PDF version - National Hospice and Palliative Care Organization

When Jimmy arrived at the
hospice house, he truly was
restrained at both the wrists and
ankles. The transport crew from
the hospital reported a relatively
quiet time during transit. Jimmy
was awake, alert and looking at
everyone who now surrounded
him. He may have been nonverbal,
but he said volumes
with his eyes. He was calm and
looked at everyone questioningly
as staff gently held the straps to
his restraints while assessing his
response to us and his possible
level of aggression.
Based on what we had learned
in our extensive pre-admission
review of his records, we were
determined to create a calm,
respectful environment for him
and his parents. We greeted him
by name, told him our names,
and told him that we wanted to
make him comfortable.
“Jimmy took my hand and at
first, was calm, but then, while
maintaining eye contact with me,
began to press his thumbnail into
my hand,” said a member of the
hospice team. “I gently pulled
his thumb away and explained
that it hurt me when he did that.
I then assured him that I was not
going to hurt him, so he should
not hurt me. As I released his
thumb, he continued to hold my
hand, but without any aggression.
This method of responding to him
was repeated by other staff in the
room when he behaved the same
way with them. Each time, he
stopped the behavior and finally,
he stopped altogether. He would
simply allow someone to gently
take his hand.”
Based on these interactions,
we were ready to remove the
restraints, but started first by
removing the ankle restraints.
With these removed, he was able
to make himself more comfortable
in bed by pulling his legs up
against himself. There were no
attempts to kick at any of us. Next,
we removed his wrist restraints
and, again, there were no attempts
to strike out at any of us.
His IV had become dislodged
during transfer, so the tape was
also removed. Our physician
agreed to leave the IV out for now
and see if he would resume eating
and drinking. He was offered
water which he drank without
difficulty. Shortly after this, we
removed his catheter and used an
adult brief instead.
We also replaced the gown he
was wearing with a t-shirt and
he relaxed even more. Bless the
volunteers and community groups
who support what we do at our
hospice house. We gave him one
of the small, silky smooth quilts
continued on next page
Based on what
we learned, staff
was determined to
create a calm and
respectful
environment
for him…
NewsLine 7