Tie-up your confused, vulnerable, fallers.

That is a quick and easy way to save yourself trouble.

It’s unethical, but it gets results.

Target achievement is a fundamental at the heart of this.

In a complex adaptive system, there is often less scrutiny of the journey than the outcome. We broadcast our successes – quick wins and triumphs. We bury (literally at times) our failures.

On a trip to Holland last year, I was met with scepticism when I explained to the hospital staff our policy of not restraining confused older people. I suspect they either thought I was lying, or perhaps joking. I mean, how else, can you keep those old folk safe?

In the UK, we believe that restraint is bad. Tying someone to their chair or bed might be effective, it might prevent wandering, it might even result in fewer patients falling, but it leads to a greater harm – damage to an individual’s sense of self and likely, the spirit of those caring for them.

We tie-up horses and donkeys, I use a lead when walking my dog. We shackle slaves.

A subtler form of restraint can sometimes be found in our hospitals; head down (in bed), or table blocking. Yes, this is restraint. If you look for them, there are even some ‘bucket’ chairs out there, a form of mechanical straightjacket that disrupts an individual’s volition.

I suspect certain world leaders wouldn’t have a problem with restraint (so long as it doesn’t affect them or their family) – yet, we have surely evolved past this interpretation of humanity.

Care.

Care can be easily abused.

I care for you, you care for me, we care for you as a person.

Care and love are what make us human.

If we disregard or disrespect care, if we fall back into mechanistic patterns of behaviour, we become worse than robots, we become free-will fascists.

Let’s sit and listen to what our patients’ are saying. Let’s try to understand their needs – their hunger or thirst, their tiredness or pain; let us not objectify their experience – let us weigh their feelings, emotions and perceptions.

If I step barefoot on a pin, that is my pain, it is the same pain that has echoed throughout our evolution. More is expected of us in the 21st Century.

Today, when you suffer, I feel pain. I can’t shut out your experience.

We exist as a community, if not we perish as individuals.

Pilgrim State Hospital

 

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