Japan is an advanced country for the elderly. What is happening now in Japan may happen in the world in the future.

There are hospitals that profess to fill out a "Physical Restraint Consent Form" when a person over 65 years of age is admitted to the hospital. A nurse at that hospital placed restraint belts on the hands and torso of an elderly patient who had been transferred to the hospital for rehabilitation, who was able to walk to the bathroom by herself with a walker, two hours after she was admitted to the hospital without telling her or her family the reason and without checking with the doctor.

The restraints were never removed until she died seven days later.

This is just the tip of the iceberg.

May 11, 10:00-17:00, Courtroom 1104, Nagoya District Court

An examination of witnesses.

Attending doctor (currently the deputy director), and nurse in charge of Orido Hospital.

Junko Abo, nursing scholars, and others.

Please come to the hearing.

Nagoya Kyodo Law Office, representative of plaintiff's lawyers

In Japan, the use of physical restraints in hospitals is prohibited in principle. Restraint is a violation of basic human rights stipulated in the Constitution, such as individual dignity, physical freedom, personal rights, and the right to life. Only temporary restraint is allowed under the judgment of a doctor when the person's life is in imminent danger and there is no alternative.

Please know Ms. I's situation before she was placed in physical restraints.

About Ms. I

　Born in 1925, Ms. I was small due to congenital hip dysplasia. She is a licensed instructor of Western and Japanese dressmaking and has raised five children on her own, despite her hardships. She had a very calm and cheerful personality, and many hobbies. She was always surrounded by people who adored her.

　When she was 60 years old, various illnesses were discovered, and in her 80s, she suffered from multiple myeloma, which went into remission. She overcame these illnesses and still lived by herself at over 90 years old. She was highly conscious of her health and beauty, and enjoyed doing handicrafts for her life's work, with her friends. Her dream was to watch the 2020 Tokyo Olympics with her family.

Hospitalized at Aichi Medical University Hospital

　On May 9, 2017, Ms. I became unconscious due to pneumonia and was rushed to Aichi Medical University Hospital, where she miraculously regained consciousness. On May 11, she was able to talk with his family while wearing an oxygen mask, and on May 30, her antibiotic treatment was once again completed.

Because of delirium, "not knowing that she was in the hospital for treatment," Ms. I sometimes pulled out her intravenous drip, so she had to wear mittens on her right hand only, or sometimes on both hands. However, during the daytime, the nurses would watch over Ms. I as she enjoyed coloring at the nurses' station, and only at night were mittens put on her hands. In addition, a clip sensor was attached to Ms. I's collar to prevent her from falling out of bed, and if it came off, a buzzer would sound and a nurse would rush to her, but there were no further restraints. Ms. I, who had never worn a diaper before, cried and complained that she needed to go to the bathroom because she didn’t want to defecate in her diaper.

Ms. I had hearing loss in both ears, so medical staff members used written messages and questions such as, "You’re going for an x-ray now. Now you’re going to take a bath. Are you in pain now?" Communication with family members was possible by reading her mouth.

　By mid-June, she was able to walk to the toilet with a walker. With the help of rehabilitation, she was able to walk up to 100 meters with a walker. She sometimes had a fever and had to be re-infused with antibiotics again, but that ended on June 21.

During visiting hours, Ms. I was able to go to the hospital's coffee shop in her wheelchair with her family, and she spent time folding her own laundry and reading the newspaper. On June 26 of the same year, she began swallowing food. "This taste isn't good enough. This one is delicious,” she said of the food. A short time later, the possibility of aspiration pneumonia came up, and she was nil per os (NPO) again.

　In July of the same year, Aichi Medical University Hospital explained to her that her symptoms would stabilize if she continued to use the same antibiotics, and she was transferred to Nisshin City Oriodo Hospital because she could also undergo rehabilitation. The medical staffs and students saw her off, saying, "We are going to lose our ward's Madonna." She got into the car with a smile and said, "Thank you so much, and good luck to all of you.”

Continue to NO2

No2 Why was Mr. I physically restrained⁉

On July 7, 2017 at noon, Ms. I was transferred from Aichi Medical University Hospital to Nisshin City Orido Hospital, 2nd floor ward, room 213.

Dr. Shiraishi, the attending physician at Orido Hospital, showed up at the hospital room and asked the charge nurse first, "Did you get the restraint consent form written?" The family heard a voice confirming this.

Ms. I moved from her wheelchair to her bed right in front of the doctor.

Ms. I's family thought, “In Aichi Medical University Hospital, she did not have to use physical restraints because she did not remove IV drips for the past few weeks. However, the environment has changed due to the transfer to a different hospital, so it may become necessary. Even if it were to become necessary, She would probably only wear mittens (= restraints that cover the fingers and hands beyond the wrists), the same as at Aichi Medical University Hospital," the family thought and signed the consent form for physical restraint. This happened within a few minutes.

Around 2:00 p.m., the charge nurse said, "It will take time for the examination on admission. The family can go home after you finish filling out the forms I gave you," so Mr. I's family left there.

On the evening of July 10, the family chose a time when both rehabilitation and treatment were over and went to visit her. They imagined that she might have been tired and sleeping after doing gait training in rehabilitation. In room 213 (a four-person room away from the nurse's station) at Oriodo Hospital, the bed that Ms. I was staying wrapped around by curtains, so that she could not be seen from the corridor. The family opened the curtain and were astonished.

They were speechless. Their blood ran cold.

What in the world had just happened...?

Ms. I had an oxygen tube passed through her nose, her hands tied to the bed rails, and her torso secured with a belt-like object so that she could not move her body, a painful sight, as if a criminal were being tortured.

There were also sensor mats on the floor, and the left side of the bed is completely set on the window side. The right side of the bed was blocked by a two-point fence, and the entire fence is covered and secured to the bed to prevent its removal. The nurse call is curled up on the wall, out of reach even if Ms. I wanted to buzz it.

The restraints were well-prepared and perfect.

The family went to the nurses' station to inquire about the situation. However, the nurse who answered said, "We are taking care of it," and went to the back of the station.

The family waited for the nurse in room 213, and thought, "The nurse usually comes every two hours to change the patient's position and we will ask her then.”

The patient in the same room came to her side and said, "Mom is sleeping quietly after being medicated at night. She talks to me calmly during the day.”

When Ms. I woke up, she called out the family member's name, and when her eyes met those of her roommate patient, she lightly bailed and said, "I often chat with her. It's hot today. Did you drive here?" She spoke in a calm tone as usual.

The family thought it would be difficult for her to breathe while in the prone position, so they tried to remove the restraint bands from her hands. However, because they were tied so tightly, they could only loosen them a little. I raised the bed at the head to make breathing a little easier.

Two and a half hours past visiting time and still no nurse came.

The roommate patient said, "Visiting hours will be over. If they find you, they will get angry.” The family left the hospital room213.

There was no one in the hallway or at the nurses' station.

An elderly woman's cry echoed from the hospital room near the elevator, "Remove this cord!”

Continue to NO3

What is happening at Oriodo Hospital

Thank you for your comment.

In Ms. I's case, the nurse in charge handed her family many forms to fill out and gave them with no explanation at all about physical restraints.

The family thought, "In the previous hospital, she didn't remove the IV drop for a while. But now the environment has changed with the transfer. So if she tried to remove the IV, it would be possible that she would need to put a mitten on one of her hands like the previous hospital did.”

The attending physician showed up at the hospital room and left after about two minutes, saying, 'I'll give you the same treatment as before.”

The nurse then told me, 'It will take some time to do the tests, so the family should fill out the paperwork and go home.”

After Ms. I's death, her family disclosed her medical records and learned that:

Two hours after the family left, three nurses tied the hands and torso of Ms. I (91 years old, under treatment for pneumonia, third grade size, disabled) who was resisting desperately, fenced the entire bed, covered the fence, put a sensor mat, hung the nurse call on the wall to prevent it from being pressed, and made sure that Ms. I's bed was not visible from around. The curtains around the bed were closed.

The nurse did not communicate with her at all, saying, "Ms. I is hard of hearing.

(She was able to communicate in writing.)

Although Ms. I was admitted for rehabilitation, she was physically restrained two hours after being transferred to the hospital, and the only rehabilitation was to check if her unrestrained legs moved on the bed.

The hospital did not provide appropriate nursing and care for Ms. I, whose physical functions were gradually deteriorating.

Before the transfer, she was able to walk to the toilet with a walker, but after the transfer, she was immediately placed in physical restraints and wore a diaper. Diapers were changed three times a day. (Ordinary hospitals change diapers at least 4 times a day to prevent infection.)

After being transferred to the hospital, the skin on her buttocks was sore and blistered with candida.

The doctor's instructions at the time of transfer stated that she could bathe and walk, but she had never bathed.

At Oriodo Hospital, wiping was scheduled twice a week.

(In ordinary hospitals, when bathing is not possible, it is performed every day.)

A family member found her sweating profusely in bed, even in her hair and bed wet, and pressed the nurse's call. That was the first and last time she was wiped clean after being admitted to the hospital. It was one hour before her death.

The hospital did not hold a conference to discuss whether the restraints were really necessary and how to release them. (In a normal hospital, this would be discussed every day.) This was a sign that the hospital did not consider restraints to be a serious problem at all.

On nursing review websites, nurses who have actually worked at Oriodo Hospital have written about the hospital. The facilities are old, but there are many restraints. They use physical restraints immediately. The patients who are restrained become restless and their condition deteriorates. Even after operations, bed release is slow and does not improve. Many were posted such as.

Oriodo Hospital has long been a chronic and regular practitioner of unnecessary physical restraints. When doctors say, "Physical restraints are necessary to continue treatment." the family members are not convinced but they have no choice and to accept it. The hospital abuses that family psychology.

We fear that more and more patients are being subjected to even more unnecessary physical restraints in Oriodo Hospital because they are restricted from visiting due to this Covid19 disaster and are completely out of sight of the outside world.

If your father is still in the hospital, you should set up a "monitor with camera" to check on his daily situation from the outside.

#OridoHospitalPhysicalRestraintTrial

#Hospital

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#Pneumonia

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