Cassandra's Compass
Restrictive Practices
Evidence-based guidance on the lawful, ethical, and person-centred use of restrictive practices in Australian aged care — definitions, legislation, least-restrictive alternatives, and reporting requirements.
Every restrictive practice carries a risk of harm, loss of dignity, and legal consequence. Australian law requires that they be used only when necessary to prevent serious harm, be the least restrictive option available, be time-limited, documented, and regularly reviewed. This page is for education and care-planning — always follow your organisation's policies and seek clinical guidance.
A restrictive practice is any practice that restricts a person's rights or freedom of movement. In Australian aged care, restrictive practices are regulated because they can cause physical and psychological harm, infringe on human rights, and are sometimes used as a substitute for adequate staffing, clinical care, or person-centred support (Royal Commission into Aged Care Quality and Safety, 2021).
The Aged Care Act and the Aged Care Quality Standards require providers to minimise and, where possible, eliminate the use of restrictive practices. When their use is unavoidable, it must be the least restrictive response, proportionate to the risk, time-limited, documented in the care plan, and subject to regular review (Department of Health and Aged Care, 2024).
Chemical Restraint
The use of medication to influence a person's behaviour where it is not required to treat a medically identified condition.
Examples
- •PRN psychotropic medication given solely to manage behaviour
- •Sedatives prescribed without a diagnosed mental health condition
- •Excess doses beyond clinical need
Alternatives
- ✓Pain assessment (Abbey Pain Scale)
- ✓Non-pharmacological BPSD interventions
- ✓Medication review (deprescribing)
Physical Restraint
The use or threat of physical force to restrict a person's free movement, or actions to restrict free movement.
Examples
- •Holding a person down
- •Manual force to keep someone seated
- •Physical blocking of movement
Alternatives
- ✓De-escalation techniques
- ✓Environmental modification
- ✓Therapeutic presence
Mechanical Restraint
A device used to restrict a person's free movement or access to their body, that is not a standard medical treatment or adaptive aid.
Examples
- •Bed rails (when used to prevent voluntary movement)
- •Lap belts
- •Wheelchair brakes locked by staff to prevent standing
- •Mittens to prevent pulling at tubes
Alternatives
- ✓Low-low beds with fall mats
- ✓Bed/chair alarms
- ✓Hip protectors
- ✓Assistive equipment (see Assistive Equipment page)
Environmental Restraint
The use of barriers, locks, or design features to restrict a person's free movement within or from a premises.
Examples
- •Locked dementia units / secure wings
- •Keypad-locked doors
- •Fenced gardens
- •Garden gates that cannot be opened from inside
Alternatives
- ✓Disguised exits / circular walking paths
- ✓Wayfinding cues and signage
- ✓Open garden design with safe boundaries
Seclusion
The confinement of a person alone in a room or area from which they cannot freely exit.
Examples
- •Placing a person alone in a locked room
- •Time-out rooms
- •Isolation as a behavioural consequence
Alternatives
- ✓Low-stimulation sensory room (with supervision)
- ✓One-to-one support
- ✓Quiet space the person can leave freely
Aged Care Act 2024 (Cth) — Commenced 1 November 2025
The new principal legislation governing Australian aged care, replacing the Aged Care Act 1997. The 2024 Act establishes a rights-based framework that strengthens the regulatory requirements around restrictive practices, requiring registered providers to minimise their use and report all instances to the Aged Care Quality and Safety Commission.
Learn moreSerious Incident Response Scheme (SIRS)
Mandatory reporting scheme for serious incidents, including the inappropriate use of restrictive practices. Every instance of a restrictive practice must be reported as a Priority 1 or Priority 2 reportable incident, depending on severity and circumstances.
Learn moreStrengthened Aged Care Quality Standards — Standard 2 (The Organisation) & Standard 5 (Clinical Care) [commenced 1 November 2025]
Providers must demonstrate that restrictive practices are used only as a last resort, are time-limited, proportionate, documented, and subject to regular review. Consumers must be involved in decisions about their care.
Learn moreAged Care Rules 2025 — Restrictive Practices [commenced 1 November 2025]
Made under the Aged Care Act 2024, the Rules replaced the Quality of Care Principles 2014 and set out the requirements for using a restrictive practice: it must be necessary to prevent harm, be the least restrictive option, be documented in the care plan, and be regularly reviewed (Chapter 4, Part 9).
Learn moreStatement of Rights (Section 23, Aged Care Act 2024)
The Statement of Rights sets out the rights of people receiving aged care — including the right to be treated with dignity and respect, to live free from exploitation and abuse, and to make decisions about their care, including the right to refuse restrictive practices unless legally justified.
Learn moreTwo temporary arrangements in the Commonwealth framework end on 1 December 2026. Both were always intended as transitional measures — put in place while states and territories developed their own legislation.
1. Immunity from civil or criminal liability ends — section 163, Aged Care Act 2024
Section 163 currently protects a registered provider from civil or criminal liability where a restrictive practice has been used consistently with the requirements of the Act. That immunity ceases to apply from 1 December 2026. From that date, providers must comply with both the Commonwealth requirements and any relevant state or territory law, and may face civil or criminal liability.
2. The Commonwealth consent hierarchy ends — Aged Care Rules 2025
The Aged Care Rules 2025 set out a hierarchy — often called the 'authorisation table' — of who may act as a restrictive practices substitute decision-maker (RPSDM) when a person cannot give informed consent themselves. That table ceases to exist from 1 December 2026. After that date, the authority to consent comes from an appointment made under state or territory law, not from the Commonwealth hierarchy.
What replaces it depends on your state or territory
There is no single national consent pathway after 1 December 2026. The replacement arrangements sit in each state and territory's own guardianship and enduring power of attorney legislation, and those laws differ. You will need to check the framework that applies where your service is delivered.
In practice, consent will come from a person or body appointed under that law — for example a guardianship or administration order, or an attorney appointed under an enduring power of attorney for personal matters. Confirm the position for your jurisdiction with your organisation, and seek legal advice where a resident's circumstances are unclear.
The underlying obligations do not change. A restrictive practice must still only be used as a last resort, in the least restrictive form, for the shortest period of time, documented in the care plan, and reported through SIRS. What changes is the protection available to providers, and where the authority to consent comes from (Aged Care Act 2024 (Cth), s 163; Department of Health, Disability and Ageing, 2025).
What to do now: check your organisation's restrictive practices policy against the change, confirm with your provider how consent will be obtained in your jurisdiction from 1 December 2026, and review any current behaviour support plan that relies on a substitute decision-maker appointed under the Commonwealth hierarchy.
Before any restrictive practice is considered, staff must follow a structured decision pathway that prioritises the person's rights, dignity, and unmet needs. This pathway aligns with the Aged Care Quality Standards and the Aged Care Rules 2025 (Department of Health, Disability and Ageing, 2025).
Identify the unmet need
Use ABC charting and clinical assessment to understand what the person is communicating. Is there pain, hunger, fear, overstimulation, or a medical cause? (See BPSD Behaviour Tracker.)
Try non-restrictive alternatives first
Environmental modification, redirection, validation, music therapy, therapeutic presence, structured activity, or addressing the unmet need directly.
Assess risk if alternatives fail
Is there an immediate risk of serious harm to the person or others? Document the specific risk and why alternatives were insufficient.
Apply the least restrictive option
If a restrictive practice is necessary, choose the minimum intervention for the shortest possible time. Chemical restraint requires a medical review and prescription.
Document, report & review
Record in the care plan, notify the person's representative, report via SIRS if required, and set a review date. Every restrictive practice must be time-limited and reassessed.
Most behavioural expressions can be addressed without restraint by understanding the person, their environment, and their unmet needs. These evidence-based alternatives are available throughout Cassandra's Compass:
Music & sensory therapy
Familiar music, sensory items, and reminiscence can reduce agitation without restraint.
BPSD behaviour tracking
ABC charting identifies triggers and patterns, enabling proactive non-restrictive strategies.
Communication & validation
Evidence-based communication frameworks reduce distress and the need for restraint.
Environmental design
Wayfinding, low-stimulation spaces, and safe wandering paths reduce exit-seeking and agitation.
Pain assessment & medication review
Unrecognised pain is a common cause of behavioural symptoms. Use the Abbey Pain Scale and request medication reviews.
Person-centred care planning
Knowing the person's life story, preferences, and routines prevents many behavioural triggers.
Under the Serious Incident Response Scheme (SIRS), the use of any restrictive practice is a reportable incident. Failure to report is a breach of the Aged Care Act and may result in sanctions (Aged Care Quality and Safety Commission, 2024).
Priority 1 — Reportable assault, serious injury, or unexplained absence
24 hoursReport to: Aged Care Quality and Safety Commission + Police (if criminal)
Includes any restrictive practice that results in serious injury or constitutes a reportable assault.
Priority 2 — All other reportable incidents
30 daysReport to: Aged Care Quality and Safety Commission
Includes the use of any restrictive practice, even when no injury occurs. Every instance must be reported.
Internal incident report
Same shiftReport to: Facility management / RN in charge
Document in the facility incident management system. The RN must assess, review the care plan, and notify the person's representative.
Care plan review
Within 7 days or at next MDT meetingReport to: Multidisciplinary team
Review the restrictive practice, attempt to reduce or eliminate it, and document the outcome. Set a specific review date.
Aged Care Quality and Safety Commission
📞 1800 951 822Report serious incidents (SIRS), make a complaint, or seek guidance on restrictive practices.
Older Persons Advocacy Network (OPAN)
📞 1800 700 600Free, independent advocacy for older people and their families — including restrictive practice concerns.
Dementia Australia
📞 1800 100 500National Dementia Helpline — support, education, and guidance for carers and professionals.
Lifeline (crisis support)
📞 13 11 1424-hour crisis support for carers, families, and staff experiencing distress.
Related Resources
This page is for educational and care-planning purposes only and does not constitute legal or medical advice. Always follow your organisation's restrictive practices policy, consult your RN in charge, and refer to current legislation and Aged Care Quality and Safety Commission guidance. Content informed by Dementia Australia.
Dignity is not something we give to people in aged care. It is something we recognise, protect, and never take away.
— Cassandra's Compass
Verified against official sources on 29 September 2026