Carter Williams, Who Unshackled Nursing House Residents, Dies at 97

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Carter Williams, Who Unshackled Nursing Home Residents, Dies at 97

In magazine articles, conferences, Congressional hearings, and regulatory meetings, Carter Catlett Williams shed light on the plight of nursing home residents with the sympathetic and descriptive power of a writer.

She told stories like that of Miss Cohen, whose restrictive diet banned the "warm, fragrant piece of challah" she had eaten on Friday nights all her life, causing Miss Cohen to refuse to eat completely. and Mr. Denby, a "courteous, worthy former manager" who suffered a "loss of identity" after being "unable to rise to greet or say goodbye to his guest because he." is bound to his chair ".

She has amassed hundreds of accounts along these lines. They helped Ms. Williams influence the 1987 Nursing Home Reform Act, which required skilled care facilities to maintain "the physical, mental, and psychosocial well-being of every resident".

The law changed current nursing home practices and fueled a reform movement whose arguments were partially confirmed by the devastation of Covid-19.

"Those words' psychosocial wellbeing 'are because of Carter," said Barbara Frank, a former assistant director for the National Citizens' Coalition for Nursing Home Reform. "That is a contribution we can trace back to Carter that differentiates how some people have been better off during the pandemic."

Ms. Williams died on September 8 at home in Gloucester, Virginia. She was 97 years old. Her daughter Mary Montague said the cause was a heart attack.

Ms. Williams wanted more dignity and autonomy for residents of nursing homes. She focused on what she called "the homely details of daily life in a nursing home," like the ability for residents to choose when to eat. In the use of shackles, like the one Mr. Denby restricts, Ms. Williams found a central target for her advocacy.

Between 1980 and 1987, at least 35 nursing home residents died as a result of restraint systems. One woman was strangled when hers was pulled backwards. Devices included vests attached to chairs and ribbons, and hands and feet attached to bed rails. As Ms. Williams frequently pointed out, reluctant people could not go to the bathroom or even scratch an itch.

In the 1980s, 41 percent of nursing home residents were detained on a daily basis. In New York State it was 60 percent.

Ms. Williams had a revelation on a trip to Sweden. She attended a nursing home with 210 residents, none of whom were withheld. Ulla Turemark, the nursing home's director, explained her philosophy of "individualized care": In contrast to American institutions, which changed staff, the Swedish nursing home asked its employees to get to know the residents.

For example, they were able to find out which types of chairs and beds are safe for different residents with different risks.

"The focus on restraints showed what it means to focus on individual care," said Ms. Frank.

The 1987 law severely restricted the use of restrictions. “Individualized care” has become a widespread goal: in a memo from the Ministry of Health and Human Services on “Cultural Change in Nursing Homes”, the term was used 28 times on 16 pages in 2006.

Today, only about 1 percent of nursing home residents are being held back, Ms. Frank said.

"Carter, I would say, was the star of the unrestrained movement," she added.

Even under the subsequent laws and regulations of 1987, Ms. Williams' vision of everyday life in nursing homes had not been fully realized. In the late 1990s, she led the founding of Pioneer Network, a not-for-profit organization dedicated to making nursing homes more humane. It supports coalitions that are working on reforming the institutional culture in 22 countries.

Pioneer Network's recommendations include giving residents private spaces, facilitating time outdoors, and keeping staff and residents together so they can form bonds.

These measures made a difference during the pandemic when the coronavirus spread to nursing homes among roommates and a changing number of employees who take turns working and all socializing indoors.

"We have worked to change the design philosophy and practices of care and senior communities from a medical facility model to a person-centered model," said Penny Cook, president of Pioneer Network. "You wouldn't think this would help in infection prevention, but it does."

Catharine Mott Catlett was born on September 2, 1923 in San Antonio. Her father, Landon Carter Catlett Jr., an aviator, was stationed there on a military base. He died in a plane crash in 1925, and his wife, Catharine Sanders Mott Catlett, a housewife, renamed their daughter Carter to the name her father had given.

Ms. Williams grew up in Gloucester in the Tidewater area of ​​Virginia, where her family had lived since the 17th century. Her home was Toddsbury, a 17th-century mansion, but she could only afford her tuition at Wellesley through a generous scholarship and sales from her mother's modest daffodil farm.

In 1949 she received a masters degree from the Simmons School of Social Work in Boston, where she met T. Franklin Williams, who attended Harvard Medical School. They married in 1951.

In 1968 the family moved to Rochester, New York, where Ms. Williams worked at a local nursing home and realized the outrage that would motivate her activism. In 1983 her husband became director of the National Institute on Aging, a division of the National Institutes of Health. Ms. Williams became involved in national politics, and she and her husband became "a power couple in the world of aging," Ms. Cook said.

Mr. Williams died in 2011. In addition to her daughter, Ms. Williams survived a son, Thomas Nelson Williams; six grandchildren; and three great-grandchildren.

In Mrs. Williams's final years, her defense of age has become personal. When an airline security officer called Ms. Williams a "young lady", Ms. Montague replied, her mother replied, "Don't rob me of my years."

As her career slowed, she found time to go through a small, battered box of letters from her father. In her opening speeches at a Pioneer Network conference, she used the experience to show the learning and growth that is possible at the end of a lifetime.

"Suppose you didn't know your father's love and very active role in your first 22 months until you were in your eighth decade," she said. "It's the wonderful adventure of my third age."

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