This paper provides a high-level introduction to restrictive practices in residential aged care in Australia. It has been prepared by staff of the Office of the Royal Commission into Aged Care Quality and Safety but does not represent a direction or position of the Royal Commission in relation to this area. Any views expressed are not necessarily the views of the Commissioners.

The use of restrictive practices in residential aged care in Australia is contentious. There is significant public interest in the issue of restraint and ways to reduce or avoid it. Numerous media reports and inquiries have highlighted accounts of the misuse or overuse of physical restraint and psychotropic medication. This includes personal accounts from members of the public about residents being physically restrained frequently, or for long periods of time, or restrained without consent.

Restrictive practices can elicit concern for a number of reasons. Fundamentally, they impact on the liberty and dignity of the care recipient. In circumstances where they are not absolutely necessary, their use is likely to sit uncomfortably for many. Their use without lawful consent may infringe the resident’s legal rights and constitute a civil or criminal offence, such as assault or false imprisonment, although there are very few cases in Australia where a criminal or civil complaint has been pursued to challenge the use of a restraint in an aged care setting.

Physical and chemical restraint can have significant adverse effects on a resident, both physically and psychologically. There are also fundamental questions about their effectiveness.