June 7, 2016, Harrisburg, Pennsylvania — Kendal Outreach, a not-for-profit organization that administers the Pennsylvania Restraint Reduction Initiative (PARRI), announced Tuesday at a news conference under the dome of Pennsylvania’s Capitol that the use of physical restraints in state nursing homes dropped to an all-time low in 2015 — 0.7 percent. Statistics compiled by the federal Centers for Medicare & Medicaid Services (CMS) indicate Pennsylvania has seen a 97.6 percent drop in physical restraint use since PARRI’s inception in 1996.
On its Nursing Home Compare website, CMS states that: “Restraints should only be used when they’re necessary as part of the treatment of a resident’s medical condition. Only a doctor can order a restraint. Restraints should never be used to punish a resident or to make things easier for the staff. Facilities aren’t allowed to use restraints based solely on a family’s request, unless there’s a documented medical need and a doctor’s order. A resident who’s restrained daily can become weak, lose his or her ability to go to the bathroom by themselves, and develop pressure sores or other medical problems.”
“Thousands of elders in our nation and around the world have been tied to chairs and beds in hospitals, nursing homes and other health care environments — and even in their own homes — by caregivers who believe restraints will keep them safe,” says Beryl Goldman, Director for Kendal Outreach LLC. “Everyone is entitled to receive compassionate, restraint–free care. It is a freedom and human rights issue.”
Funded by state grants financed by fines levied against Pennsylvania nursing homes, PARRI has been praised for providing leadership, direction and technical support to more than 700 long-term care providers throughout the Commonwealth. The state Department of Health fines nursing homes found to be out of compliance with standards for long-term care.
Kendal Outreach announced the milestone in reducing physical restraint use at a midday news conference held Tuesday in the Main Rotunda of the Capitol in Harrisburg.
Since its inception in 1996, PARRI staff have:
- Reached 93 percent of nursing homes in Pennsylvania.
- Educated over 40,000 long-term care professionals (including residents, nursing home administrators, nurses, CNA’s, activities professionals, rehab staff, dietary, housekeeping, maintenance, chaplains, pharmacists, doctors, surveyors, ombudsmen and others, as well as families).
- Offered more than 200 in-person regional training programs.
- Conducted over 6,000 on-site consultation
- Developed over 40 training sites that have hosted 450 training sessions for Pennsylvania health care facilities.
“Kendal was born of Quaker ideals 45 years ago in Chester County. Those ideals are part of what drives our organization’s desire to serve others,” Goldman says. “We are fortunate to have grown to a scale that has allowed us to serve older people in every county in Pennsylvania over the past 20 years through Kendal Outreach and the Pennsylvania Restraint Reduction Initiative.”
Kendal has been committed to restraint-free care since 1973, when the first residents moved into Kendal at Longwood in Kennett Square, Pennsylvania, and Jill A. Blakeslee, Kendal at Longwood’s first Director of Nursing, made it her mission to sharply reduce the use of restraints nationwide. Lloyd Lewis, who was Kendal at Longwood’s first Executive Director, said he hired Blakeslee, in part, because he, too, was determined to not to use physical restraints at Kendal. In 1989, Kendal used a generous bequest from Dr. Emily T. Wilson, a Kendal resident, to publicize Untie the Elderly®, a national initiative by Kendal to eliminate physical and chemical restraints in health care settings.
In December 1989, Kendal cosponsored a symposium — “Untie the Elderly: Quality Care Without Restraints” — on Capitol Hill with the U.S. Senate Special Committee on Aging. That educational forum laid the groundwork for what became a nationwide effort to eliminate the use of physical and chemical restraints in caring for older adults. The following year, federal regulations went into effect limiting use of physical restraints and psychoactive drugs in long-term care settings.
“The U.S. has clearly taken the leading role in restraint-free care,” Goldman says. “And, even though the use of physical restraints has been reduced considerably in the U.S. since we began educating providers, consumers, government agencies and advocates about more effective and humane methods of providing care, we still have a long way to go to accomplish quality care without restraints.”
One of the speakers at the news conference marking PARRI’s 20th anniversary was Pennsylvania State Representative Pam DeLissio, a former nursing home administrator.
About Kendal Outreach
Since PARRI was launched in 1996 to address the widespread use of physical restraints in Pennsylvania’s nursing homes, it has expanded its educational offerings to include pressure ulcer prevention and treatment, compassionate dementia care, fall prevention and promotion of safe health care environments, among others. The program has:
- Conducted hundreds of local, state and national educational training programs through a variety of methods on a wide range of topics and performed thousands of on-site consultations.
- Developed numerous long-term care facility training sites across the Commonwealth, which hosted hundreds of educational programs for staff, nursing home residents and their families.
- Educated over 200 nurses to become certified Wound Treatment Associates, enhancing their ability to prevent pressure ulcers and provide appropriate wound care, if necessary.
The programs offered and relationships built have assisted in improving the lives of nursing home residents, provided tailored programs to health care professionals and ancillary caregivers working within the field of aging, and allowed for more collaborative work across the health care continuum and regulatory agencies.
Posted by Larry Elveru