Additional items addressed challenges encountered during a cluster outbreak, difficulties in managing residents with dementia infected with COVID-19, measures implemented for these residents, and considerations when residents were unable to isolate in their rooms owing to wandering. Multiple logistic regression analysis was used to identify factors associated with physical restraint use. RESULTS: Data from 286 SNHs and 151 GHs were analyzed, all of which housed residents with dementia infected during COVID-19 clusters. Among them, 49 SNHs (17.1%) and 14 GHs (9.3%) reported using physical restraints. In SNHs, multiple logistic regression analysis identified wandering, worsening dementia symptoms, and ongoing infections as significant factors associated with restraint use. In GHs, difficulty communicating the situation to other residents and families was notably associated with restraint implementation. CONCLUSIONS: The use of physical restraints in facilities caring for older adults with moderate to severe dementia may be associated with worsening dementia symptoms during the COVID-19 pandemic in Japan. These findings underscore the need for improved staff training and the development of care strategies aimed at minimizing restraint use during infectious disease outbreaks.