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Falls, Wandering, and Physical Restraints: A Review of Interventions for Individuals With Dementia in Assisted Living and Nursing Homes

Tilly, Jane DrPH; Reed, Peter PhD

doi: 10.1097/01.ALCAT.0000309015.85457.f5
Phase 2

Among the consequences of dementia are falls and unsafe wandering. Sometimes, residents of assisted living and nursing homes who have these symptoms are subject to physical restraints in a misguided effort to protect them from potential harm. The authors screened 109 articles published between 1994 and August 2006 for inclusion in this review, and 28 met the inclusion criteria. Successful interventions to reduce falls and related injuries involve tailoring exercise programs, medication reviews, and environmental modifications to the needs of individual residents. Few intervention studies addressing wandering met the inclusion criteria. Furthermore, the articles regarding physical restraints clearly demonstrate the harm associated with their use and the fact that restraint reduction programs do not result in increased injury to residents.

Jane Tilly, DrPH, is Director for Quality Care Advocacy for the National Office of the Alzheimer's Association, Washington, DC. She is responsible for policy analysis and advocacy related to long-term care and quality issues. Part of her work involves serving as co-director of the Association's Campaign for Quality Residential Care. Before joining the Association in 2003, Jane was a Senior Research Associate at The Urban Institute in Washington, District of Columbia. Prior to that, she managed long-term care policy research for the AARP Public Policy Institute.

Peter Reed, PhD, is Senior Director of Programs for the National Office of the Alzheimer's Association, Chicago, Illinois. In this role he leads the development and delivery of Association care and support programming for people affected by Alzheimer's disease and dementia, including people with dementia, families, and professionals. He received his training in the School of Public Health at the University of North Carolina, where he is a Fellow of the Institute on Aging Carolina Program on Healthcare and Aging Research.

Address correspondence to: Jane Tilly, DrPH, Quality Care Advocacy, Alzheimer's Association, 1319 F St, NW Suite 500, Washington, DC 20004 (

© 2008 Lippincott Williams & Wilkins, Inc.