Chronologic age older than 65 years is a predictor for restraint use in the acute care setting. The therapeutic effect of restraints has not been established. Geriatric patients in the hospital are more vulnerable to the risks associated with physical and chemical restraints. A framework is presented to guide Ehe clinician in the decision making process on restraint use. Nursing homes have been successful in the implementation of restraint reduction programs, and these models might be reviewed for applicability to the acute care setting.