When you are dealing with a patient with dementia, restraint can be a tough topic. You might not want the patient tied down, but sometimes there is a risk that they might wander, or fall and hurt themselves.

Restraint was one of the hot buttons at a recent seminar run by two leading dementia experts, Tim Forester-Morgan, and Sarah Mould, Directors of the Dementia Training Company in the United Kingdom.

The event was arranged by local charity Action on Alzheimer’s and Dementia.

During a break in workshops, Ms Mould told The Royal Gazette there had been interesting discussions on the topic of restraint, which still seemed to be a fairly common practice in Bermuda.

“We have hopefully emerged from an old culture of care that was about preventing people doing every day things like standing up, walking around and going outside,” she said.

In the United Kingdom it is illegal to restrain patients with dementia, except under specific conditions. If a patient must be restrained for a period of time, there is a legal process to follow.

In Bermuda restraint of dementia patients, including the use of ankle and waist restraints, is fairly common. Mr Forester-Morgan spoke out about this on a previous visit to the Island, and called for review of Bermuda’s laws regarding restraint of patients.

“It might be done to maintain the safety of the person,” said Ms Mould. “There are different ways that a person could be restrained. You could push a cantilever table in front of someone. If it is for the purpose of stopping them from getting up, then it is restraint. Just keeping someone in their nightwear during the day could be a form of restraint, if it is to stop them from going outside. You have to think about why you are doing this and for whose benefit. I think a lot of people are really anxious about people falling or going outside and getting lost.

“You might be protecting their physical health, but what about their mental health? The discussions, today, have gone in all sorts of directions. There is a genuine sense that people want to do this properly. Some people in the workshops have said this is what we would do as a first resort, whereas it should be a last resort.”

Mr Forester-Morgan said sometimes a patient might be tied to a chair to stop them falling.

He said: “Unfortunately, the more you tie someone to a chair the more physically frail they are going to become. Actually, you are perpetuating and increasing the risk. It is counter productive.”

The trainers conducted a similar one day seminar last year in Bermuda.

Ms Mould said they had seen indications that last year had had a positive impact on the Bermuda community. She hoped it would become an annual event.

“We’ve seen a result just since we started the workshop yesterday,” said Ms Mould. “Yesterday, we were talking about the benefits of music to dementia patients. One lady came in today and said she had tried playing music to her elderly relative with dementia and she noticed an immediate difference. He was stringing words together afterward in a way he hadn’t been doing before. It was his favourite music.”

Other topics were also covered including the importance of making every moment meaningful when caring for someone with dementia.

“We want people to think about quality of care and quality of life,” said Mr Forester-Morgan.

He said in this workshop participants had been more open to discussing their experiences some pleasant, some not so pleasant.

Local resident, Elizabeth Stewart started Action on Alzheimer’s and Dementia several years ago when her mother developed Alzheimer’s. Her mother has since passed away, but Ms Stewart has continued working to raise awareness of dementia related issues in Bermuda.

“This year we have had about 90 people come to the training for two and a half days,” she said. “We had a lot of representation from the large care homes, such as Sylvia Richardson Care Facility and Westmeath Residential and Nursing Care Facility and staff from King Edward VII Memorial Hospital. We have had some family members and private caregivers.”

After the workshops, the trainers toured the Sylvia Richardson Care Facility and Westmeath and chatted with staff members.

The workshops were funded by XL Insurance (Bermuda) Ltd, and also were held at XL’s O’Hara House in the City of Hamilton.

Patrick Tannock, President of XL Insurance (Bermuda) Ltd and President of the XL Foundation said: “The reason the XL Foundation is supporting these training sessions is that they are practically and effectively addressing a significant need in the community.

“As a philanthropic organisation the XL Foundation’s mission is to do all we can to improve life for those who need help in the community, to level the playing field and give everyone a fair chance at a reasonable quality of life. Action on Alzheimer’s and Dementia is focused on providing help to people who have nowhere to turn, including families in deep distress.

“Over the next few decades we are probably all going to feel the impact of our increasingly ageing population. Statistics show that one in three people over 65 will die with some form of dementia. We need to be prepared. We’re grateful for the work of Action on Alzheimer’s and Dementia led by Liz Stewart, and XL Foundation is pleased to be in a position to partner with her.”