Modifying the environment to decrease use of restraints.

Because the majority of residents lack the skills and capacities to adapt to the nursing home environment, it is the staff's responsibility to modify the environment to reflect the residents' needs. In persons with dementia, anxious behavior occurs when the individual's environment provides too many stressors or no opportunities to relax or avoid stimuli, the stress threshold is exceeded, and dysfunctional or problem behaviors are manifested. Nurses must decrease their reliance on physical restraints, think creatively to solve problems, and look to theories to provide ideas and guidance. Administrators must encourage innovation and be willing to take calculated risks.