Removing Restraints Frees Patient, Family Members

WASHINGTON —  Keith Grant never considered that he would ever have to choose a nursing home for his wife, an active, intelligent 52-year-old mother of five.

But then Virginia Grant’s personality began to change and months of tests pointed to Alzheimer’s disease. After three years of home care, Mrs. Grant’s behavior became so erratic that her family made the painful decision in 1985 to place her in Tel Hai Retirement Community in Honey Brook, Pa.

“She would wander off, pick up things to eat anywhere, out on the road, hitchhike, stop cars,” Grant recalled. When family members visited, however, they were troubled to find that more often than not, Mrs. Grant was strapped down to keep her from wandering and eating foreign objects.

“She seemed very upset and so were we,” said her daughter, Susan McTyier. “Mom no longer was able to speak but she would often look very angry or grumpy whenever we visited. Dad often made the comment, ‘It looks as if she’s saying, “Why are you doing this to me?” ’ “

A year ago, Tel Hai launched a program to reduce its use of restraints, cutting the rate from 43% of patients to less than 10%. Confused residents who once were tied down now are free to stroll an outdoor “wandering garden;” those who were restrained because they were unsteady on their feet have been fitted with sturdy walking shoes.

“I remember from my nursing school days, it was considered a standard of good care to restrain residents who might fall and injure themselves,” said assistant administrator Betty Petersheim. “But now there’s been a bubbling up from within the health-care providers saying there’s a better way.”

The resulting new freedom has improved Mrs. Grant’s demeanor and that of other residents, McTyier said at a recent symposium on restraints.

“She’s calmed down visibly and we’ve also noticed an overall happier attitude in the whole facility. It used to disturb us when we would walk in and hear the residents moaning and crying for help. Since the change, the noise level has dropped considerably. . . .

“The nursing home doesn’t seem like such a prison anymore when you walk through and don’t find people strapped down all the time.”