“Untie the Elderly” was arguably Kendal’s most important project ever and one that changed laws and standards of care throughout the country and around the world. At a time when a significant proportion of residents in nursing homes and retirement communities were kept in chairs or beds using restraints, Kendal adopted a restraint-free policy, and went on to lead a campaign to eliminate restraints everywhere.
For more specifics about “Untie the Elderly”, you might want to read two previous blog posts. In one post, I wrote about a case study of a man at a Kendal affiliate who wandered and whose wife wanted him restrained (https://kendaljourney.com/2020/08/09/untie-the-elderly-the-story-of-a-confused-man/); and in another post, about the story of the remarkable U.S. Senate symposium that Kendal’s program triggered (https://kendaljourney.com/2020/08/22/untie-the-elderly-kendal-goes-to-washington/).
In this post, I am focusing on one of the key players in the Untie the Elderly campaign: Beryl Goldman, who devoted most of her 30-year Kendal career to it. I recently had the privilege of interviewing Beryl, who retired a few years ago and still lives in the area. Kendal residents are planning interviews about Kendal history in preparation for our 50th anniversary, and this one is my contribution to that effort.
The interview itself (conducted via Zoom) is about 45 minutes long. You can watch it here, and there is a transcript here. The interview is well worth viewing. Beryl has a fascinating story to tell. However, I know some of you might not get around to watching the interview (or reading the transcript), so I am providing a few excerpts in this blog post to give you a feeling for this remarkable woman.
Here, then, are a few of Beryl’s observations, excerpted from the June 16, 2021 interview.
On Kendal’s reputation:
But I always knew of this community [Kendal], and so at conferences and all, I would meet people, and the people I felt like I resonated the most with always seemed to be people from Kendal. And the more we talked, and the more I listened to them, and how they genuinely felt about the people they worked with and the people they worked for, the more I felt “now, that would feel right to me”.
On getting hired without a job:
So at the very end I was offered a position to come work at Kendal. There was no job for me. Lloyd [Lloyd Lewis, Kendal’s director] hired people because he felt they fit with the organization, but he didn’t necessarily have a role for them. For the first six months that I was there, I really just shadowed anybody I wanted to shadow. I spent a lot of time with Lloyd. If he was travelling, I’d go with him. I was on a fair amount of pretty bad driving escapades with him. [smiles] But it was always a learning opportunity, and I always had the chance to meet some very interesting people, see interesting things I never would have otherwise.
On what was different about Kendal:
There are a number of things. I think the ones that come to mind are the fact that people’s autonomy and independence were respected and valued, that it wasn’t just lip service. It was clearly the way that they operated. That residents were part of the decision-making, were asked to be involved in just about everything that happened there. And to me, that was wonderful. We were able pull on a lot of expertise [from residents] that we didn’t necessarily have among the staff that was there. The people had varied careers who brought a lot to the organization and who wanted to participate.
And I think the fact that we looked at every person in the Quaker way that there’s that of God in each person, regardless of whether the person was able to speak up for themselves or not, we treated each person equally. They didn’t “put people away” because they were confused or disabled in some way. They were considered equal members of the community and accepted and valued in the same way.
These things sound like they’re wonderful pie-in-the-sky ideas. Certainly, 35 years ago everyone looked at us like we were crazy. But the fact of it was, this was the way that we all wanted to be treated, regardless of where we are at the point of our lives, we all want to be treated equally. And so that’s why it felt like home to me. You know, it’s an amazing place.
On the expense of implementing the no-restraints policy:
And the fact of it was, everybody could do it. It was not a question of money. … you mention “doesn’t it cost more?” but we learned it didn’t cost more. Because, when you start restraining people, they become more dependent. You’ve made them less able to get up on their own. They’re not able to stay as mobile, so you end up with more people who need more support by staff, who start getting some fractures, who have more skin breakdown, a variety of things that are affected by being tied down to a bed or a chair.
On people who insisted it would never work:
In the early days, in particular at one place, I forget where we were, in the Midwest, and we were in some kind of hotel lobby kind of a setup. It was a long room, and there were people like stacked on top of each other. And we asked for questions and one really irate man got up and blasted us. That we were two crazy women, that there was no way you were doing this, and we were nuts…. He went crazy on us. We had that periodically.
On people who want a single, standard solution:
And we’d always tell people, “Just because it works today doesn’t mean it’s going to work tomorrow.” It’s constantly thinking about, “OK that wasn’t so good, let’s try this.” It’s not a one thing that we did for everybody. People wanted the one fix.
On what happens when people are restrained:
[At a facility Beryl visited, they] had one person who had been in a … Geri-Chair, those old geriatric chairs. Adult highchairs, that’s what I think of them as, with a tray in front of them. This person had been there—I said, “how long has this person been in that chair?” And the staff thought about it and thought about it. She had been in that chair for five years, had been sitting in that chair every day for five years. And we said, “why?” And someone finally remembered that one day she fell. And that was it. One day she fell, and they put her in that chair, and no one thought again about, was this appropriate for her? Did she need this? Was there something better?
This is what happens. Once you put it [a restraint] on, it doesn’t come off. It’s sort of like when someone walks into a nursing home, and a week later someone says “let’s put them in a wheelchair to get them to the dining room sooner.” They’re never out of that wheelchair again. It just becomes routine, and nobody seems to ask any questions.
On dignity, safety, and the inevitability of accidents:
I had an uncle who went to a nursing home and within the first 24 hours he felt out of a chair and he broke his leg. And the family was so upset—everybody was so upset. And of course they called me. … Everybody thinks their case is different. I remember my family saying, “well, this is a little different.” No, it’s not any different. It’s the same thing. The choice is: do you want the person to have a dignified life, or do you want it to be where they’re tied and, you know, just be totally away from the rest of the world, not participating.
So I think families have a hard time. I used to always tell the facilities, “you can’t promise people that their loved one is never going to fall.” You can’t promise them they’re never going to be hurt. It’s unrealistic. I was with my granddaughter yesterday, and I fell. I tripped. We were walking, the ground was uneven, and I tripped and I fell. She was like, I’m so upset. And I was like, this is what happens. This is part of life. We just sometimes fall. That just happens.
On the future of the restraint-free movement:
I would say certainly the “Untie the Elderly” program is not there [anymore]. Do people still know about it? Yeah. Are there still a lot of references to it in other people’s literature, people’s writings? I don’t know. I know over the years since I’ve been gone, if there’s phone calls about it, I get phone calls from Kendal, asking for help. Which makes me very sad. … it saddens me to think that even the basic philosophy of it, how we got from where we were to where we are today, I’m not sure who within the organization is moving that forward. If I’m still getting phone calls for that kind of help, it sort of makes me feel like there should be people within the organization that have [this background].