The Hidden Restraint, Part 2

not-all-those-who-wander-are-lost, smallerThis post by Dr. Al Power was published on on August 10, 2016.

Recently, I posted a provocative argument for considering locked doors as physical restraints.  I have received many comments about the post; and as promised, I am following up with a second installment (of three), in which I will give some guidelines for those who wish to take up the challenge.

In this installment, I’ll start with a few general comments, and then address issues around the person’s current living environment.

First off, it is important to emphasize that we will never succeed in this endeavor until we believe it is possible. Those who continue to embrace medicalized views that blame “wandering” and “exit-seeking” on brain disease will not have the insight to recognize the structural, relational, and operational factors that contribute to the situation. (Photographer Dewitt Jones once said, “People say, ‘I’ll believe it when I see it’; but I say, ‘You won’t see it until you believe it.’”)

So, as I mentioned in Part 1, it is best to start by imagining that people’s perambulations are not random but purposeful, even if that purpose is not immediately obvious to us. Let’s also drop the “wandering” and “exit-seeking” terminology, so as not to overmedicalize people’s actions. This is not simply a “BPSD” (Behavioral and Psychotic Symptoms of Dementia). When you see the person instead of the disease, you can see agency instead of confusion…

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2 Comments. Leave new

Annemarie Manners
August 16, 2016 5:46 pm

I work in a locked dementia unit and I constantly see the wounding of people when they realise they can’t walk out the doors. I even had a lady (who had volunteered in the court system) say to me ‘I don’t racall having a hearing ‘ … surely we can do better than this!


Thanks for your comment, Annemarie. I believe we CAN do better. More to come in Part 3 about how people can get started.


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