When Care becomes Control
Protecting our family and friends doesn’t mean controlling them.
Theme: The Broken
Key Take:
Sadly, restrictive care is normal practice.
DoLS use is rising and backlogs grow.
Better training will protect freedom and dignity.
So Sad - Still Happening
Hospitals are still restraining patients. A recent study by the University of West London found that people with dementia are routinely held, confined, or sedated “for their own safety.”
Locked doors. Constant supervision. Controlled movement. Patients can’t leave. They can’t make everyday choices.
For anyone with effective, person-centred experience in dementia care, this is deeply concerning - and not surprising. These approaches can increase stress, confusion, and a profound loss of dignity.
Perhaps even more worrying is how normal this has become. Many staff no longer recognise these practices as restrictive. And it’s hard to imagine this creates a positive or fulfilling working environment.
So Depressing - Nothing Changes
This isn’t new. Back in 2019, the National Institute for Health and Care Research warned about the same issues.
Patients were being kept in bed, prevented from moving freely, and given limited choice. It wasn’t deliberate cruelty - it had simply become routine.
The recent University of West London study suggests the situation may be worsening, with sedation now more commonly used. The problem isn’t just continuing - it’s evolving.
Meantime – Mirroring Hospital Care
Care homes face similar challenges.
When a home needs to significantly restrict someone’s freedom to keep them - or others - safe, and that person lacks capacity, legal authorisation is required.
This comes through the Deprivation of Liberty Safeguards (DoLS), applied for via the Local Authority. These safeguards are designed to ensure restrictions are necessary, proportionate, and regularly reviewed.
Figures from the Care Quality Commission and NHS Digital show that DoLS use in care homes is rising.
In 2023–24, over 330,000 applications were made - yet more than 120,000 were still waiting.
Just like in hospitals, restrictive practices risk becoming the norm, with residents’ freedom and dignity gradually eroded.
Same Old, Same Old
Both studies point to the same solutions: better training, more flexible person-centred care, and stronger communication.
It’s Not Rocket Science
I understand the pressures on staff - but I believe they are being let down.
Training is often too complex, and there remains a great deal of fear and misunderstanding around dementia. When staff are stretched, restraint can feel like the safest and easiest option.
Ironically, it often creates the very behaviours staff are trying to prevent.
When someone with dementia is treated as though they are incapable or dangerous, it can heighten fear -leading to distress, agitation, and reactive behaviour.
By contrast, a calm, contented person is far less likely to present challenges. When people feel safe and understood, difficult situations are not escalated - they are reduced.
As a daughter, nurse, and full-time carer for my 90-year-old mother living with mixed dementia, this isn’t theoretical - it’s daily life.
M.A.G.I.Q. - A Different Approach
There is another way - one that reduces fear, supports staff, and helps people with dementia feel safe and understood.
I developed M.A.G.I.Q., a simple training approach, from years of professional experience and from witnessing the reality of care - particularly in hospital settings - where fear and misunderstanding can so easily escalate distress.
I’ve also seen friends struggle as their loved ones become increasingly anxious, reactive, and unhappy, often without the right support or understanding.
Most importantly, I needed something practical I could share with my own family - an approach that would help them support my mother with confidence, calm, and compassion.
I’ve started sharing this with a small number of care homes, and I’ll report back on what happens next.