Coercion and restraint

What is coercion?

Coercion and restraint are when an individual’s right to self-determination is taken away against the will. Often without the individual being able to object or do anything about it.

Coercion and restraint are serious interventions and can have major negative consequences and are therefore prohibited by law except in exceptional cases.

Which groups are most likely to be subjected to coercion?

• Disabled people. Especially those who find it difficult to express themselves or are unable to express themselves.
• Older people. Especially older people with dementia.

Types of coercion and restraint

Physical use of force

When a person is held down by physical force. Often used to prevent the individual from causing harm to themselves or others or damaging their or others' property.

Sometimes the use of physical force is considered necessary to protect the individual or others.

It is important to try to find the cause of a person's violent behaviour because it is often simple to prevent the cause.

Forced Acts

When a person is forced to do activities that they do not want to do.

The activities may be considered necessary such as taking medication, eating, washing, using assistive devices, and so on.

Freedom of movement limited

When a person's home is locked so that they cannot get out unless they ask for permission.

It also applies when a person is tied down in a chair or bed.

Removal against will

When an individual is moved from place to place against their will, such as from home to day care.

Access to assets restricted

When an individual is given limited or no access to their property. An example of this is when access to a bank account is removed or a refrigerator is locked if it is believed that the person is eating too much.

Where can you go for help?

Relatives

If a relative believe that coercion is being used, it may be a sign that the caregiver does not have the resources or knowledge to properly support the disabled or elderly person.

Healthcare centres and the Alzheimer’s Association offer counselling for relatives.

The Disability Rights Protection Office of Iceland

The Disability Rights Protection Office of Iceland handles helping people with disabilities to protect their rights. There is no age limit there, so older people are covered by the law on the protection of the rights of people with disabilities.

On the Ísland.is website, you can send a general message The Disability Rights Protection Office of Iceland, but you can also send a report of violations of rights.

On the website you can also find an application to become a personal advocate for an individual who has difficulty protecting their interests.

Counselling for coercion and restraint for service providers

If service providers believe it necessary to use coercion or restraint on a client, then an exemption must be obtained from the Ministry of Social Affairs and Labour where the grounds for the request are defined.

Grounds for exemption from the law

According to the Ministry of Social Affairs and Labour, it is possible to grant service providers an exemption from the law and allow the use of coercion. It is only granted if the safety of the individual can be ensured and that there are legitimate grounds for requesting an exemption.

It should be noted that this only applies to those that provide services to people with independent residence, not public institutions that are a part of the health system (that includes nursing homes).

Legitimate exceptions may include:

• To prevent the individual from harming themselves or others.
• To prevent the individual from causing large-scale property damage.
• To make sure the individual's basic needs on nutrition, health and hygiene are met.
• To reduce an individual's inhibition.