Involuntary Interventions: Medications, Forced Feeding, Restraints, and Prevention of Wandering

  • Catherine Cheng
  • Eric Gee
  • Timothy LauEmail author


Severely ill geriatric patients who lack the capacity to appreciate their illness or its need for treatment may require involuntary interventions to achieve full recovery. Problems which prompt such actions include food/fluid refusal and resulting dehydration/malnutrition, severe depressive disorders, suicidality, agitation, psychosis, catatonia, aggression, homicidality, and wandering. Interdisciplinary team approaches and alliance with the family/caregivers are likely to achieve the best outcomes in these situations. Understanding the legal environment and controlling statutes, along with legal counsel and ethics consultation, give clinicians the confidence to intervene. Common situations and key principles surrounding involuntary interventions in an inpatient geriatric psychiatry unit are reviewed.


Involuntary treatment Food refusal Severe depression Suicidality Psychosis Catatonia and Aggression Homicidality Wandering Restraints Physical restraints Chemical restraints 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of AlbertaEdmontonCanada
  2. 2.Department of PsychiatryUniversity of TorontoTorontoCanada
  3. 3.Faculty of Medicine, University of Ottawa, Department of Psychiatry, Geriatric Psychiatry Inpatient Unit, The RoyalOttawaCanada

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