Tippy Irwin regularly investigates elder abuse complaints, but she’s still haunted by the April death of a cancer patient in a small San Mateo County board-and-care home.
When the man became combative, his caregivers phoned for an ambulance, Irwin recalled. Hospital emergency room staff sedated him with drugs and sent him back to the home in an ambulance. Still violent, paramedics tied his hands and feet in four-point restraints — “trussing him up like a turkey,” according to Irwin, who is executive director of Ombudsman Services of San Mateo County.
When the struggling patient arrived back at the board-and-care home, the staff bound his hands overhead to the headboard, and tied his feet down. In the morning, he was found dead on the floor — he had managed to free himself of all but one of the restraints, Irwin said.
While it’s unknown whether the struggle contributed to the man’s death, the loss of his dignity still troubles Irwin.
“Can you imagine being in his position? It’s tragic,” she said.
Unfortunately, thousands of nursing home and board-and-care residents don’t have to imagine. Residents in California’s nursing homes are restrained at double the national average.
While the national restraint rate is 6 percent, California’s is 13 percent. Out of San Mateo County’s 18 nursing homes, five are at or over the national average, according to Medicare data. Two homes — St. Francis Heights Convalescent Hospital in Daly City and Linda Mar Care Center in Pacifica — are over the California average, at 14 and 17 percent, respectively. Numbers were unavailable for six facilities, and there is no data kept on restraints used in board-and-care homes.
Sunday marked the beginning of national Residents Rights Week, and county supervisors and mayors from several cities issued proclamations and are planning visits to facilities with their local ombudsman.
While many local facilities are making strides to reduce the number of restrained residents, Irwin says she hopes the attention of government officials will shed light on the need for improvement in general.
In addition to ties, restraints can also include bed railings that don’t allow the resident to get out, being tied into a wheelchair or having all doors and windows locked to prevent wandering. Although some restraining may be necessary, it is a practice that is vastly overused in lieu of hiring more staff to supervise residents and engaging the residents activities to reduce their risk of agitation or wandering, Irwin said.
It is a culture change that the staff at Atherton Health Care in Menlo Park has instituted in order to get rid of restraints all together.
Atherton Administrator Nana Cocachvili said that instead of restraining people to prevent falls, her facility simply assigns more staff members to supervise the residents in their activity room.
“The first thing we did was hire more people. We assign them to certain residents and they really watch out for their safety,” she said.