Objective: To provide a critical review of contemporary literature published between 1992 and 2003 on the use of physical restraints on residents with dementia in long term care. Design: Forty two manuscripts related to dementia (cognitive impairment) and physical restraint in long term care settings were examined. Results: Four dominant themes were identified in the literature: relationship between restraint use and cognitive decline; falls/related injuries and associated mortality; reduction/removal/alternatives to use; and, nurses' attitudes to restraints. It appears that despite nurses' desire to use physical restraint for protection there is no scientific evidence that physical restraint actually protects residents against injuries. A discussion of the methodological issues arising in the literature and recommendations for further research and implications for nursing practice are outlined. Conclusion: To curb the practice of restraint use the concentrated assistance of Australia federal and state governments and peak geriatric and dementia organisations may be required. (author abstract)
