People with dementia are being subjected to restraints and non-consensual sedation as a routine part of hospital care in England, according to the first study of its kind. Researchers from the University of West London observed 225 days of care across nine NHS wards and conducted over 1,000 interviews with healthcare professionals.
The study found that restrictive practices, such as raising bedside rails, blocking doors and pathways with furniture, issuing verbal commands to sit down or go back to bed, and administering sedatives without consent, are an “embedded aspect of routine ward care”. Many staff did not view these actions as restrictive due to their widespread use, questioning how else they could keep dementia patients safe.
Up to half of all acute hospital admissions involve patients living with dementia, often admitted after a fall or other illness. Lead author Prof Andy Northcott said: “Once a person with dementia is admitted, they’re essentially expected to stay in bed, and a series of subtle to quite overt restrictive practices are used to ensure the hospital can manage around them.” He noted that while staff act in patients’ best interests, the practices can cause agitation, distress, and confusion.
Andy Woodhead, who has vascular dementia, described being confined to bed and forced to use a urine bottle, feeling like “a bit of a nuisance”. The report recommends alternatives such as supported walking, personal care assistance, and engaging patients in conversation. Paul Edwards of Dementia UK called for better staff training and specialist support, while an NHS England spokesperson stressed that restrictive practices should only be used as a last resort.
