Reaction: The course of the in-patient treatment had been difficult because of fits of rage due to his misjudging situations. At the beginning, it had only been possible to care for the patient with several nursing staff at once since he had frequently kicked and struck out. Because he was no longer able to control his impulses, it could also be presumed that he posed a danger to other patients. It had been necessary to fix the patient; the attempts that had been made to remove the fixation had initially been unsuccessful, also because the medication had not worked. Constant fixation for a period of several days was necessary, and it had not been possible to provide physiotherapy because of the aggressive resistance put up by the patient. Increasing relaxation had now been achieved under a combination therapy, so that it had been possible to do without fixation to an increasing extent. The patient had been mobilised using physiotherapy. In the context of “activating care”, and through attempts to structure his day, the patient had taken part as far as he was able in the therapeutic services offered by the wing. It had been possible to release the patient 14 days after the Commission’s visit to a department of a care facility that specialised in dementia. Fixation in the clinic was as a rule carried out in a supervision area that was specifically intended for this purpose with four fixation beds in the emergency wing – with the exception of the gerontological psychiatric wing. Roughly 227 instances of fixation had taken place per year on the emergency room in the past three years. The average duration was 14 hours in 2011. With the most frequent reasons there were virtually no differences in the number of self-endangerment and endangerment of others. 5-point fixation was by far the most frequent type of fixation. In the gerontological psychiatric wing, by contrast, 902 instances of fixation were carried out in 2010, whilst there were 466 in 2011. The average duration was 39 hours. The most frequent reasons were the danger of falling and personal endangerment of others. Bed bars and 3-point fixation were the most frequent types of fixation here. The nature and extent of fixation appeared to the Commission to be extremely high in comparison to the emergency room. Despite the quality committee in fixation that was uniform within the clinic, it therefore appears to depend on the personal handling of the person respectively ordering and/or on the patient structure. The gerontological psychiatric wing should adopt the standards of the emergency room. Reaction: There would be a comparison between the standards of the emergency room and gerontological psychiatry. The patients in the two departments however constituted very different clientele, so that the gerontological psychiatry patients and the younger patients had to be accommodated separately. The reasons for fixation in the two areas differed very widely. Whilst in the emergency room in most 71